ADHD Transition From Jornay PM to Azstarys
Jornay PM (methylphenidate) and Azstarys (serdexmethylphenidate/dexmethylphenidate) are not interchangeable on a milligram-to-milligram basis. [1] [2]
Transition should discontinue Jornay PM and titrate Azstarys using Azstarys’s labeled dosing schedule. [2]
Medication Comparison for Transition Planning
Jornay PM is designed for evening dosing with delayed-release onset intended to cover next-morning symptoms. [1]
Azstarys is designed for once-daily morning administration. [2]
Medication Selection Algorithm During Switching
- Replace Jornay PM with Azstarys when symptoms require a different methylphenidate formulation with a morning dosing schedule. [2]
- Discontinue the current methylphenidate product before starting Azstarys. [2]
- Avoid milligram-per-milligram substitution when switching between Jornay PM and Azstarys. [1] [2]
Dosing Start Point for Azstarys After Discontinuing Jornay PM
Azstarys is indicated for patients 6 years and older. [2]
Azstarys labeled recommended starting dosage is 39.2 mg/7.8 mg (serdexmethylphenidate/dexmethylphenidate) once daily in the morning. [2]
Titration Schedule for Azstarys After Switching
Azstarys dosage may be increased after one week to 52.3 mg/10.4 mg once daily in patients 13 to 17 years and in adults, based on response and tolerability. [2]
Azstarys dosage may be increased after one week to 52.3 mg/10.4 mg once daily or decreased after one week to 26.1 mg/5.2 mg once daily in patients 6 to 12 years, based on response and tolerability. [2]
Administration and Practical Transition Timing
Azstarys should be administered orally once daily in the morning with or without food. [2]
Jornay PM should be taken only in the evening. [1]
Switching should be implemented by discontinuing Jornay PM and then starting Azstarys per Azstarys’s titration schedule rather than overlapping or converting doses on a milligram basis. [2] [1]
ADHD Titration Principles and Monitoring
Dose titration should be slower and monitoring should be more frequent when neurodevelopmental conditions or comorbid mental or physical health conditions increase risk during stimulant management. [3]
Effectiveness and adverse effects should be monitored and documented during ADHD medication treatment. [3]
Common Pitfalls to Avoid During Transition
- Milligram-per-milligram conversion between methylphenidate products should be avoided because different formulations have different pharmacokinetic profiles and may lead to dosing errors. [1] [2]
- Morning dosing of Jornay PM should be avoided because Jornay PM is intended for evening administration only. [1]
Treatment Goals During Titration
Medication should be titrated to improve ADHD symptoms and reduce associated impairment while monitoring adverse effects during the titration period. [3]