Vyvanse

(lisdexamfetamine) 

 

 

 

 Full Prescribing Information 

 DailyMed Drug Information 

 

 

 

 

 Forms/Strengths 

 

 Capsules: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg 

 Chewable (Strawberry-flavored): 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg 

 

 

 Dosing 

 

 Age: ≥ 6 y/o 

 Onset: ~60 min 

 Duration: 8-12 hours 

 

 Considerations: Can be taken with or without food. It is a pro-drug that is metabolized into 100% dextroamphetamine, with a reduced risk of abuse. The chewable tablet and capsule are interchangeable on a mg-to-mg basis.  

 

 

 Chewable tablet: Strawberry-flavored and can be taken with or without food.  

 

 

 Capsule: The capsule can be opened and its contents dissolved in liquid, such as water, yogurt, or orange juice. Use immediately after dissolving. 

 

 

 

 Initial Dose: 20-30 mg 

 Titration: 10-20 mg every 3-7 days 

 Max Dose: 70 mg 

 

 

 Quick Facts 

 

 Prodrug converted to dextroamphetamine; increases synaptic dopamine/norepinephrine 

 Enhances focus, attention, and impulse control 

 Unique prodrug formulation provides a smooth onset and extended duration 

 Common side effects: decreased appetite, insomnia, dry mouth, irritability, abdominal pain 

 

 

 Indications 

 

   ADHD (ICD-10: F90.0) 

 Moderate to severe binge eating disorder (BED) in adults (ICD-10: F50.81) 

 

 

 Off-Label Uses 

 

 Depression (F33.9) : Sometimes used adjunctively for treatment-resistant depression (limited data). 

 Narcolepsy (ICD-10: G47.411) : Sometimes used off-label but not FDA-approved for this indication. 

 

 

 How to Take 

 

 Take once daily in the morning to minimize the risk of insomnia. 

 Can be taken with or without food . 

 Swallow the capsule whole ; do not crush or chew. 

 If needed, the capsule may be opened, and contents mixed with water, yogurt, or orange juice —consume immediately without chewing. 

 If using the chewable tablet , chew thoroughly before swallowing. 

 

 

 Side Effects 

 

 Common: Decreased appetite, insomnia, dry mouth, irritability, nausea, vomiting, anxiety, weight loss 

 Serious: Cardiovascular events, psychiatric adverse reactions, growth suppression in pediatric patients, peripheral vasculopathy, serotonin syndrom 

 

 

 Monitoring / Labs 

 

 Cardiovascular : Baseline and routine monitoring of heart rate and blood pressure. 

 Growth in Pediatrics : Regular monitoring of height and weight to detect growth suppression. 

 Psychiatric Symptoms : Observe for mood changes, anxiety, or psychosis. 

 Abuse Potential : Monitor for misuse or diversion. 

 

 

 Education 

 

 

 When to Call the Doctor: 

 

 Severe mood changes, aggression, or suicidal thoughts . 

 Chest pain, rapid heartbeat, shortness of breath ( cardiovascular concerns ). 

 Uncontrolled movements, tics, or worsening anxiety. 

 Numbness, coldness, or color changes in fingers or toes ( circulatory issues ). 

 Unexplained weight loss or delayed growth in pediatric patients . 

 

 

 

 Safety Tips: 

 

 Monitor blood pressure and heart rate , especially in patients with cardiovascular risk. 

 Use caution in patients with anxiety, bipolar disorder, or psychosis , as symptoms may worsen. 

 Avoid caffeine and other stimulants , which may amplify side effects. 

 Ensure adequate hydration and nutrition , as appetite suppression is common. 

 Tapering may be required if discontinuing after long-term use. 

 

 

 

 Parent Tips for Pediatric Patients: 

 

 Encourage a nutrient-dense diet to counteract appetite suppression. 

 Administer in the morning before school for optimal effect. 

 Monitor school performance and behavioral changes . 

 Observe for sleep disturbances ; adjust timing if necessary. 

 Communicate regularly with teachers and caregivers about medication effects.   

 

 

 

 

 Additional Information 

 

 

 Contraindications: 

 

 Hypersensitivity to lisdexamfetamine or formulation components. 

 Use within 14 days of MAOI therapy (risk of hypertensive crisis). 

 Symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, glaucoma . 

 History of substance use disorder , unless benefits outweigh risks. 

 

 

 

 Pregnancy: 

 

 Category C ; use only if benefits outweigh risks. 

 May cause neonatal withdrawal symptoms or low birth weight . 

 

 

 

 Lactation: 

 

 Excreted in breast milk ; not recommended due to potential infant exposure. 

 

 

 

 Drug Interactions: 

 

 Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) increase serotonin syndrome risk . 

 Acidifying agents (e.g., ascorbic acid) may reduce drug absorption. 

 Alkalinizing agents (e.g., sodium bicarbonate) may increase amphetamine levels. 

 May potentiate hypertensive effects of certain medications (e.g., decongestants, beta-agonists).