What is the maximum dose of Vyvanse (Lisdexamfetamine) for a 17-year-old adolescent?

From the Guidelines

The maximum recommended dose of Vyvanse for a 17-year-old is 70 mg daily. This dosage is based on the most recent and highest quality study available, which provides guidelines for the treatment of attention-deficit/hyperactivity disorder (ADHD) 1. According to this study, the usual starting dose of Vyvanse is 20-30 mg orally once a morning, with a titration schedule that allows for an increase by 10 mg weekly to a maximum of 70 mg daily.

Key Considerations for Vyvanse Dosage

• The medication should be taken in the morning to avoid sleep disturbances, as it is a long-acting stimulant that can remain active in the body for 10-14 hours.
• Vyvanse works by increasing levels of dopamine and norepinephrine in the brain, which helps improve attention, focus, and behavioral control.
• Side effects, including decreased appetite, insomnia, irritability, and potential cardiovascular effects, should be closely monitored.
• Regular follow-up appointments with the prescribing healthcare provider are essential to assess the effectiveness of the treatment, monitor side effects, and adjust dosing as needed.

Importance of Adhering to Recommended Dosage

Adhering to the recommended dosage of 70 mg daily is crucial for balancing symptom control with minimizing adverse effects. The study 1 emphasizes the importance of careful dose titration and monitoring to ensure the safe and effective use of Vyvanse in adolescents. By following these guidelines, healthcare providers can help adolescents with ADHD manage their symptoms while minimizing the risk of side effects.

From the FDA Drug Label

Table 6: Summary of Primary Efficacy Results from Short-term Studies of Lisdexamfetamine Dimesylate Capsules in Pediatric Patients (Ages 6 to 17) and Adults with ADHD Study Number (Age range)Primary EndpointTreatment GroupMean Baseline Score (SD)LS Mean Change from Baseline (SE)Placebo-subtracted Difference* (95% CI) Study 4(13 to 17 years)ADHD-RS-IVLisdexamfetamine dimesylate capsules (30 mg/day)†38.3 (6.7)-18.3 (1.2)-5.5 (-9.0, -2.0) Lisdexamfetamine dimesylate capsules (50 mg/day)†37.3 (6.3)-21.1 (1.3)-8.3 (-11.8, -4.8) Lisdexamfetamine dimesylate capsules (70 mg/day)†37.0 (7.3)-20.7 (1.3)-7.9 (-11.4, -4.5)

The maximum dose of Vyvanse for a 17-year-old is 70 mg/day 2.

From the Research

Maximum Dose of Vyvanse for a 17-Year-Old

• The maximum dose of Vyvanse (lisdexamfetamine) for a 17-year-old is not explicitly stated in the provided studies.
• However, according to the study 3, patients aged 6-17 years were randomized to an optimized daily dose of LDX (30,50, or 70 mg) or ATX.
• The study 4 also mentions that patients aged 6-17 years were randomized to dose-optimized LDX (30,50, or 70 mg/day) or ATX.
• Based on these studies, it can be inferred that the maximum dose of Vyvanse for a 17-year-old is 70 mg/day, as this is the highest dose mentioned in the studies for this age group 3, 4.

Dosing Information

• The dosing information for Vyvanse is as follows:
  • Patients <70 kg: 30,50, or 70 mg/day 3, 4
  • Patients ≥70 kg: 40,80, or 100 mg/day (for ATX, but not explicitly stated for LDX) 3
• However, the study 5 mentions that lisdexamfetamine dimesylate is a long-acting, prodrug formulation of dexamfetamine, and its conversion to the active form is unaffected by gastrointestinal pH and variations in normal transit times.

Safety and Efficacy

• The studies 3, 6, 4 demonstrate the safety and efficacy of Vyvanse in children and adolescents with ADHD, with significant improvements in ADHD symptoms and functional outcomes.
• The study 7 compares treatment adherence of lisdexamfetamine with other medications for ADHD and finds that LDX-treated patients demonstrate better treatment adherence compared to patients initiated on other ADHD medications, except for AMPH LA in adults and OROS MPH and ATX in treatment-naïve children and adolescents 7.