From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
When transitioning from Adderall XR to Vyvanse, the recommended protocol is to discontinue Adderall XR and start Vyvanse the following day, with the dose of Vyvanse determined by the patient's current Adderall XR dose, as the most recent and highest quality study 1 suggests that lisdexamfetamine, the active ingredient in Vyvanse, has a distinct safety profile compared to other ADHD medications.
Key Considerations for Transitioning
- For patients taking 10-15 mg of Adderall XR, begin with 30 mg of Vyvanse; for those on 20-25 mg of Adderall XR, start with 50 mg of Vyvanse; and for patients taking 30 mg of Adderall XR, initiate 70 mg of Vyvanse, based on the pharmacological properties of lisdexamfetamine and its conversion to dextroamphetamine in the body 2.
- Vyvanse should be taken once daily in the morning, as its pharmacokinetics provide smoother, longer-lasting effects with potentially fewer side effects compared to Adderall XR 3.
- After starting Vyvanse, monitor for effectiveness and side effects over 1-2 weeks, adjusting the dose as needed within the range of 30-70 mg daily, considering the patient's response and potential side effects, such as those identified in the pharmacovigilance analysis 1.
- If transitioning is urgent, some clinicians may overlap medications for 1-2 days, starting Vyvanse while tapering off Adderall XR, although this approach should be used with caution and close monitoring, given the potential for increased side effects or interactions 4.
Patient Education and Monitoring
- Patients should be informed that Vyvanse may feel different from Adderall XR despite containing similar active compounds, and full therapeutic effects may take several days to stabilize, as the body adjusts to the new medication and its pharmacokinetics 5.
- Regular follow-up appointments should be scheduled to monitor the patient's response to Vyvanse, adjust the dose as needed, and address any concerns or side effects that may arise, ensuring the best possible outcome in terms of morbidity, mortality, and quality of life.