Vyvanse Dosing for Adults
For adults with ADHD, start Vyvanse at 30 mg once daily in the morning and titrate in 10-20 mg increments at weekly intervals up to a maximum of 70 mg daily. 1
ADHD Treatment Dosing
The FDA-approved dosing regimen is straightforward:
- Starting dose: 30 mg once daily in the morning
- Titration: Increase by 10 mg or 20 mg increments at approximately weekly intervals
- Maximum dose: 70 mg once daily
- Administration: Take in the morning with or without food; avoid afternoon doses due to insomnia risk 1
This dosing applies to adults and pediatric patients 6 years and older with ADHD. The medication provides efficacy for up to 14 hours post-dose, making it suitable for managing symptoms throughout the day 2.
Binge Eating Disorder Dosing (Adults Only)
If treating moderate to severe binge eating disorder in adults:
- Starting dose: 30 mg once daily
- Titration: Increase by 20 mg increments at weekly intervals
- Target dose: 50-70 mg daily
- Maximum dose: 70 mg once daily 1
Discontinue if binge eating does not improve 3.
Special Populations Requiring Dose Adjustment
Renal impairment requires mandatory dose reductions:
- Severe renal impairment (GFR 15 to <30 mL/min/1.73 m²): Maximum 50 mg daily
- End-stage renal disease (GFR <15 mL/min/1.73 m²): Maximum 30 mg daily 1
Administration Options
Vyvanse offers flexibility for patients who cannot swallow capsules:
- Swallow capsules whole, OR
- Open capsules and mix entire contents with yogurt, water, or orange juice—consume immediately, do not store
- Chewable tablets available as 1:1 mg equivalent to capsules 1
Critical Pretreatment Requirements
Before initiating Vyvanse, you must:
- Assess for cardiac disease (careful history, family history of sudden death or ventricular arrhythmia, physical exam)
- Evaluate family history and clinically assess for motor/verbal tics or Tourette's syndrome 1
Common Pitfalls to Avoid
Do not divide doses. A single dose should not be split—take at least one full capsule or tablet daily 1.
Monitor for drug interactions affecting urinary pH. Acidifying agents (like ascorbic acid) decrease amphetamine blood levels, while alkalinizing agents (like sodium bicarbonate) increase levels—adjust dosing accordingly 1.
Watch for typical stimulant adverse effects: The most common (>10% incidence) include dry mouth, insomnia, headache, decreased appetite, and weight loss 3, 4, 5. Mean increases in pulse (4-6 bpm) and blood pressure (systolic 0.2-1.5 mmHg, diastolic 1-2 mmHg) occur with treatment 3.
Duration and Monitoring
The prodrug design provides rate-limited enzymatic conversion to d-amphetamine, allowing once-daily dosing with approximately 12-hour duration of activity 2, 4. This extended coverage is particularly valuable for adults managing work and evening responsibilities.