How long does Vyvanse (lisdexamfetamine) stay positive on a urine toxicology screen (utox)?

From the Guidelines

Vyvanse (lisdexamfetamine) typically remains detectable in urine drug tests for 2-4 days after the last dose, with a possible extension of up to 5-7 days in cases of higher doses and chronic use. This timeframe can vary based on several factors including dosage, frequency of use, individual metabolism, urine pH, and hydration status 1. Vyvanse works by converting to dextroamphetamine in the body, which is what drug tests actually detect. Standard urine toxicology screens don't distinguish between different amphetamine sources, so Vyvanse will show positive as an "amphetamine" rather than specifically as Vyvanse.

Some key factors to consider when interpreting urine test results for Vyvanse include:

• Dosage: Higher doses may lead to longer detection times
• Frequency of use: Chronic use may extend detection time
• Individual metabolism: Variations in metabolism can affect how quickly the body eliminates Vyvanse
• Urine pH and hydration status: These factors can influence the concentration of Vyvanse metabolites in the urine

It's essential to note that the provided evidence does not directly address the duration of Vyvanse detection in urine tests. However, based on the pharmacokinetics of stimulants and the conversion of lisdexamfetamine to dextroamphetamine, it is reasonable to estimate the detection time frame as 2-4 days, with possible extensions up to 5-7 days in certain cases 1. If you're taking Vyvanse as prescribed, it's crucial to inform the testing facility or medical provider before the test and bring your prescription information to ensure proper interpretation of positive results.

From the FDA Drug Label

Plasma concentrations of unconverted lisdexamfetamine are low and transient, generally becoming non-quantifiable by 8 hours after administration. The plasma elimination half-life of dextroamphetamine was approximately 8.6 to 9. 5 hours in pediatric patients 6 to 12 years and 10 to 11. 3 hours in healthy adults. Following oral administration of a 70 mg dose of radiolabeled lisdexamfetamine dimesylate to 6 healthy subjects, approximately 96% of the oral dose radioactivity was recovered in the urine and only 0. 3% recovered in the feces over a period of 120 hours.

The length of time Vyvanse stays positive on a urine toxicology screen (utox) is related to the elimination half-life of its active metabolite, dextroamphetamine.

• The plasma elimination half-life of dextroamphetamine is approximately 8.6 to 9.5 hours in pediatric patients and 10 to 11.3 hours in healthy adults.
• It may take around 2-3 days (based on 4-5 half-lives) for dextroamphetamine to be mostly eliminated from the system, but this can vary depending on individual factors.
• Urine toxicology screens can detect the presence of amphetamines, including dextroamphetamine, for a certain period after use.
• The exact duration of detection in urine is not directly stated in the provided drug label, but it is expected to be several days based on the pharmacokinetics of dextroamphetamine 2.

From the Research

Detection Time of Vyvanse in Urine

• The detection time of Vyvanse (lisdexamfetamine) in urine can vary depending on several factors, including the dose, individual metabolism, and the sensitivity of the testing method 3.
• According to a study on the pharmacokinetics of lisdexamfetamine, the active ingredient d-amphetamine is eliminated within 48 hours following the final dose, with a mean concentration of 20.6 ng/mL at steady state 4.
• Another study suggests that amphetamine, the active metabolite of Vyvanse, can be detected in urine for up to 5 days after intake at a cut-off value of 1000 ng/mL, and up to 6 days at a lower cut-off of 300 ng/mL 5.
• However, it's essential to note that these studies may not directly apply to Vyvanse, as they were conducted with other amphetamine compounds or in different contexts.

Factors Influencing Detection Time

• The detection time of Vyvanse in urine can be influenced by various factors, including:
  • Dose and route of administration
  • Individual metabolism and renal clearance
  • Sensitivity of the testing method
  • Presence of other substances or medications
• These factors can affect the concentration of d-amphetamine in urine, making it difficult to predict the exact detection time 3, 5.

Clinical Relevance

• A case report describes the successful treatment of ADHD with Vyvanse in a patient with a history of stimulant use disorder, with significant improvement in symptoms and no exacerbation of addictive behaviors 6.
• This report suggests that Vyvanse may be a feasible treatment option for patients with ADHD and a history of substance use disorder, due to its unique pharmacokinetic profile and lower abuse potential.