From the Guidelines
Vyvanse (lisdexamfetamine) is indicated for the treatment of attention-deficit/hyperactivity disorder (ADHD) in patients aged 6 years and older, with a recommended starting dose of 20-30 mg once daily in the morning, which may be increased in increments of 10 mg weekly to a maximum of 70 mg daily, as per the most recent guidelines 1.
Indications and Dosage
- ADHD in patients aged 6 years and older: starting dose of 20-30 mg once daily in the morning, with titration to an effective dose up to 70 mg daily 1
- The medication should be taken in the morning to avoid insomnia, with or without food
- Vyvanse works as a prodrug that is converted to dextroamphetamine in the body, stimulating the release of norepinephrine and dopamine in the brain to improve attention and reduce impulsivity
Important Considerations
- Common side effects include decreased appetite, insomnia, dry mouth, and increased heart rate and blood pressure
- Vyvanse is contraindicated in patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, glaucoma, agitated states, history of drug abuse, during or within 14 days of taking MAO inhibitors, and in patients with known hypersensitivity to amphetamine products
- Limited published information is available on the use of lisdexamfetamine in pregnancy, and it is recommended to consult guidelines for amphetamine for information on fetal or neonatal risk in pregnancy 1
Clinical Decision Making
- The choice of medication and dosing regimen should be individualized based on patient factors, such as severity of symptoms, presence of comorbidities, and patient preferences 1
- Medication adherence should be regularly assessed and potential issues openly discussed to improve treatment outcomes 1
From the FDA Drug Label
Lisdexamfetamine Dimesylate Capsules are indicated for the treatment of: Attention Deficit Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older Moderate to severe binge eating disorder (BED) in adults
The indications for Vyvanse (lisdexamfetamine) are:
- Attention Deficit Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older
- Moderate to severe binge eating disorder (BED) in adults
The dosing guidelines for Vyvanse (lisdexamfetamine) are:
- ADHD:
- Recommended starting dosage: 30 mg once daily in the morning
- Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals
- Maximum recommended dosage: 70 mg once daily
- Moderate to severe BED:
- Recommended starting dosage: 30 mg once daily
- Dosage may be titrated in increments of 20 mg at approximately weekly intervals to achieve the recommended target dose of 50 mg to 70 mg once daily
- Maximum recommended dosage: 70 mg once daily
- Renal Impairment:
- Severe renal impairment: Maximum dosage should not exceed 50 mg once daily
- End stage renal disease: Maximum recommended dosage is 30 mg once daily 2
From the Research
Indications for Vyvanse (Lisdexamfetamine)
- Vyvanse (lisdexamfetamine) is approved for the treatment of moderate to severe binge eating disorder (BED) in adult patients 3, 4, 5.
- It is also used for the treatment of attention-deficit/hyperactivity disorder (ADHD) in pediatric and adult patients 6.
Dosing Guidelines for Vyvanse (Lisdexamfetamine)
- For the treatment of moderate to severe BED, the recommended dosage is 50-70 mg/day 3, 7, 5.
- For the treatment of ADHD, the dosage is not specified in the provided studies, but it is mentioned that lisdexamfetamine is available in 20 mg and 30 mg capsules 6.
- The dosage may be titrated over 3 weeks and maintained for 8 weeks, with follow-up for a mean of 7 days after the last dose 5.
Efficacy of Vyvanse (Lisdexamfetamine)
- Lisdexamfetamine has been shown to be effective in reducing binge eating days/week, with significant reductions seen at dosages of 50-70 mg/day 3, 7, 5.
- It has also been shown to be effective in achieving 4-week binge eating cessation, with higher percentages of participants achieving this outcome compared to placebo 5.
Safety and Tolerability of Vyvanse (Lisdexamfetamine)
- Lisdexamfetamine has been generally well tolerated in clinical trials, with most treatment-emergent adverse events being mild or moderate in intensity 3, 6, 5.
- Common adverse events include dry mouth, headache, and insomnia, with serious treatment-emergent adverse effects occurring in a small percentage of participants 5.
- The safety profile of lisdexamfetamine is generally consistent with its known safety profile in adults with ADHD 5.