Managing Dry Mouth Caused by Vyvanse (Lisdexamfetamine)
For patients experiencing dry mouth from Vyvanse (lisdexamfetamine), implement a stepwise approach starting with hydration optimization, saliva substitutes, and salivary stimulants, escalating to systemic medications only if necessary. 1
First-Line Management Strategies
- Optimize hydration by increasing water intake throughout the day and limiting caffeine consumption, which can worsen dry mouth symptoms 1
- Use saliva substitutes such as moisture-preserving mouth rinses, sprays, or gels that have a neutral pH and contain electrolytes to mimic natural saliva 1
- Employ salivary stimulants including sugar-free chewing gum, lozenges, or candy to mechanically stimulate saliva production 2
- Implement dietary modifications by avoiding crunchy, spicy, acidic, or hot foods that may exacerbate discomfort 2
- Practice good oral hygiene with regular brushing, flossing, and dental check-ups to prevent complications like dental caries that can result from chronic dry mouth 3
Second-Line Management Strategies
- Consider saliva substitute oral sprays containing xylitol, which can provide temporary relief while also offering protection against dental caries 1, 3
- Use specialized toothpastes and rinses designed for dry mouth that are less irritating and contain fluoride for additional protection 1
- Try using a humidifier at night to maintain moisture in the air, particularly for patients who experience worsening symptoms while sleeping 3
Pharmacological Interventions (For Severe Cases)
- Systemic sialagogues such as pilocarpine (5 mg orally four times daily) or cevimeline may be considered for severe cases not responding to other measures 2
- Be cautious with sialagogues as they can cause side effects including excessive sweating (reported in over 40% of patients), nausea, and bronchoconstriction, requiring careful monitoring especially in older adults 2, 4
Important Considerations
- Medication timing may help manage symptoms—taking Vyvanse earlier in the day might reduce nighttime dry mouth severity 3
- Regular dental follow-up is essential as chronic dry mouth increases risk for dental caries, periodontal disease, and oral infections 3
- Monitor for complications such as difficulty swallowing, speaking, or changes in taste sensation that may impact quality of life and require more aggressive intervention 3
When to Seek Additional Care
- Consult a healthcare provider if dry mouth symptoms are severe, persistent despite management strategies, or significantly affecting quality of life 2
- Consider dental referral for patients with signs of dental complications from chronic dry mouth 2
Dry mouth is one of the most common side effects of stimulant medications like Vyvanse due to their sympathomimetic properties. While it can be uncomfortable, implementing these management strategies can significantly improve symptoms and prevent complications while maintaining the therapeutic benefits of the medication 3, 4.