Lisdexamfetamine (Vyvanse) Dosing for a 10-Year-Old Child
For a 10-year-old child with ADHD, the recommended starting dose of lisdexamfetamine (Vyvanse) is 30 mg once daily in the morning, with titration in increments of 10 mg at weekly intervals up to a maximum of 70 mg once daily. 1
Initial Dosing and Administration
- The recommended starting dose is 30 mg once daily in the morning 1
- Lisdexamfetamine should be taken in the morning to avoid insomnia 1
- The medication can be taken with or without food 1
- Administration options include:
- Swallowing the capsule whole
- Opening the capsule and mixing contents with yogurt, water, or orange juice for immediate consumption 1
Titration Schedule
- Dose may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals 1
- Titrate based on clinical response and tolerability 2
- Maximum recommended dosage is 70 mg once daily 1
Monitoring During Treatment
- Monitor vital signs including blood pressure and pulse 2
- Track height and weight regularly, as stimulants can affect growth 2
- Assess for common side effects such as:
- Decreased appetite
- Insomnia
- Headache 3
Important Considerations
- Prior to initiating treatment, screen for:
- Presence of cardiac disease (family history, physical exam)
- History of tics or Tourette's syndrome 1
- Lisdexamfetamine is a prodrug that is converted to dextroamphetamine after ingestion 3
- The rate-limited hydrolysis provides a gradual release of active dextroamphetamine 3
- Do not divide a single dose; always administer as a complete capsule or chewable tablet 1
Common Side Effects and Management
- Most treatment-emergent adverse events are mild to moderate in intensity 3
- Common side effects include:
- Dry mouth
- Decreased appetite
- Insomnia
- Headache 4
- Weight loss may occur and should be monitored 4
Cautions
- Avoid afternoon doses due to potential for insomnia 1
- Assess for risk of abuse, misuse, and addiction before prescribing 1
- Educate patients and families about proper storage and disposal 1
- Lisdexamfetamine is contraindicated in patients taking MAOIs or within 14 days of stopping MAOIs 1
Lisdexamfetamine's unique pharmacokinetic profile as a prodrug provides a longer duration of action compared to immediate-release stimulants, potentially allowing for once-daily dosing with approximately 12 hours of symptom control 5.