Maximum Dose of Vyvanse (Lisdexamfetamine)
The maximum recommended dose of Vyvanse (lisdexamfetamine) is 70 mg once daily. 1
Dosing Guidelines
- The recommended starting dose for adults and children 6 years and older with ADHD is 30 mg once daily in the morning 1
- Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals 1
- For treatment of moderate to severe Binge Eating Disorder (BED) in adults, the recommended target dose is 50 mg to 70 mg once daily 1
- Vyvanse should be taken in the morning to minimize the risk of insomnia 2, 1
Special Populations
- In patients with severe renal impairment (GFR 15 to < 30 mL/min/1.73 m²), the maximum dosage should not exceed 50 mg once daily 1
- In patients with end-stage renal disease (ESRD, GFR < 15 mL/min/1.73 m²), the maximum recommended dosage is 30 mg once daily 1
Administration Considerations
- Vyvanse can be taken with or without food 1
- The capsule can be swallowed whole or opened and the contents mixed with yogurt, water, or orange juice 1
- The entire mixture should be consumed immediately and not stored 1
- A single dose should not be divided 1
Clinical Efficacy
- Lisdexamfetamine is a prodrug that is converted to the active d-amphetamine after ingestion, providing a longer duration of action compared to immediate-release formulations 3, 4
- Clinical trials have demonstrated efficacy for up to 14 hours post-dose in adults with ADHD 5
- The 70 mg maximum dose has been shown to be effective in clinical trials for both ADHD and BED 6, 7
Safety Considerations
- Common side effects include dry mouth, insomnia, decreased appetite, and headache 5, 7
- Cardiovascular monitoring is recommended, as Vyvanse may increase blood pressure and heart rate 2, 7
- Avoid afternoon doses due to the potential for insomnia 2, 1
- Agents that alter urinary pH can impact blood levels of amphetamine - acidifying agents decrease levels while alkalinizing agents increase levels 1