Is it safe to take Vyvanse (lisdexamfetamine) during a procedure that requires sedation?

Vyvanse (Lisdexamfetamine) Should Be Discontinued Before Procedures Requiring Sedation

It is not safe to take Vyvanse (lisdexamfetamine) during a procedure that requires sedation due to potential drug interactions that could increase cardiovascular risks and complicate anesthesia management. 1

Understanding the Risks

• Stimulant medications like Vyvanse can interact with sedative medications, potentially causing unpredictable cardiovascular effects including blood pressure fluctuations and heart rhythm disturbances 1
• The combination may require higher doses of sedatives to achieve adequate sedation, increasing the risk of respiratory depression 1, 2
• Vyvanse can mask the sedative effects of anesthetic medications, making it difficult to assess the appropriate level of sedation 2

Recommended Protocol

Before the Procedure

• Discontinue Vyvanse prior to the scheduled procedure (consult with your prescribing physician about the specific timing) 1
• Inform all healthcare providers involved in your care about your Vyvanse prescription 1
• Follow standard fasting guidelines for elective procedures:
  • Clear liquids: 2 hours before procedure 1
  • Light meal: 6 hours before procedure 1

Alternative Approaches

• For patients requiring sedation who regularly take Vyvanse:
  • The American Society of Anesthesiologists recommends selecting sedative agents with minimal cardiovascular effects 1
  • Ketamine may be preferred in some cases due to its sympathomimetic properties that can help maintain blood pressure 2
  • Etomidate presents a favorable hemodynamic profile with minimal effects on blood pressure 2

Special Considerations

• The practitioner administering sedation must be informed about all medications the patient is taking, including Vyvanse 1
• Herbal medicines and other medications may alter drug pharmacokinetics through inhibition of the cytochrome P450 system, potentially affecting sedation 1
• Stimulants like Vyvanse can increase the risk of cardiovascular complications during sedation 3

Monitoring Requirements

• Continuous monitoring of vital signs is essential during sedation, especially for patients who regularly take stimulants 1
• ECG monitoring is required for deep sedation and recommended for moderate sedation 1
• Pulse oximetry and blood pressure monitoring at regular intervals (every 5-15 minutes) until the patient is suitable for discharge 1

Common Pitfalls to Avoid

• Failing to disclose Vyvanse use to the healthcare team before sedation 1
• Assuming that taking "just one dose" of Vyvanse on the day of the procedure is harmless 1
• Not allowing sufficient time between the last dose of Vyvanse and the procedure 1

Remember that only routine necessary medications (such as antiseizure medications) should be taken with a sip of clear liquid on the day of the procedure 1. Stimulant medications like Vyvanse are not considered necessary medications for procedural sedation and should be temporarily discontinued.