Vyvanse to Concerta Conversion
For a patient taking 60 mg of Vyvanse, there is no established direct conversion ratio to Concerta (methylphenidate), as these are different medication classes (amphetamine vs. methylphenidate) with distinct mechanisms and pharmacokinetics. However, based on available dosing guidance, a reasonable starting approach would be Concerta 54-72 mg once daily, with careful titration based on clinical response.
Why Direct Conversion Is Not Straightforward
Lisdexamfetamine (Vyvanse) is a prodrug converted to dextroamphetamine, while Concerta contains methylphenidate—these are fundamentally different stimulant classes with no validated equianalgesic conversion ratios 1.
The American Journal of Obstetrics and Gynecology guidelines indicate Vyvanse dosing ranges from 20-70 mg daily, with 60 mg representing a moderate-to-high therapeutic dose 1.
Concerta utilizes an osmotic pump delivery system providing 12-hour duration, with typical dosing ranging from 18-72 mg once daily in adults 2, 3.
Practical Conversion Approach
Initial Dosing Strategy
Start with Concerta 54 mg once daily as a conservative initial dose, recognizing that 60 mg Vyvanse represents established symptom control 2, 3.
Alternatively, consider starting at 36 mg Concerta if concerned about tolerability, though this may provide suboptimal initial control given the patient's current dose level 2.
Titration Protocol
Increase Concerta by 18 mg increments at weekly intervals if symptom control is inadequate, up to a maximum of 72 mg daily 2, 3.
The maximum recommended adult dose is 72 mg daily for Concerta, though some patients may require this higher end of dosing 3.
Key Clinical Considerations
Pharmacokinetic Differences
Concerta provides consistent methylphenidate delivery independent of food intake, unlike some other extended-release formulations 4.
Peak effects occur 1-3 hours post-dose with duration of 12 hours, compared to Vyvanse's longer duration of action 2, 3.
Monitoring Parameters
Assess symptom control at 4-6 hours post-dose (when Concerta reaches peak effect) and throughout the 12-hour duration 2.
Monitor for appetite suppression and insomnia, the most common adverse effects of methylphenidate 2.
Cardiovascular monitoring including heart rate and blood pressure should be performed before dose adjustments 5.
Common Pitfalls to Avoid
Do not assume 1:1 dose equivalence—amphetamines and methylphenidate have different potencies and individual response varies significantly 2.
Avoid mid-day dosing with Concerta—the osmotic pump system is designed for once-daily administration only 3.
Do not use plasma concentration monitoring—behavioral response is highly variable and not correlated with serum levels 2.
Weight-based dosing is not clinically useful for determining appropriate methylphenidate dosage; titrate to clinical effect 2.