What are the common doses of Vyvanse (lisdexamfetamine) for Attention Deficit Hyperactivity Disorder (ADHD)?

Common Vyvanse Doses for ADHD

Start Vyvanse at 30 mg once daily in the morning for both adults and children 6 years and older, then titrate in 10-20 mg weekly increments to a maximum of 70 mg daily based on symptom control and tolerability. 1

Starting Dose

• Begin with 30 mg once daily in the morning for all patients 6 years and older, taken with or without food 1
• Avoid afternoon dosing due to insomnia risk 1
• Alternative guideline recommendations suggest starting at 20-30 mg daily 2

Titration Protocol

• Increase by 10 mg or 20 mg increments at approximately weekly intervals until optimal symptom control is achieved 1
• Maintain weekly contact (by telephone is acceptable) during initial titration to assess response and side effects 3
• Systematically assess for specific stimulant side effects including insomnia, anorexia, headaches, and weight loss at each dose adjustment 3
• Collect standardized ADHD rating scales from patients and significant others before each dose increase 3

Target and Maximum Doses

• Maximum recommended dose is 70 mg once daily for ADHD treatment 1
• Most patients achieve optimal response somewhere in the 30-70 mg range 1
• The typical titration reaches optimal dosing within 2-4 weeks 3

Dose Modifications for Special Populations

Renal impairment requires dose adjustment:

• Severe renal impairment (GFR 15 to <30 mL/min/1.73 m²): maximum 50 mg daily 1
• End-stage renal disease (GFR <15 mL/min/1.73 m²): maximum 30 mg daily 1

Administration Options

Vyvanse can be given in two ways 1:

• Swallow capsules whole, OR
• Open capsules and mix entire contents with yogurt, water, or orange juice; consume immediately (do not store)
• Never divide a single dose - always take the full capsule amount 1

Monitoring Requirements

Before starting treatment, obtain: 3

• Baseline blood pressure, pulse, height, and weight
• Cardiac history including family history of sudden death or ventricular arrhythmia
• Assessment for tics or Tourette's syndrome

During titration, monitor: 3

• Weight regularly (weight loss is common)
• Blood pressure and pulse at each dose adjustment
• Standardized ADHD rating scales to objectively track response

Critical Pitfalls to Avoid

• Starting at too high a dose leads to unnecessary side effects and decreased medication adherence 3
• Failing to systematically assess both benefits and side effects during titration 3
• Not allowing sufficient time (approximately 1 week) between dose increases to evaluate response 1
• Continuing to escalate dose when symptom control plateaus - consider switching medications or adding non-stimulant options instead 3

Duration of Effect

• Vyvanse provides efficacy throughout a full treatment day, with effects lasting up to 14 hours post-dose in adults 4
• In children and adolescents, symptom control is maintained through evening hours (1800 hours) following early morning dosing 5
• This long duration eliminates the need for multiple daily doses, unlike immediate-release formulations 6, 4

When Maximum Doses Don't Work

• If adequate symptom control is not achieved at 70 mg daily, consider alternative treatments or adding non-stimulant medications rather than exceeding the maximum dose 3
• Document clearly that symptoms could not be controlled at lower doses before considering any alternative approaches 3