What is the recommended starting dose of Vyvanse (lisdexamfetamine) for a 6-year-old?

Vyvanse Dosing for a 6-Year-Old

For a 6-year-old child with ADHD, start Vyvanse at 30 mg once daily in the morning, with an alternative starting dose of 20 mg for children who may be more sensitive to stimulant medications. 1

Initial Dosing Strategy

• The recommended starting dose is 30 mg once daily in the morning for pediatric patients aged 6-12 years, including 6-year-olds 1
• An alternative starting dose of 20 mg may be considered for patients who may be more sensitive to stimulant medications or have concerns about tolerability 1
• Morning administration is essential to minimize potential sleep disturbances 1

Dose Titration Protocol

• Titrate in increments of 10 mg or 20 mg at approximately weekly intervals based on clinical response and tolerability 1
• The maximum approved daily dose is 70 mg and should not be exceeded 1
• If the maximum dose (70 mg) does not provide adequate symptom control, switch to a different medication class rather than exceeding the maximum dose 1

Monitoring Requirements

• Assess target ADHD symptoms through parent and teacher reports during the initial titration phase 1
• Maintain weekly telephone contact during dose adjustments 1
• Monitor vital signs including blood pressure and pulse, as well as height and weight regularly, since stimulants can affect growth 1
• Assess for common side effects including decreased appetite, insomnia, headache, irritability, upper abdominal pain, and affect lability 1, 2
• Clinical improvement typically occurs within 2-4 days of reaching an effective dose 3

Duration of Effect

• Vyvanse demonstrates efficacy from 1.5 hours through 13 hours postdose in school-aged children (6-12 years) with ADHD 2
• Efficacy is maintained throughout the full treatment day, including through 6 PM based on parent ratings 4

Common Pitfalls to Avoid

• Do not start at doses higher than 30 mg in treatment-naïve 6-year-olds, as this increases the risk of adverse effects without established benefit
• Do not exceed 70 mg daily, even if symptom control is inadequate—instead, consider switching medication classes 1
• Do not administer in the afternoon or evening, as this will cause insomnia 1
• Do not skip growth monitoring, as stimulants can affect height and weight trajectories in young children 1