From the FDA Drug Label
2.3 Dosage for Treatment of ADHD The recommended starting dosage in adults and pediatric patients 6 years and older is 30 mg once daily in the morning. Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals up to maximum recommended dosage of 70 mg once daily
2.4 Dosage for Treatment of Moderate to Severe BED in Adults The recommended starting dosage in adults is 30 mg once daily to be titrated in increments of 20 mg at approximately weekly intervals to achieve the recommended target dose of 50 mg to 70 mg once daily. The maximum recommended dosage is 70 mg once daily
The maximum dose of Vyvanse per day is 70 mg.
- For ADHD, the maximum recommended dosage is 70 mg once daily.
- For Moderate to Severe BED in Adults, the maximum recommended dosage is also 70 mg once daily.
- However, in patients with severe renal impairment, the maximum dosage should not exceed 50 mg once daily, and in patients with end stage renal disease, the maximum recommended dosage is 30 mg once daily 1.
From the Research
The maximum recommended daily dose of Vyvanse (lisdexamfetamine dimesylate) for adults is 70 mg once daily, and for children with ADHD aged 6-17, the maximum dose is also 70 mg daily. Treatment typically starts at a lower dose (30 mg for adults and children) and may be gradually increased by 10-20 mg increments at weekly intervals until the optimal dose is reached, as supported by studies such as 2 and 3. Vyvanse should be taken in the morning since it can cause insomnia if taken later in the day. It's essential to note that individual responses to medication vary, and some patients may achieve optimal symptom control at lower doses. The 70 mg maximum is established based on clinical trials showing limited additional benefit above this dose while side effects increase, as seen in studies like 4 and 5. Patients should never exceed the prescribed dose, as higher amounts can increase the risk of serious cardiovascular effects, severe psychiatric symptoms, and potential for abuse or dependence, highlighted in a recent review 6. Any dose adjustments should only be made under healthcare provider supervision.
Key Considerations
- The dosage of Vyvanse should be individualized according to the needs and response of the patient.
- Monitoring of blood pressure and pulse is recommended, especially in patients with pre-existing cardiovascular conditions, as emphasized in 6.
- The efficacy and safety of Vyvanse have been demonstrated in various studies, including 2, 4, and 3, supporting its use in the treatment of ADHD in children and adults.
- Side effects such as decreased appetite, insomnia, upper abdominal pain, headache, irritability, weight loss, and nausea are common but generally manageable, as reported in 4 and 5.
Clinical Implications
- Healthcare providers should carefully evaluate the benefits and risks of Vyvanse treatment for each patient.
- Regular follow-up appointments are necessary to monitor the patient's response to the medication and adjust the dose as needed.
- Patients and their families should be educated about the potential side effects of Vyvanse and the importance of adhering to the prescribed dosage regimen.