Maximum Single-Script Duration for Vyvanse
Vyvanse (lisdexamfetamine) is a Schedule II controlled substance and federal regulations prohibit refills on Schedule II prescriptions, but a single prescription can be written for up to a 90-day supply in most states. 1
Federal Controlled Substance Regulations
- Schedule II controlled substances, including Vyvanse, cannot have refills written on the prescription. 1
- The prescriber must write a new prescription each time the medication needs to be dispensed. 1
- However, federal law does not limit the quantity that can be prescribed on a single prescription, allowing prescribers to write for up to a 90-day supply in one prescription. 1
Practical Prescribing Considerations
- Most practitioners write prescriptions on a monthly basis (30-day supply) for Schedule II stimulants, though prescriptions for up to 90 days are legally permissible in many jurisdictions. 1
- Some states have specific regulations that may further restrict the maximum days' supply—for example, New York State allows prescriptions to be written for up to 3 months at a time. 1
- The monthly prescribing pattern is often preferred because it facilitates regular monitoring of efficacy, side effects, blood pressure, pulse, weight, and ADHD symptoms. 2, 3
Clinical Monitoring Requirements
- Once stabilized on Vyvanse, patients can be seen every 3-4 months for routine monitoring, but prescriptions still need to be written monthly or up to every 90 days depending on state regulations. 1
- Children with stable responses and no comorbidities can have less frequent visits (every 3-4 months), while complex cases may require monthly appointments. 1
- Blood pressure and pulse should be checked quarterly, weight monitored at every visit, and ADHD symptoms assessed using standardized rating scales. 2, 3
Important Caveats
- State-specific regulations may impose additional restrictions beyond federal law—some states limit Schedule II prescriptions to 30-day supplies, while others allow 90 days. 1
- Insurance companies may also impose their own limitations on days' supply regardless of what is legally permissible. 1
- The lack of refills means patients must obtain a new written prescription before each dispensing, which can create logistical challenges if not planned appropriately. 1