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
Vyvanse Dosing:
- The recommended starting dose for ADHD is 30 mg once daily in the morning, with a maximum dose of 70 mg once daily.
- The recommended starting dose for moderate to severe BED in adults is 30 mg once daily, with a target dose of 50 mg to 70 mg once daily.
- Doses can be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals 1
From the Research
Vyvanse (lisdexamfetamine) should be started at 30mg once daily in the morning for both children and adults with ADHD, with dosage adjustments made every 1-2 weeks based on response and tolerability, as this dosing strategy has been shown to be effective in managing ADHD symptoms while minimizing side effects 2.
Key Considerations
- The effective dose range is usually 30-70mg daily, with a maximum recommended dose of 70mg per day.
- The medication should be taken in the morning to avoid sleep disturbances, and can be swallowed as a capsule or dissolved in water.
- Patients should expect the medication to take effect within 1-2 hours and last approximately 10-14 hours.
- Vyvanse works by being converted to dextroamphetamine in the body, which increases dopamine and norepinephrine levels in the brain, improving attention and reducing hyperactivity.
Monitoring and Safety
- Regular monitoring of blood pressure, heart rate, growth (in children), and mental health status is necessary during treatment.
- Abrupt discontinuation should be avoided to prevent withdrawal symptoms, and the medication should not be taken with vitamin C or acidic juices as they can reduce absorption.
- Common side effects include decreased appetite, insomnia, and increased heart rate.
Evidence-Based Recommendations
- A recent review of stimulant prodrugs, including lisdexamfetamine, highlights the importance of flexible dosing strategies to optimize treatment outcomes in ADHD 2.
- A meta-analysis of stimulant dose and dosing strategy in children and adolescents with ADHD found that flexible titration to higher doses was associated with improved efficacy and acceptability 3.
- The chemistry, pharmacodynamics, pharmacokinetics, and clinical efficacy of lisdexamfetamine have been well-established, supporting its use in the treatment of ADHD and binge eating disorder 4.