Maximum Approved Dose of Vyvanse for ADHD
The maximum approved daily dose of Vyvanse (lisdexamfetamine) for treating ADHD in patients aged six years and older is 70 mg once daily. 1
FDA-Approved Dosing Guidelines
Starting dose: The recommended starting dose is 30 mg once daily in the morning for both adults and pediatric patients aged 6 years and older. 1
Titration schedule: Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals until optimal symptom control is achieved. 2, 1
Maximum dose: The maximum recommended dosage is 70 mg once daily for all patients with ADHD, regardless of age (6 years and older). 1
Administration Considerations
Timing: Vyvanse should be taken in the morning with or without food; afternoon doses should be avoided due to the potential for insomnia. 1
Duration of action: The prodrug formulation provides approximately 12 hours of therapeutic effect following a single morning dose. 3, 4
Whole or dispersed: The capsule may be swallowed whole or opened and mixed with yogurt, water, or orange juice and consumed immediately. 1
Special Population Dosing Restrictions
Severe renal impairment (GFR 15 to <30 mL/min/1.73 m²): Maximum dose should not exceed 50 mg once daily. 1
End-stage renal disease (GFR <15 mL/min/1.73 m²): Maximum recommended dose is 30 mg once daily. 1
Monitoring Requirements During Titration
Symptom assessment: Use standardized ADHD rating scales (such as ADHD-RS-IV) from parents, teachers, and patients at each dose level to objectively measure response. 2
Cardiovascular monitoring: Assess blood pressure, pulse, height, and weight at each visit, as stimulants can affect growth and cardiovascular parameters. 2
Weekly intervals: Rating scales should be obtained at approximately weekly intervals during dose adjustments to guide titration decisions. 2
Clinical Efficacy at Maximum Dose
Response rates: Long-term studies of LDX at doses of 30,50, and 70 mg/day demonstrated that the medication was generally well tolerated and effective in children with ADHD, with mean ADHD Rating Scale scores improving by 27.2 points from baseline (P<0.0001). 5
All-day coverage: At the 70 mg dose, improvements in ADHD-related symptoms and behaviors were maintained throughout the day and were ongoing at the last measurement in the evening (1800 hours). 4
Common Pitfall to Avoid
- Do not divide doses: A single dose should not be divided; patients must take at least one full capsule per day. 1 The prodrug design requires intact administration to achieve the intended pharmacokinetic profile and duration of action.