Are Vyvanse (lisdexamfetamine) and Stelara (ustekinumab) interchangeable medications?

Vyvanse and Stelara Are Completely Different Medications and Are Not Interchangeable

Vyvanse (lisdexamfetamine) and Stelara (ustekinumab) are entirely different drug classes used for completely unrelated medical conditions and cannot be substituted for one another under any circumstances.

Vyvanse (Lisdexamfetamine)

Drug Class and Mechanism:

• Vyvanse is a central nervous system (CNS) stimulant classified as a controlled substance (raw material for stimulants requiring strict distribution control) 1
• It is a prodrug that is enzymatically hydrolyzed in the blood to its active form, d-amphetamine 1, 2
• D-amphetamine works by competitively inhibiting dopamine transporter (DAT) and noradrenaline transporter (NAT), increasing dopamine and noradrenaline concentrations in the synaptic cleft 1

Approved Indication:

• Treatment of attention-deficit/hyperactivity disorder (ADHD) in children (ages 6-12 years) and adults (ages 18-55 years) 1, 2, 3

Dosing and Duration:

• Once-daily oral administration with approximately 12-14 hours duration of action 2, 3

Common Adverse Effects:

• Appetite suppression, insomnia, headache, abdominal pain, and irritability 2, 3

Stelara (Ustekinumab)

Drug Class and Mechanism:

• Stelara is a human monoclonal antibody (biologic immunosuppressant) that antagonizes interleukin-12 and interleukin-23 4, 5
• It inhibits key molecules in cellular immunity by blocking IL-12 and IL-23 pathways 6

Approved Indications:

• Moderate to severe plaque psoriasis 6
• Psoriatic arthritis 6, 7
• Crohn's disease 6, 4
• Ulcerative colitis 4, 5

Dosing:

• Weight-based dosing: 45 mg for patients <100 kg, 90 mg for patients ≥100 kg 6
• Administered subcutaneously at weeks 0,4, then every 12 weeks 6
• May be escalated to every 8 weeks for inadequate response 6, 8

Common Adverse Effects:

• Upper respiratory tract infections, nasopharyngitis, headache, arthralgia 6
• Serious infection risk (0.93/100 patient-years in psoriasis data) 6
• Requires tuberculosis screening before initiation 6

Critical Safety Distinctions

Vyvanse carries risks of:

• Cardiovascular events including sudden cardiac death 2
• Growth suppression in children 2
• Abuse potential (though reduced compared to immediate-release amphetamines) 2

Stelara carries risks of:

• Serious infections including tuberculosis reactivation 6
• Potential malignancy risk (though data are reassuring) 6
• Immunogenicity with neutralizing antibodies in approximately 5% of patients 6

Why This Question May Arise

This comparison likely stems from confusion about medication names or a fundamental misunderstanding of drug classes. There is absolutely no clinical scenario where these medications would be considered alternatives to each other, as they treat entirely different organ systems and disease processes.