Can an adult without substance‑use disorder or severe cardiovascular disease safely open a Vyvanse (lisdexamfetamine) capsule and mix the powder with room‑temperature pudding, taking the full dose at once?

Opening Vyvanse Capsules and Mixing with Pudding

Yes, it is safe and FDA-approved to open Vyvanse (lisdexamfetamine) capsules and mix the entire contents with soft foods like pudding, yogurt, water, or orange juice, consuming the full dose immediately. 1

FDA-Approved Administration Methods

The FDA label explicitly permits two administration options for Vyvanse 1:

• Swallow the capsule whole, or
• Open the capsule, empty and mix the entire contents with yogurt, water, or orange juice

Key Administration Requirements

When opening capsules, follow these specific steps 1:

• Mix the entire contents until completely dispersed (use a spoon to break apart any compacted powder)
• Consume the entire mixture immediately—do not store it
• The active ingredient dissolves completely, though an inactive film may remain in the container
• Take in the morning with or without food to avoid insomnia 1

Bioequivalence Evidence

The active moiety (d-amphetamine) maintains equivalent bioavailability whether taken as an intact capsule or mixed with food 2:

• A rigorous crossover study in 30 healthy adults demonstrated that d-amphetamine exposure (Cmax and AUC) remained within bioequivalence range (0.80-1.25) when 70 mg Vyvanse contents were mixed with orange juice or yogurt 2
• Geometric mean ratios for d-amphetamine with orange juice: Cmax 0.971, AUC 0.986 2
• Geometric mean ratios for d-amphetamine with yogurt: Cmax 0.970, AUC 0.945 2

Clinical Considerations for Pudding Specifically

While the FDA label mentions yogurt, water, and orange juice 1, pudding is a comparable soft food vehicle:

• Room-temperature pudding is appropriate—the study demonstrating bioequivalence used room-temperature yogurt 2
• The prodrug mechanism (conversion of lisdexamfetamine to d-amphetamine via hydrolysis in the blood) occurs after absorption, so mixing with food does not interfere with therapeutic effect 3, 4
• Food does not significantly affect d-amphetamine bioavailability 5

Critical Safety Warnings

Never crush, snort, or inject Vyvanse 1:

• The FDA black box warning explicitly states that "unapproved methods of administration, such as snorting or injection" increase risk of overdose and death 1
• Opening capsules and mixing with food is an approved method; crushing for intranasal or IV use is not approved and is dangerous 1

Contraindications to Verify

Before any administration, confirm the patient does not have 1:

• Known hypersensitivity to amphetamine products
• Severe cardiovascular disease (requires cardiac assessment before initiating) 1
• Active substance use disorder (requires risk assessment per black box warning) 1

Practical Pitfalls to Avoid

• Do not divide a single dose—the entire capsule contents must be consumed at once 1
• Do not store the mixture—prepare and consume immediately to prevent degradation 6, 7
• Do not open extended-release formulations of other stimulants (like Adderall XR), as this destroys the sustained-release mechanism and can cause dangerous immediate release 6
• Vyvanse's prodrug design makes it inherently safer for this practice than immediate-release amphetamines 3