Can Vyvanse (lisdexamfetamine) be taken with or without food without affecting its efficacy?

Vyvanse Administration with Food

Vyvanse (lisdexamfetamine) can be taken with or without food without clinically significant effects on its efficacy, as food does not meaningfully alter the bioavailability of the active metabolite dextroamphetamine. 1

Effect of Food on Absorption

Capsule Formulation

• Food does not affect the overall drug exposure (AUC and Cmax) of dextroamphetamine in healthy adults after a 70 mg dose of lisdexamfetamine capsules. 1
• Food (high-fat meal or yogurt) only prolongs the time to peak concentration (Tmax) by approximately 1 hour—from 3.8 hours in the fasted state to 4.7 hours after a high-fat meal or 4.2 hours with yogurt. 1
• This delay in Tmax has no clinical significance for therapeutic efficacy, as the total drug exposure remains unchanged. 1, 2

Chewable Tablet Formulation

• Administration of a 60 mg Vyvanse chewable tablet with a high-fat meal decreases dextroamphetamine exposure (Cmax and AUC) by only 5-7%, which is not clinically meaningful. 1
• Food prolongs Tmax by approximately 1 hour (from 3.9 hours fasted to 4.9 hours fed) with the chewable formulation. 1

Clinical Implications

Dosing Flexibility

• Patients may take Vyvanse with or without food based on personal preference and tolerability without concern for reduced efficacy. 1, 2
• The once-daily morning dosing schedule remains appropriate regardless of food intake. 3

Managing Side Effects

• Taking Vyvanse with meals may help mitigate appetite suppression, a common side effect of stimulant medications. 4
• High-calorie snacks can be offered in the evening when medication effects wear off to address appetite-related concerns. 4

Pharmacokinetic Considerations

• Lisdexamfetamine is a prodrug that is converted to active dextroamphetamine primarily through hydrolysis by red blood cells after oral administration, not through gastrointestinal or hepatic metabolism. 1, 5
• This unique conversion mechanism explains why food has minimal impact on bioavailability—the rate-limiting step occurs in the blood, not during absorption. 1, 6
• The plasma elimination half-life of dextroamphetamine is approximately 10-11.3 hours in healthy adults, providing therapeutic coverage throughout the day regardless of food intake timing. 1

Common Pitfalls to Avoid

• Do not counsel patients that they must take Vyvanse on an empty stomach or with food for optimal effect—either approach is acceptable. 1, 2
• The slight delay in Tmax with food intake does not translate to delayed therapeutic onset in clinical practice and should not influence dosing recommendations. 1
• Orange juice also does not affect dextroamphetamine exposure, contrary to concerns sometimes raised about acidic beverages with amphetamine medications. 1