Is it safe to take famotidine before Vyvanse (lisdexamfetamine) without adjusting doses?

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Famotidine Before Vyvanse: Safety and Dosing

Taking famotidine before Vyvanse (lisdexamfetamine) is safe without dose adjustment, as famotidine does not interfere with amphetamine pharmacokinetics or metabolism. 1

No Pharmacokinetic Interaction

  • Famotidine has no clinically significant drug interactions with medications metabolized through hepatic pathways, as it does not interfere with cytochrome P450 enzymes or other metabolic systems 2, 3

  • The American College of Cardiology specifically notes that H2 blockers like famotidine do not interfere with other drug mechanisms, unlike some PPIs that inhibit CYP2C19 4, 1

  • Research demonstrates famotidine does not impair drug clearance when co-administered with other medications, showing no kinetic interactions in clinical practice 5

Timing Considerations

  • Famotidine reaches peak plasma concentrations in 1-3 hours after oral administration, with antisecretory activity beginning within 1 hour 2

  • Vyvanse demonstrates efficacy starting at 1.5 hours postdose and maintains effect through 13 hours in school-aged children with ADHD 6

  • Taking famotidine first allows it to establish gastric acid suppression before Vyvanse administration, which is pharmacologically appropriate since Vyvanse absorption is not pH-dependent 2, 6

Standard Dosing Remains Unchanged

  • Famotidine standard dosing is 20-40 mg daily depending on indication, with oral administration providing 10-12 hours of antisecretory activity 1, 2

  • No dose adjustment is needed for either medication when taken together, as they work through completely independent mechanisms 4, 1

Clinical Caveats

  • Famotidine is eliminated primarily through the kidneys (approximately 70%), so dose reduction may be necessary in patients with renal impairment, but this is unrelated to Vyvanse co-administration 2

  • Tolerance to H2-receptor antagonist therapy develops within 6 weeks of continuous use, requiring periodic reassessment of famotidine efficacy 1

  • The most common adverse events with Vyvanse include decreased appetite, insomnia, headache, and irritability, which are unaffected by famotidine co-administration 6

References

Guideline

Famotidine Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Clinical pharmacology of famotidine: a summary.

Journal of clinical gastroenterology, 1987

Guideline

Combination Therapy with Famotidine and Pantoprazole

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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