From the Guidelines
When converting from Adderall XR to Vyvanse, a general guideline is that 30 mg of Adderall XR is approximately equivalent to 70 mg of Vyvanse, but the conversion should be individualized based on the patient's response and factors such as metabolism, body weight, and specific response to stimulants 1.
Key Considerations for Conversion
- The conversion from Adderall XR to Vyvanse is not straightforward due to differences in their mechanisms of action, with Vyvanse being a prodrug that is converted to dextroamphetamine in the body 1.
- Vyvanse typically provides smoother effects with less pronounced peaks and crashes compared to Adderall XR, which may influence the conversion and dosing strategy 1.
- Patients should be monitored for effectiveness and side effects, and dosage adjustments may be needed over several weeks to optimize the treatment outcome 1.
Factors Influencing Conversion
- Individual factors such as metabolism, body weight, and specific response to stimulants should be considered when converting from Adderall XR to Vyvanse 1.
- The presence of comorbidities, severity of symptoms, and patient preferences should also be taken into account to ensure the best possible treatment outcome 1.
Recommendations for Healthcare Providers
- Healthcare providers should supervise the conversion from Adderall XR to Vyvanse and adjust the dosage based on the patient's response and tolerance to the medication 1.
- Regular assessments of medication adherence and potential issues should be conducted to ensure the patient's safety and the effectiveness of the treatment 1.
From the FDA Drug Label
Lisdexamfetamine dimesylate capsules can be substituted with Vyvanse chewable tablets on a unit per unit/mg per mg basis (for example, 30 mg capsules for 30 mg chewable tablet) [see Clinical Pharmacology (12.3)].
The conversion from Adderall XR to Vyvanse can be done on a unit per unit/mg per mg basis. For example, if a patient is taking 30 mg of Adderall XR, they can be switched to 30 mg of Vyvanse.
- Key points to consider:
- The conversion should be done under the guidance of a healthcare professional.
- The patient should be monitored for signs and symptoms of abuse, misuse, and addiction.
- The dosage may need to be adjusted based on the patient's response to the medication.
- It is essential to follow the recommended dosage and administration instructions for Vyvanse. 2
From the Research
Adderall XR Conversion to Vyvanse
- Adderall XR and Vyvanse are both stimulant medications used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) 3, 4.
- Adderall XR is a mixed amphetamine salt, while Vyvanse is lisdexamfetamine, a prodrug that is converted to dextroamphetamine in the body 5.
- There is no direct conversion ratio between Adderall XR and Vyvanse, as they have different mechanisms of action and pharmacokinetic profiles 4, 5.
- However, studies have compared the efficacy and tolerability of lisdexamfetamine and mixed amphetamine salts, suggesting that lisdexamfetamine may have a larger effect size in reducing ADHD symptoms 3.
- A crossover design clinical trial found that lisdexamfetamine and mixed amphetamine salts-immediate release had significant and equal reductions on ADHD clinician ratings, but lisdexamfetamine had greater reductions in Clinical Global Impression Severity Scale and Behavior Rating Inventory of Executive Function scores 4.
- The molecular mechanisms of lisdexamfetamine and methylphenidate, another stimulant medication, are not fully understood, and further studies are needed to improve knowledge of ADHD pathophysiology and treatment 5.
Key Considerations
- When converting from Adderall XR to Vyvanse, it is essential to consider individual patient factors, such as medical history, comorbidities, and previous response to stimulant medications 6.
- Close monitoring of patients during the conversion process is crucial to minimize potential side effects and optimize treatment outcomes 7, 4.
- Healthcare providers should carefully assess medication use and adjust doses as needed to ensure the best possible treatment outcomes for patients with ADHD 7, 3.