Alex Yampolsky, PharmD, is a clinical pharmacist at Elizabeth Seton Children’s Center, a pediatric long-term care facility in Yonkers, New York.
CNS stimulants, like Vyvanse, other amphetamine-containing products, and methylphenidate, have a high potential for abuse and dependence. The risk of abuse should be determined prior to prescribing and monitor for signs of abuse and dependence while on therapy.
Vyvanse (lisdexamfetamine dimesylate) is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD) in adults and children age 6 years and older. It’s also used to treat moderate to severe binge eating disorder (BED) in adults.
Vyvanse is a member of the amphetamine drug class and the exact way that it works (its "mechanism of action") in ADHD or binge eating disorder is not known. However, it's absorbed into the gastrointestinal tract and converted to dextroamphetamine, which increases the availability of the neurotransmitters dopamine (a hormone that affects mood) and norepinephrine (a stress hormone) in the central nervous system.
Vyvanse is a controlled medication, meaning that it has a high potential for abuse and misuse. It's available as an oral capsule or chewable tablet.
Generic Name: Lisdexamfetamine dimesylate
Brand Name(s): Vyvanse
Controlled Substance: Schedule II
Active Ingredient: Lisdexamfetamine dimesylate
Dosage Form(s): Oral capsule, chewable tablet
Vyvanse is used to treat attention deficit hyperactivity disorder (ADHD) in adults and children age 6 years and older. It's also used to treat moderate to severe binge eating disorder (BED) in adults. Studies have shown that ADHD may affect between 2% and 9% of school-age children and around 4.4% of adults. BED affects around 1.5% of women and 0.3% of men around the world.
Vyvanse is a controlled substance, meaning it can be addictive and its use may lead to dependence. Do not share Vyvanse with anyone else.
You should take Vyvanse as prescribed by your healthcare provider. Your healthcare provider may need to adjust your dose a few times in the beginning of treatment to find which strength works best for you. Do not take anything less than one capsule or one chewable tablet per day. A single dose should not be divided.
It’s best to take Vyvanse in the morning, with or without food. If this medication is taken in the afternoon or evening, it may be harder for you or your child to go to sleep. Not getting enough sleep can negatively impact attention, mood, and other factors. Be sure to discuss with your healthcare provider if you or your child is not able to get enough sleep while taking Vyvanse.
Capsule: Vyvanse capsules should be swallowed whole. Do not crush, divide or chew them. If you have trouble swallowing the capsules, you may open the capsule and mix all of the powder with water, yogurt, or orange juice. You can use a spoon to break up any clumps of powder. Mix thoroughly and eat or drink all of this mixture right away. Do not save any for later.
Chewable tablet: Vyvanse chewable tablets need to be chewed thoroughly before swallowing. You may substitute Vyvanse capsules with Vyvanse chewable tablets with the same dosage strength.
Vyvanse should be stored in a safe place—preferably locked—to prevent children or pets from accessing it, or to prevent potential misuse. Store this medicine in a closed container at room temperature (between 68 and 77 degrees Fahrenheit), away from heat, moisture, and direct light. Dispose of remaining, unused or expired medication through a medicine take-back program.
Vyvanse has been used off-label to treat the sleep disorder narcolepsy.
Your body reaches a maximum concentration of Vyvanse within several hours.
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.
Common side effects of Vyvanse may include:
Call your healthcare provider right away if you have serious side effects. Please call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms can include the following:
The long-term side effects of Vyvanse are unknown.
Vyvanse may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
The following modifications (changes) should be kept in mind when using Vyvanse:
Pregnancy: While lisdexamfetamine dimesylate had no apparent effect on fetal development or survival in some animal studies, other animal studies on the effect of amphetamines during pregnancy did have long-term brain and behavioral effects. However, the potential for these effects is unclear in humans. Let your healthcare provider know if you become pregnant or intend to become pregnant while you're being treated with Vyvanse.
Breastfeeding: Vyvanse can be present in your breast milk and may cause heart issues, stunted growth, and other issues in your child. Avoid breastfeeding while taking Vyvanse. If you need to take Vyvanse, consider working with your healthcare provider to find an alternative way to feed (using formula).
Children: Vyvanse has caused decreased weight gain and an increase in stunted growth in children. Your child's healthcare provider will work with you to help monitor your child for these problems, as well as any behavioral changes.
Adults over the age of 65 years: Studies suggest starting at a lower dosage and monitoring for side effects in adults over the age of 65 years.
Kidney problems: Individuals with kidney problems may not be able to clear medication from their bodies as easily. This means the medicine stays in the body longer and can have increased side effects. For this reason, if you have severe kidney impairment, your healthcare provider will likely not prescribe Vyvanse beyond a certain dosage.
Thyroid issues: Taking Vyvanse with thyroid medicine may increase the risk of cardiovascular (heart and blood vessel) problems.
Administration modifications: If you have difficulty swallowing Vyvanse capsules, you may open the capsule and mix all of the powder with water, yogurt, or orange juice. A spoon can be used to break up any clumps of powder. Be sure to mix the powder thoroughly and eat or drink all of this mixture right away. Do not save any for later.
If you miss your dose of Vyvanse, take it as soon as you remember. If it’s almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose as this can cause side effects.
Overdose symptoms can vary from person to person. Some symptoms of overdose may include restlessness, tremor, overactive reflexes (hyperreflexia), rapid breathing, confusion, physically violent behavior (assaultiveness), hallucinations, panic, high fever from brain changes (hyperpyrexia), and breakdown of muscle tissue (rhabdomyolysis). In addition, changes in heart rate and blood pressure can occur.
If you think you or someone else may have overdosed on Vyvanse, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Vyvanse, call 911 immediately.
It is very important that your doctor check the progress of you or your child at regular visits and make sure that your dose is right and that the medicine is helping you. Your doctor will need to check your or your child's blood, heart, and blood pressure for any problems or unwanted effects that may be caused by this medicine.
You should not use this medicine if you or your child is using or have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
Tell your doctor about all the medicines you or your child take or plan to take, including prescription and nonprescription (over-the-counter) medicines, dietary supplements, herbal remedies (eg, St. John's wort), or medicines for appetite control, asthma, colds, cough, hay fever, and sinus problems.
This medicine may cause blurred vision or make you drowsy or dizzy. If any of these occur, do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
Lisdexamfetamine dimesylate may cause serious heart or blood vessel problems, such as heart attack or stroke. This may be more likely in patients who have a family history of heart disease. Check with your doctor right away if you or your child have chest pain, fast, pounding, or uneven heartbeat, trouble breathing, or fainting while taking this medicine.
Tell your doctor right away if you or your family notices any unusual changes in behavior, such as an increase in aggression, hostility, agitation, irritability, or suicidal thinking or behaviors. Also tell your doctor if you or your child have hallucinations or any unusual thoughts, especially if they are new or getting worse quickly.
This medicine may cause slow growth. If your child is using this medicine, the doctor will need to keep track of your child's height and weight to make sure that your child is growing properly.
This medicine may cause a condition called Raynaud phenomenon. Check with your doctor right away if you have tingling or pain in the fingers or toes when exposed to cold, paleness or a cold feeling in the fingertips and toes, or a skin color change in your fingers.
Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.
Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.
You should not take Vyvanse if you:
In general, medications that interact with Vyvanse include:
Specific medicines that interact with Vyvanse may include, but are not limited to:
Please talk to your healthcare provider if you're using any of the medications above.
And be sure to talk with your healthcare provider about any other medicines that you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs or plant-based medicines.
Similar stimulant medications that treat ADHD include:
Non-stimulant medications, including Strattera (atomoxetine), are also available to treat ADHD. These medications are effective and tend to produce fewer side effects than stimulant medications.
Be sure to talk with your healthcare provider or pharmacist before using any other medications, supplements, or herbal products with Vyvanse.
Vyvanse is used to treat ADHD in adults and children age 6 years or older and moderate to severe binge eating disorder in adults.
The exact way that Vyvanse works (its "mechanism of action") is unknown. However, it is absorbed into the gastrointestinal tract and converted to dextroamphetamine, which increases the availability of dopamine and norepinephrine in the central nervous system.
Do not take Vyvanse if you are currently taking monoamine oxidase inhibitors (MAOIs) or have taken an MAOI within the past 14 days.
Vyvanse has a high potential for misuse and abuse.
While taking Vyvanse, it's important to be aware of how it may affect you. Side effects can make you dizzy or tired, so don't drive or do anything that could be dangerous until you know exactly how Vyvanse affects you. Vyvanse can also cause weight loss and decreased growth in children or make it difficult to fall asleep. Talk with your healthcare provider if you or your child experiences any of these side effects.
This medication has the potential to become habit-forming. Do not take more than prescribed. Instead, talk to your healthcare provider if you feel that Vyvanse is not working for you.
If you or your child is coping with ADHD, behavioral therapy for both you and your child, as well as organizational and social skills training, may help.
Studies have shown that biofeedback may be a viable adjunct therapy for ADHD in adults and children. A link between ADHD and adverse childhood experiences has been found in some people. Although not everyone with ADHD will have this problem, addressing trauma with a licensed therapist can be a step in the healing process for those with these childhood events. Speak with your or your child's healthcare provider about different approaches and treatment options.
It's important to note that several other medical conditions can be mistaken for ADHD. Your healthcare provider will need to rule these out first to make a diagnosis of ADHD. For example, studies show that sleep disturbances over time may increase a child's odds of developing ADHD.
Your healthcare provider may evaluate you or your child's sleep hygiene practices (behaviors that can help promote a good night's sleep) and also rule out or address any potential sleep disorders, including sleep apnea, and restless leg syndrome, before an ADHD diagnosis may be made.
Other disorders that will be considered before making an ADHD diagnosis include:
Work with your or your child's healthcare provider to help determine the root cause of your or your child's issue.
If you're coping with binge eating disorder (BED), there are several additional treatment strategies that can support your healing process. These include different types of therapy, journaling, yoga, and group support. Another way to support yourself is through working with a registered dietitian nutritionist (RD or RDN). An RD is specially trained to help you build your toolkit with guidance on food choices and eating patterns.
Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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