Guidelines for Effectively Dosing Vyvanse
Medically reviewed by Alex Yampolsky, PharmD
Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed childhood neurodevelopmental disorder.
To date, more than 6 million children ages 6–17 years old have been diagnosed with ADHD in the United States.
Fortunately, prescription medications are a safe and effective way to combat the consequences of an ADHD diagnosis.
One example of them is Vyvanse (lisdexamfetamine), a central nervous system (CNS) stimulant medication approved by the Food and Drug Administration (FDA) to treat ADHD.
Vyvanse can also treat eating disorders, such as binge eating disorder (BED). BED is a mental disorder characterized by recurrent episodes of obsessive overeating).
Vyvanse is a Schedule II-controlled drug that must be dosed accurately to achieve its desired therapeutic effects. Therefore, having the correct prescribed dosage of Vyvanse is crucial to using it effectively.
Read on for an in-depth analysis of how Vyvanse is dosed and other pertinent information regarding its consumption.
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Understanding ADHD
Common symptoms of ADHD in adolescents may include trouble paying attention, controlling impulsive behaviors (acting without thinking), hyperactivity, and forgetfulness.
Such symptoms can be severe and cause difficulty at school, home, or with friends.
The causes and risk factors for ADHD are unknown, but research shows that genetic mutations (abnormalities) play an important role.
In addition to genetics, other risk factors include brain injury, premature delivery, low birth weight, and exposure to environmental risks, among others.
Treatment for ADHD involves a combination of behavior therapy and medication.
Understanding BED
According to some recent studies, 20% of children with ADHD also develop eating disorders such as anorexia, bulimia, and BED.
These studies suggest that children and adolescents with ADHD should be monitored for eating disorders, but more work is still necessary to find a direct relation between both.
People with BED consume more significant amounts of food and lack control over their eating.
People with this condition eat when they are not even hungry and may become socially and physically uncomfortable due to overeating.
BED may cause weight gain and other health problems.
What is Vyvanse?
Vyvanse is a prescribed, FDA-approved, brand-name product for managing ADHD in people 6 years and older and moderate to severe BED in adults.
It contains the active drug lisdexamfetamine, which is categorized as a CNS stimulant. Vyvanse, an orally administered drug, is available as capsules and chewable tablets that can vary in strength.
However, Vyvanse is not approved for treating weight loss and should not be taken to avoid the risk of cardiovascular (heart and blood vessel) problems.
Further, its safety and effectiveness have not been established in treating obesity.
How It Works
How Vyvanse works on a pharmacological level, known as its mechanism of action, is unknown.
Still, it's understood to work generally by changing the level of certain brain chemicals, specifically dopamine and norepinephrine.
Brand-Name Associations
Vyvanse is the only FDA-approved brand-name drug that contains lisdexamfetamine.
However, various other generic alternatives are available.
If you are prescribed a generic form of lisdexamfetamine, know that FDA-approved generic medicines provide the same therapeutic benefits and risks as their brand-name counterparts.
What Happens When My Vyvanse Dose Is Too Low?
An adequate dose of Vyvanse is essential to controlling symptoms. The correct dose of Vyvanse will depend on the individual needs of the person.
Your healthcare provider will start the initial dose at a lower level. If necessary, they will then gradually increase the dose weekly.
If the Vyvanse dose is too low, symptoms might not improve, and the condition may remain the same, or the medication's effects may wear off too soon, decreasing its effectiveness.
You may experience a shorter attention span, hyperactivity, restlessness, frequent mood swings, forgetfulness, and an inability to control anger and frustration.
How your body reacts to Vyvanse depends on factors like metabolism, medication history, and severity of symptoms. Your healthcare provider will assess benefits and side effects to see if the dose is too low and needs adjustment.
If the dose of Vyvanse is more than required, it can be habit-forming. Take doses less often than needed or take them for longer.
If you take too much Vyvanse, you may need to continue taking higher doses of it, after which you may experience symptoms such as cardiac arrhythmia (irregular heartbeat), sweating, dilated pupils, mood swings, irritability, sleep problems, aggression, and anxiety.
Overusing Vyvanse may cause sudden death or severe heart problems, such as heart attack or stroke.
The dose range for ADHD is 30–70 milligrams (mg) per day in adults and children. The exact dose will depend mainly on the severity of the condition.
Dosing Overview
Vyvanse is available in the form of capsules and chewable tablets in various strengths:
Capsules: 10-, 20-, 30-, 40-, 50-, 60-, and 70-mg
Chewable tablets: 10-, 20-, 30-, 40-, 50-, and 60-mg
Vyvanse is administered once a day, usually in the morning, with or without food. Avoid taking it in the afternoon and evening because it may affect sleeping patterns.
Take capsules whole or open them and mix their contents in a liquid. When taking tablets, chew well before swallowing.
Your healthcare provider will probably start the treatment at a low dose and increase the dose gradually, not more often than once every week.
Indication: | Initial Dose: | Increase in Dose at Weekly Intervals: | Recommended Dose: | Maximum Dose: |
• ADHD (adults and children 6 years old) | • 30 mg daily | • 10–20 mg weekly | • 30–70 mg daily | • 70 mg daily |
• BED (adults 18 years and older) | • 30 mg daily | • 20 mg weekly | • 50–70 mg daily | • 70 mg daily |
Additional information regarding safe dosing practices includes:
The maximum dosage of Vyvanse is 50 mg once daily in people with severe renal impairment.
In people with end-stage renal disease, the recommended dosage is 30 mg once daily.
Tell your healthcare provider if you are taking other drugs to adjust your required dosage of Vyvanse.
Efficacy
Vyvanse has proved effective at treating ADHD.
Clinical studies show the efficacy and safety of once-daily Vyvanse in adults (18–55 years old) diagnosed with ADHD.
A review of various clinical studies comparing Vyvanse and several other drugs, such as Adderall (dextroamphetamine/amphetamine), concluded that Vyvanse was more effective than other clinically stimulating drugs at managing the symptoms of ADHD.
In comparison, clinical trials proved the efficacy of Vyvanse 30-, 50-, and 70-mg daily in reducing the number of binge-eating days or weeks in adults with moderate to severe BED.
Side Effects & Safety
Vyvanse is a Schedule II drug that must be taken as prescribed and has the potential for abuse and addiction.
It can be habit-forming if taken for a longer duration. Consider the risk of abuse before prescribing and monitoring for signs of misuse and addiction.
If taken as prescribed, it is safe and effective. However, it may cause some side effects and must be taken cautiously.
Common Side Effects
Some common side effects associated with the use of Vyvanse include:
Call your healthcare provider if these symptoms get worse or do not go away.
Severe Side Effects
Vyvanse may cause some rarer but severe side effects.
As a result, seek advice from your healthcare provider if you or a loved one experiences the following symptoms:
Hallucinations (seeing or believing in the presence of things that aren't there)
Hypersensitivity reactions, including symptoms such as urticaria (hives), rash, and swelling in the eyes, face, lips, and tongue
Motor or verbal tics (uncontrolled movements and sounds)
Numbness, pain, or sensitivity to cold in the fingers, toes, arms or legs
Peripheral cyanosis (paleness or blue color of fingers and toes)
Severe heart problems in children, including symptoms such as angina (chest pain), fainting, or shortness of breath
Who Shouldn't Take Vyvanse?
The consumption of Vyvanse is not recommended in people with the following conditions:
Known hypersensitivity to ingredients of Vyvanse
People who have taken monoamine oxidase inhibitors (MAOIs) within the past 14 days, which can lead to an increased risk of hypertensive crisis (a sudden increase in blood pressure)
People who are currently pregnant, given the potential side effects of Vyvanse treatment during pregnancy
People who are currently breastfeeding, given that the expulsion of this drug through breast milk can lead to heart problems, high blood pressure (HBP), reduced growth, and peripheral vasculopathy (reduced blood supply to body parts) in nursing infants
Furthermore, in people 65 years and older, dose selection should start at the low end of the dosing range because of the chances of decreased liver, kidney, or heart problems.
Potential for Interaction
Depending on the type of medication, Vyvanse can interact with other drugs. Adverse interactions can affect the ability of either product to work safely and effectively.
Tell your healthcare provider if you are taking any of the following medicines:
Other stimulant medications, such as Adderall (dextroamphetamine/amphetamine) or Dexedrine (dextroamphetamine)
MAOIs, such as Marplan (isocarboxazid), Zyvox (linezolid), Nardil (phenelzine), and Parnate (tranylcypromine)—as mentioned above, however, your healthcare provider will likely tell you not to take Vyvanse until at least 14 days after taking MAOIs
Some dietary supplements, such as vitamin C (ascorbic acid)
Some antacids, such as Soda Mint (sodium bicarbonate)
Some laxatives, such as Dulcolax (bisacodyl)
Call your healthcare provider about all prescription and non-prescription medicines, vitamins, and herbal products you are taking before starting taking Vyvanse.
Alternative Treatment Options
Alternative treatments for ADHD may include therapies in addition to medicines. Moreover, combining medication treatment with behavior therapy may prove effective for children and adults.
These can include parents, teachers, and social organizations to help with training in behavior management.
Parents can help children by creating a routine, limiting screen time, calming them with praise and rewards, and creating positive opportunities and a healthy lifestyle.
Some other therapies include healthy eating habits, weight loss programs, and additional psychological support to avoid eating disorders.
Summary
ADHD is a neurological disease that affects a large population of children. It affects nearly 4–12% of school-aged children worldwide.
Vyvanse is an effective treatment for managing the symptoms of ADHD and BED. It is a controlled drug that comes with an FDA warning regarding its potential for addiction and misuse.
It is vital to prescribe Vyvanse with an accurate dosage because a low dosage does not help ease the symptoms. Conversely, a high dose can be dangerous and may cause some severe side effects.
Your healthcare provider may determine the most suitable dose for you by starting from the lower end and monitoring your improvement.
Frequently Asked Questions
How can I safely store Vyvanse?
Store Vyvanse in a dry, secure location at room temperature (68–77 F).
Keep Vyvanse out of sight and reach of children and pets. Dispose of unwanted or expired medicines properly.
What could be some underlying causes of binge eating?
The exact cause of BED is unknown.
However, like other eating disorders, binge eating disorder may result from factors related to genes, thoughts and feelings, eating habits, and social issues.
Read the original article on Verywell Health.
