Vyvanse

(Lisdexamfetamine Dimesylate)

The active ingredient in Vyvanse is lisdexamfetamine dimesylate. It is a prodrug meaning that it is converted into its active form dextroamphetamine once in the body. Vyvanse behaves as a central nervous system stimulant by increasing excitatory neurotransmitters such as norepinephrine and dopamine. That being said, the exact mechanism of action in ADHD and BED is unknown. Patients taking Vyvanse for ADHD find that it helps decrease impulsiveness and improve concentration. Those taking it for BED will have a decreased urge to binge eat.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Vyvanse. However, the following is a synopsis of the general guidelines for the use of Vyvanse:

• Take exactly as prescribed to minimize the high potential of abuse and dependence.
• Take in the morning without regard to meals. Avoid taking it later in the day as it can cause trouble sleeping.
• If chewable tablets are taken, they must be chewed thoroughly before swallowing.
• If you have trouble swallowing, Vyvanse capsules can be opened and the contents mixed with yogurt, water, or orange juice. Mix thoroughly to ensure no clumps and consume immediately. A film containing the inactive ingredients may remain in the glass or container once the mixture is taken.

The most common side effects of Vyvanse seen in clinical trials as compared to placebo for ADHD include:

• Anxiety
• Dry mouth
• Trouble sleeping
• Loss of appetite
• Irritability
• Stomach pain
• Diarrhea
• Nausea and vomiting
• Dizziness
• Weight loss

The most common side effects of Vyvanse seen in clinical trials as compared to placebo in adults with BED include:

• Dry mouth
• Constipation
• Trouble sleeping
• Jitteriness
• Loss of appetite
• Anxiety
• Increased heart rate

Some individuals may experience serious side effects while using Vyvanse. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Symptoms of stroke or heart attack such as chest pain, shortness of breath, weakness, or slurring of speech
• Symptoms of serotonin syndrome such as agitation, hallucinations, fever, flushing, sweating, shivering, fast heart rate, dizziness, tremors, muscle stiffness, involuntary jerking, twitching, seizures, nausea, vomiting, or diarrhea
• New or worsening mental symptoms such as psychosis, visual or auditory hallucinations, paranoia, aggression, hostility, or manic symptoms
• Blood circulation problems such as Raynaud's phenomenon, which can cause your fingers or toes to change to a pale, white, or bluish color and feel cold, numb, or painful
• Slowed growth in children

These are not all of the possible side effects of Vyvanse. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Vyvanse, it is crucial to discuss any existing health conditions with your healthcare provider. In some medical conditions, the use of Vyvanse can result in sudden death. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have or have a family history of:

• Heart problems or heart defects
• High blood pressure
• Mental health problems including psychosis, mania, bipolar disorder, or depression
• Substance abuse or dependence
• A circulation problem in fingers and toes, including Raynaud’s Phenomenon
• Tics or Tourette’s syndrome
• Liver or kidney problems
• Thyroid problems
• Seizures
• Vyvanse should not be used for weight loss. Evidence is lacking on its safety and effectiveness for obesity.
• In pediatric patients, Vyvanse can suppress growth, especially at higher doses. Patients who are not growing or gaining weight as expected should have their Vyvanse use reassessed by their healthcare provider.

Boxed Warning

• CNS stimulants such as Vyvanse, Adderall XR (dextroamphetamine/amphetamine), and Concerta (methylphenidate) have a high risk of abuse and dependence. If started on for therapy, monitor for signs of abuse and dependence throughout treatment.

Do not use Vyvanse if you have:

• Advanced arteriosclerosis
• Symptomatic cardiovascular disease
• Moderate to severe hypertension or high blood pressure
• Hyperthyroidism
• A known hypersensitivity or idiosyncrasy to sympathomimetic amines
• Glaucoma
• Agitated states
• A history of substance or drug abuse
• Are using or have used in the last 14 days an anti-depressant called a monoamine oxidase inhibitor or MAOI

You should feel the effects of both Vyvanse capsules and chewable tablets in about 1 hour with maximum effect at about 4 hours. Like any medication, it may take a few weeks to adjust to side effects, and your healthcare provider may need to adjust the dose over a period of time to determine the right dose for you.

When Vyvanse is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid drug interactions, including:

• MAOIs such as isocarboxazid, linezolid, IV methylene blue, phenelzine, rasagiline, tranylcypromine, or selegiline
• Norepinephrine
• Meperidine
• Phenobarbital
• Phenytoin
• Serotonergic agents such as SSRIs, SNRIs, triptans, TCAs like desipramine or protriptyline, fentanyl, lithium, tramadol, tryptophan, buspirone, paroxetine, fluoxetine St. John’s Wort
• CYP2D6 inhibitors such as quinidine and ritonavir (with a notable exception being atomoxetine)
• Medications that alter the pH of your urine such as acidifying agents (e.g., ascorbic acid, ammonium chloride, sodium acid phosphate, methenamine salts) or alkalinizing agents (e.g., sodium bicarbonate, acetazolamide, some thiazide diuretics)

Vyvanse is available in 2 formulation types: chewable tablets and capsules.

Vyvanse chewable tablets are available in the following strengths:

• 10 mg
• 20 mg
• 30 mg
• 40 mg
• 50 mg
• 60 mg

Vyvanse capsules are available in the following strengths:

• 10 mg
• 20 mg
• 30 mg
• 40 mg
• 50 mg
• 60 mg
• 70 mg

Vyvanse should be stored at room temperature away from light and out of reach of children. To prevent the risk of misuse and abuse, store in a safe place.

Vyvanse is manufactured by the Takeda Pharmaceutical Company.

Yes, there is a generic version of the brand name Vyvanse available.

Vyvanse should not be abruptly stopped due to the risk of withdrawal symptoms such as depression and extreme fatigue. Like other CNS stimulants, a gradual taper is preferred. Consult your healthcare provider before starting, stopping, or changing medications while taking Vyvanse.

Vyvanse may cause harm to your unborn child. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Generally, breastfeeding is not recommended while using Vyvanse. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.