LISDEXAMFETAMINE
(Vyvanse)Standard Prescription
Lisdexamfetamine __ mg PO daily in the AM.
Dosages
ADHD:
> 6 years old: 10-30 mg QAM; increase by 10-20 mg/24 hr at weekly intervals to a maximum of 60 mg/24 hr.
CADDRA ADHD guidelines support dosages above manufacturer recommended maximum dosages when prescribed by specialists.
Binge Eating Disorder:
Adults: 30 mg QAM; increase by 20 mg/24 hr at weekly intervals to a maximum of 70 mg/24 hr.
> 6 years old: 10-30 mg QAM; increase by 10-20 mg/24 hr at weekly intervals to a maximum of 60 mg/24 hr.
CADDRA ADHD guidelines support dosages above manufacturer recommended maximum dosages when prescribed by specialists.
Binge Eating Disorder:
Adults: 30 mg QAM; increase by 20 mg/24 hr at weekly intervals to a maximum of 70 mg/24 hr.
Mechanism of Action
Lisdexamfetamine is an inactive prodrug that is converted in the body to dextroamphetamine, a pharmacologically active compound which is responsible for the drug's activity. Amphetamines have high binding affinity for TAAR1 inhibiting site specific monoamine transporter reuptake, increasing dopaminergic activity in the mesolimbic pathway.
Forms Supplied
Capsule: 10 mg, 20 mg,
30 mg, 40 mg, 50 mg 60 mg
(Not stocked at BCCH:70 mg)
Not stocked at BCCH:
Chewable tablet:
10 mg, 20 mg, 30 mg, 40 mg. 50 mg, 60 mg
30 mg, 40 mg, 50 mg 60 mg
(Not stocked at BCCH:70 mg)
Not stocked at BCCH:
Chewable tablet:
10 mg, 20 mg, 30 mg, 40 mg. 50 mg, 60 mg
Comments
Adverse effects may include insomnia, restlessness, increased aggression, anorexia, anxiety, dysphoria/sadness, psychosis, headache, vomiting, abdominal cramps, dry mouth, growth suppression, arrhythmias, increased blood pressure, may cause/worsen tics, stereotypic movements.
Consider lower starting dose in young children.
Use with caution in patients with cardiovascular disease including structural abnormalities, hypertension, ventricular arrhythmias and family history of sudden cardiac death. Ensure appropriate cardiac evaluation including ECG prior to starting treatment in patients with identified cardia/abnormalities/risk profile. During treatment, monitor heart rate, blood pressure and for symptomatic cardiac dysfunction.
Formulated as a prodrug to reduce misuse/diversion. Hydrolyzed to active dextroamphetamine in blood after absorption.
13-14 hr intended duration of action.
Capsules may be opened and the contents dissolved in water, yogurt or orange juice prior to administration.
Chew chewable tablets well before swallowing; contains artificial strawberry flavoring.
Amphetamine derivatives are commonly abused, and have a significant street value.
Prescribers must be aware of warnings issued by Health Canada regarding the use of ADHD medications. Refer to the Health Canada website.
Consider lower starting dose in young children.
Use with caution in patients with cardiovascular disease including structural abnormalities, hypertension, ventricular arrhythmias and family history of sudden cardiac death. Ensure appropriate cardiac evaluation including ECG prior to starting treatment in patients with identified cardia/abnormalities/risk profile. During treatment, monitor heart rate, blood pressure and for symptomatic cardiac dysfunction.
Formulated as a prodrug to reduce misuse/diversion. Hydrolyzed to active dextroamphetamine in blood after absorption.
13-14 hr intended duration of action.
Capsules may be opened and the contents dissolved in water, yogurt or orange juice prior to administration.
Chew chewable tablets well before swallowing; contains artificial strawberry flavoring.
Amphetamine derivatives are commonly abused, and have a significant street value.
Prescribers must be aware of warnings issued by Health Canada regarding the use of ADHD medications. Refer to the Health Canada website.
References
234, 512
Last Edited
2022-04-04 06:45:30