Lisdexamfetamine: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Lisdexamfetamine is a prescription medication commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) and Binge Eating Disorder (BED). It works by affecting certain chemicals in the brain that help improve focus and control impulsive behaviors. Lisdexamfetamine is available in different forms and strengths, and it’s important to follow your healthcare provider’s dosing instructions carefully. If you have any concerns or need guidance, our telemedicine providers are here to assist you.

Names of Medication

US Brand Name: Vyvanse (Lisdexamfetamine)

The generic name refers to the active ingredient in the medication. In this case, Lisdexamfetamine is the generic name, which is listed in parentheses.

Pharmacologic Category

Central Nervous System (CNS) Stimulant

Lisdexamfetamine belongs to the CNS stimulant class, which includes medications like amphetamine and methylphenidate. These drugs are frequently prescribed for ADHD and related conditions, helping to improve attention and reduce impulsivity.

Lisdexamfetamine Dosage

Lisdexamfetamine is prescribed for various conditions. Below are the recommended doses for adults. Always consult your healthcare provider before making any changes to your medication.

Lisdexamfetamine for ADHD Treatment

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: Long-term, as directed by your doctor.

Lisdexamfetamine for Binge Eating Disorder (BED)

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Narcolepsy

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: Long-term, as prescribed by your doctor.

Lisdexamfetamine for Obesity

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Depression (Off-label use)

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Anxiety Disorders (Off-label use)

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Conduct Disorder

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Oppositional Defiant Disorder

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Sleep Disorders (Off-label use)

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Lisdexamfetamine for Cognitive Impairment (Off-label use)

Starting dose: 30 mg once daily in the morning.

Maintenance dose: The dose may be increased by 10-20 mg weekly, up to a maximum of 70 mg per day.

Length of treatment: As directed by your healthcare provider.

Dosage Forms and Strengths

Capsules: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg

Chewable Tablets: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg

Administration Instructions

Lisdexamfetamine should be taken once daily in the morning, with or without food. It’s important to take it at the same time each day to maintain consistent levels in your body. Avoid taking it in the afternoon or evening, as it may interfere with your ability to sleep. If you miss a dose, take it as soon as you remember, but skip it if it’s close to your next scheduled dose. Do not take two doses at once.

Contraindications for Lisdexamfetamine

A contraindication is a specific situation where a medication should not be used because it may cause harm. For Lisdexamfetamine, several conditions could increase the risk of serious health complications.

1. History of cardiovascular disease: Lisdexamfetamine can raise heart rate and blood pressure, which may worsen conditions such as heart disease, high blood pressure, or arrhythmias.
2. Moderate to severe hypertension (high blood pressure): Lisdexamfetamine can elevate blood pressure, making it unsuitable for individuals with uncontrolled hypertension.
3. Hyperthyroidism: This condition already increases metabolism and heart rate, and Lisdexamfetamine may exacerbate these symptoms, leading to potential complications.
4. Glaucoma: Lisdexamfetamine can increase intraocular pressure, which may worsen glaucoma.
5. History of drug or alcohol abuse: Lisdexamfetamine has the potential for misuse and dependence, making it inappropriate for individuals with a history of substance abuse.
6. Use of monoamine oxidase inhibitors (MAOIs): Taking MAOIs with Lisdexamfetamine can cause a dangerous rise in blood pressure. Lisdexamfetamine should not be used within 14 days of taking an MAOI.

Drug to Drug Interactions

Several medications can interact with Lisdexamfetamine, potentially leading to harmful side effects or reducing its effectiveness. It’s important to inform your healthcare provider about all the medications you are taking to avoid any dangerous interactions.

Monoamine oxidase inhibitors (MAOIs): (e.g., Marplan [isocarboxazid], Nardil [phenelzine], Parnate [tranylcypromine]) – Combining MAOIs with Lisdexamfetamine can result in dangerously high blood pressure, which may require immediate medical attention.

Serotonergic drugs: (e.g., Zoloft [sertraline], Prozac [fluoxetine]) – These medications increase serotonin levels. When taken with Lisdexamfetamine, they can raise the risk of serotonin syndrome, a potentially life-threatening condition.

Antihypertensives: (e.g., Norvasc [amlodipine], Lotensin [benazepril]) – Lisdexamfetamine may reduce the effectiveness of medications used to lower blood pressure, potentially making it harder to control hypertension.

Tricyclic antidepressants: (e.g., Elavil [amitriptyline], Pamelor [nortriptyline]) – These medications can increase the risk of cardiovascular side effects, such as elevated heart rate or blood pressure, when combined with Lisdexamfetamine.

Antacids: (e.g., Tums [calcium carbonate], Rolaids [magnesium hydroxide]) – Antacids may increase the absorption of Lisdexamfetamine, potentially leading to higher levels of the drug in your system, which could increase the risk of side effects.

Lisdexamfetamine in Pregnancy

Is it Safe to Take Lisdexamfetamine During Pregnancy?

Lisdexamfetamine is classified as a Category C drug by the FDA, meaning that while there are no well-controlled studies in pregnant women, animal studies have shown some risk to the fetus. The decision to use Lisdexamfetamine during pregnancy should be made after carefully weighing the potential benefits against the possible risks. If you are pregnant or planning to become pregnant, it’s essential to discuss this with your healthcare provider. They will help you evaluate whether continuing the medication is the best option for you and your baby.

Lisdexamfetamine While Breastfeeding

Is it Safe to Take Lisdexamfetamine While Breastfeeding?

Lisdexamfetamine can pass into breast milk and may cause side effects in a nursing infant, such as irritability, poor feeding, or difficulty sleeping. If you are breastfeeding or planning to breastfeed, it’s important to consult your healthcare provider. They may recommend an alternative treatment or closely monitor your baby for any potential side effects.

Estimated Cost of Lisdexamfetamine

The cost of a 30-day supply of Lisdexamfetamine without insurance can vary depending on the dosage and pharmacy. Using a GoodRX coupon, the estimated cost for a 30-day supply of Lisdexamfetamine (brand name Vyvanse) ranges from approximately $350 to $400. Prices may vary, so it’s a good idea to check with your local pharmacy or use a discount card to help lower the cost.

Possible Alternatives to Lisdexamfetamine

If Lisdexamfetamine is not suitable for you, or if you’re exploring alternative treatments, several options are available depending on the condition being treated. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss your options.

Alternatives for ADHD Treatment

Attention Deficit Hyperactivity Disorder (ADHD): Alternatives include other stimulant medications like Adderall (amphetamine/dextroamphetamine) or non-stimulant options such as Strattera (atomoxetine). Behavioral therapy and lifestyle changes, such as regular exercise and structured routines, can also help manage symptoms effectively.

Alternatives for Binge Eating Disorder

Binge Eating Disorder: Other medications, such as Topamax (topiramate), or cognitive-behavioral therapy (CBT) may be effective. Additionally, lifestyle changes like mindful eating and regular physical activity can support treatment and improve outcomes.

Alternatives for Narcolepsy

Narcolepsy: Medications like Provigil (modafinil) or Ritalin (methylphenidate) are potential alternatives. Maintaining a consistent sleep schedule and practicing good sleep hygiene can also help manage symptoms.

Alternatives for Obesity

Obesity: Other medications, such as Contrave (naltrexone/bupropion) or Qsymia (phentermine/topiramate), may be considered. A balanced diet and regular exercise are essential components of long-term weight management.

Alternatives for Depression

Depression: Antidepressants like Zoloft (sertraline) or Lexapro (escitalopram) may be used. Therapy, such as cognitive-behavioral therapy (CBT), along with lifestyle changes like regular exercise and mindfulness practices, can also be beneficial in managing symptoms.

Alternatives for Anxiety Disorders

Anxiety Disorders: Medications such as Xanax (alprazolam) or Buspar (buspirone) may be alternatives. Cognitive-behavioral therapy (CBT) and relaxation techniques, including meditation, can also help manage anxiety.

Alternatives for Conduct Disorder

Conduct Disorder: Behavioral therapy and family therapy are often recommended as first-line treatments. In some cases, medications like Risperdal (risperidone) may be used to help manage symptoms.

Alternatives for Oppositional Defiant Disorder

Oppositional Defiant Disorder: Behavioral therapy, family therapy, and parent training programs are typically the first line of treatment. Medications are generally not recommended unless there are co-existing conditions, such as ADHD, that may require additional intervention.

Alternatives for Sleep Disorders

Sleep Disorders: For insomnia or other sleep disorders, medications like Ambien (zolpidem) or Lunesta (eszopiclone) may be considered. Good sleep hygiene, including a regular sleep schedule and a relaxing bedtime routine, can also improve sleep quality.

Alternatives for Cognitive Impairment

Cognitive Impairment: Medications like Aricept (donepezil) or Namenda (memantine) may be used for conditions such as Alzheimer’s disease. Cognitive training exercises and a diet rich in antioxidants may also support brain health and cognitive function.

Recent Updates on Lisdexamfetamine Research

Recent studies have focused on the long-term effects of Lisdexamfetamine, particularly in treating ADHD and Binge Eating Disorder. One area of ongoing research is its potential to help manage cognitive impairment in adults with ADHD. Additionally, researchers are exploring its use in treating other conditions, such as treatment-resistant depression. While these studies are promising, more research is needed to fully understand the long-term safety and effectiveness of Lisdexamfetamine for these conditions. Always consult your healthcare provider to stay informed about the latest research and how it may impact your treatment plan.

James Kingsley

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