Vyvanse

Overview

What is Vyvanse? 

Vyvanse, known generically as lisdexamfetamine dimesylate, is a prescription medication that acts as a central nervous system (CNS) stimulant to treat Attention-Deficit/Hyperactivity Disorder (ADHD) and binge eating disorder (BED). It is a prodrug, which means it is inactive until it is converted into its active form, dextroamphetamine, in the body. The active ingredient is lisdexamfetamine dimesylate.

Global Name

• Generic name: Lisdexamfetamine dimesylate
• Brand name: Vyvanse (also marketed as Elvanse or Tyvense in some regions)

Usage

What is Vyvanse used for?

Vyvanse is used to treat:

• ADHD in patients 6 years of age and older.
• Moderate to severe BED in adults.

How do you use Vyvanse?

Dosage form:

Available in both oral capsules and chewable tablets. 

Dosage information:

• For treatment of ADHD, the recommended starting dose is 30 mg once daily. The dose may be adjusted at weekly intervals up to a maximum of 70 mg per day.
• For treatment of moderate-to-severe BED, the recommended starting dose is 30 mg once daily. The dose may be adjusted at weekly intervals to a target of 50 mg to 70 mg per day. 

Are the following suitable for getting the drug?

• Children: Suitable for children aged 6 years or older for the treatment of ADHD.
• Adults: Suitable for adults for the treatment of ADHD and BED.
• Patients with renal impairment: Suitable. 
  o    Maximum daily dose in patients with severe renal impairment (GFR 15 to <30 mL/min/1.73 m2): 50 mg.
  o    Maximum daily dose in patients with end-stage renal disease (ESRD, GFR <15 mL/min/1.73 m2): 30 mg.

• Children: Not recommended for children under 6 years old. 
• Adults: Those with known structural cardiac abnormalities, cardiomyopathy, serious heart arrhythmia, or coronary artery disease.
• Elderlies: Those with the conditions listed above for adults.
• Pregnant women: May cause fetal harm. 
• Nursing mothers: Breastfeeding is not recommended.

• High potential of abuse and dependence: Assess each patient’s risk for abuse, misuse, and addiction before the prescription.
• Serious Cardiovascular Reactions: Avoid the use of Vyvanse in patients with known pathologic cardiac conditions.
• Increased Blood Pressure and Heart Rate: Monitor patients for potential tachycardia and hypertension.
• Psychiatric Adverse Reactions: Screen patients for risk factors for developing a manic episode in patients with bipolar disorder prior to initiating Vyvanse. May cause psychotic symptoms in patients with now prior history of psychosis or mania.
• Long-term Suppression of Growth: Close monitoring on the height and weight in paediatric patients.
• Peripheral Vasculopathy: Careful observation for digital changes during VYVANSE treatment.
• Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (SSRI’s, SNRI’s) and overdosed.
• Motor and Verbal Tics, and Worsening of Tourette’s Syndrome: Before starting Vyvanse, evaluate the patients for tics or Tourette’s syndrome and monitor regularly.

Interactions and Contraindications of Vyvanse: 

• Interactions: Avoid co-administration of Vyvanse and urinary alkalinizing agents. Dosage adjustment is needed when Vyvanse is taken with serotonergic drugs, CYP2D6 inhibitors, acidifying agents and tricyclic antidepressants. Consult a doctor before use.    
• Contraindications: Avoid Vyvanse in patients with known hypersensitivity to amphetamine products or any of its ingredients, and in patients taking MAOIs or within 14 days of discontinuing MAOIs.

Side Effects

Common side effects in paediatric patients (6 to 17 years of age) with ADHD may include:

• anorexia

• anxiety

• decreased appetite

• decreased weight

• diarrhea

• dizziness 

• dry mouth

• irritability

• insomnia

• nausea

• upper abdominal pain

• Vomiting

Common side effects in adults with BED may include:

• dry mouth

• insomnia

• decreased appetite

• increased heart rate

• constipation

• feeling jittery

• anxiety

Serious side effects include abuse and misuse of Vyvanse and sudden death in people with serious heart disease. 

Pharmacist Tips

• Storage information: Store Vyvanse in a safe place (like a locked cabinet) and in a tightly closed container at room temperature (20°C to 25°C). Protect Vyvanse from light. 
• Administration: Take Vyvanse once a day in the morning with or without food. Swallow the capsule whole. Chew tablets completely before swallowing.
  
  

Availability

Where is Vyvanse available in Hong Kong?

Vyvanse is a prescription-only medication available through healthcare providers upon doctor’s prescription.

FAQs

What is Vyvanse used for?

Vyvanse is used for treating ADHD and Binge Eating Disorder, but not for weight loss. 

What is the difference between Vyvanse and Ritalin?

Vyvanse and Ritalin are both stimulant medications for treating ADHD, but they differ in composition and duration of action. Vyvanse is an amphetamine-based, long-acting formulation, while Ritalin is a methylphenidate-based short-acting stimulant. 

How long does Vyvanse last?

Vyvanse typically begins working within about 90 minutes and its effects can last for approximately 13 hours.

How much does Vyvanse cost?

Vyvanse is a prescription-only medicine, and the price varies depending on the healthcare provider.