1 What Is Vyvanse?

Brand: Vyvanse

Generic: Lisdexamfetamine

Vyvanse is used to treat attention deficit/hyperactive disorder. It is a disorder that affects both children and adults. A person with this condition is overactive, restless, impulsive, and has difficulty concentrating on one thing for a long time, as they are easily distracted.

Vyvanse works by affecting certain chemicals in the brain that improve behavior and attention span. It is used as part of a treatment program that includes social, educational, and psychological treatment.

Vyvanse is also beneficial for binge eating disorder. It is available in the form of a capsule only with a doctor’s prescription.

Vyavanse may help a person stay focused, increase their ability to pay attention, and stop fidgeting. Also, the number of binge-eating days can be reduced with the help of this medicine. It works as a stimulant; the balance of certain brain chemicals is restored with the help of this medication. Since it may cause some side effects, it is not used for weight loss. Vyvanse is the brand name for the prescription drug lisdexamfetamine dimesylate. It is not a narcotic, but it is considered a Schedule II controlled substance by the Drug Enforcement Administration. Vyvanse belongs to a class of drugs called sympathomimetic amines. The part of the nervous system involved in the fight-or-flight response is known to be stimulated by this drug. It was approved by the FDA in 2007 and is manufactured by Shire pharmaceuticals.

Vyvanse and Abuse

Even though all CNS stimulants are considered to have a potential risk of abuse by the DEA, Vyvanse is known to be at a lesser risk. This is because, before it is converted into dextroamphetamine (its active form), it is absorbed into the intestine. The drug would not have the same effect if it was injected or inhaled.

Vyanese and Weight Loss

People who take this drug have reported weight loss and changes in appetite, which is why some people take this to reduce weight. For the treatment of obesity, the safety and effectiveness of Vyvanse has not yet been established. Other sympathomimetic drugs, when used for weight loss, have been reported to cause adverse cardiovascular events. 

2 What To Know Before Using

If you are about to start Vyvanse, speak with your doctor about what you need to know.

Before starting treatment, your doctor should be informed about conditions or circumstances such as:

  • Allergies: Inform your doctor if you are allergic to any foods, preservatives, dyes, or if you’ve had a previous allergic reaction to this drug.
  • Children: Vyvanse is safe to use in children ages six and older. Safety is not established for children younger than six.
  • Elderly: This medicine does not cause any different side effects or problems in the elderly than it does in younger adults. However, there may be age-related problems, so the drug should be used cautiously.
  • Pregnancy: Vyvanse is a category C drug. There are no studies that prove its safety during pregnancy, so consult your doctor and discuss the benefits and risks of using lisdexamfetamine while you are pregnant.
  • Breastfeeding: There are no adequate studies which prove that lisdexamfetamine passes into breast milk. If you are using lisdexamfetamine while nursing, discuss it with your doctor for possible risks.
  • Drug Interactions: Lisdexamfetamine interacts with many drugs, so it should not be used with certain ones. Vyvanese is known to have 39 major drug interactions, 434 moderate, and 12 minor. Your doctor should be informed of any other medicines you are taking, as the dosage or the drug entirely may need to be changed.

Some of the drugs Vyvanse interacts with are listed below:

  • MAOIs (phenelzine), which may cause side effects such as severe high blood pressure, fever, headache, and irregular heartbeat
  • Alkalinizing agents (acetazolamide, sodium bicarbonate), which can increase the risk of lisdexamfetamine's side effects
  • Ascorbic acid (vitamin C) or urinary acidifiers (Methenamine, ammonium chloride), as these may decrease lisdexamfetamine's effectiveness

Several other conditions may reduce the effectiveness of Vyvanse.

Inform your doctor about all prescription and over-the-counter medications, dietary supplements, vitamins, and herbal supplements you are taking. The following drugs should not be taken with Vyvanse:

  • MAOIs, such as Nardil (phenelzine), Marplan (isocarboxazid), and Parnate (tranylcypromine)
  • Diet drugs, such as benzphetamine (didrex), phentermine (adipex-P), and phendimetrazine (Bontril PDM)
  • Procazine (matulane)
  • Selegiline, including Emsam, Zelapar, and Eldepryl
  • Drugs that make urine more acidic, such as sodium bicarbonate and vitamin C
  • Alcohol, which can make the side effects of Vyvanse worse 

Vyanse is known to interact with Lexapro. If taken together, they may cause side effects such as anxiety, nervousness, jitteriness, restlessness, and racing thoughts. Combined use may also cause a serious condition called serotonin syndrome. Although it’s rare, serotonin syndrome may cause side effects such as hallucinations, seizures, confusion, increased heart rate, changes in blood pressure, excessive sweating, fever, shivering, muscle spasms, blurred vision, stiffness, incoordination, tremors, nausea, stomach cramps, diarrhea, and vomiting. Severe cases may cause coma or even death.

Make sure you inform your doctor of conditions such as:

  • A history of alcohol or other substance abuse
  • Allergies to any ingredients in lisdexamfetamine or similar medicines
  • Serious heart problems (heart defect, irregular heartbeat, cardiomyopathy, arrhythmias)
  • Stroke
  • Blood vessel problems (Raynaud disease)
  • Bipolar disorder (manic-depressive illness), or a family history of it
  • Mania
  • Motor tics (repeated muscle movements)
  • Psychosis (mental illness)
  • Seizures, or a history of them
  • Tourette's syndrome, or a family history of it

3 Proper Usage

To use Vyvanse properly, you must follow all instructions given by your doctor. It comes with an extra patient information guidance sheet called a medication guide. Read and understand it before using Vyvanse.

Do not use it more than recommended, as you may develop an addiction to it. If you feel it is not working properly, do not increase the dosage without consulting your doctor.

It is best to take it in the morning with or without food. It may cause trouble sleeping if taken in the afternoon or evening.

The capsule should be swallowed; do not crush or chew it. If you or your child has difficulty swallowing it, you may carefully open the capsule and pour it into a glass of water, orange juice, or yogurt. Mix it well and drink immediately. Do not keep it for future use.

Before a child, adolescent, or adult is prescribed Vyvanse, they are assessed for the presence of any cardiac disease. The doctor will check the patient’s family history and perform a physical examination. The risk of abuse is also assessed before prescribing this medication in order to reduce this possibility. After the medication is prescribed, prescription records are carefully maintained, patients are educated about substance abuse, and the doctor monitors any signs of overdose or abuse.

The dosage of the drug is different for each patient and is based on body weight. The following information includes an average dose of Vyvanse:

  • Dosage for moderate to severe binge eating disorder in adults: The starting dose is 30mg/day. In order to meet the recommended dose target of 50–70mg/day, it needs to be titrated in increments of 20mg at weekly intervals. The maximum recommended dose is 70mg/day. If the binge eating disorder does not improve, stop the medication.
  • Dosage for renal impairment: The maximum dose for a patient with severe renal impairment is 50mg/day. The maximum recommend dose for patients with end stage renal disease is 30mg/day.
  • Drug modification due to drug interactions: Some drugs can make the urine acidic by altering its pH and impact its excretion. They can also alter the level of amphetamine in the blood: sodium bicarbonate is an alkalinizing agent that can increase the blood level, whereas ascorbic acid is an acidifying agent that can decrease the blood level. Hence, the dosage of Vyvanese should be adjusted accordingly. 

The capsules are available in doses of 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg and 70mg. The chewable tablets are available in doses of 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, and 60mg. The time-release formulation has been designed to maintain a steady level of medicine in the body over the entire day. The optimal dosage varies from patient to patient. The doctor will adjust the dosage weekly by increasing 10–20mg until the best response is achieved. At the lowest dosage, a child may experience improvement without any side effects. The maximum dosage is 70mg per day. During the course of treatment, the doctor may tell the patient to stop taking the medicine in order to monitor symptoms. The doctor may check the blood pressure, heart, and blood statistics. Height and weight may also be evaluated. If there are any problems, the doctor may suggest stopping the medication. After long-term use, some patients develop a tolerance to the medication. So, if you feel the dosage is not helping you, talk to your doctor.

For attention deficit/hyperactivity disorder (ADHD):

  • For adults and children: Average dose is 30mg once a day. Your doctor may increase your dose if necessary.

For moderate to severe binge eating disorder (BED):

  • Adults: At least 30mg once a day in the morning
  • Children: Dosage is determined by the doctor.

If you miss a dose of lisdexamfetamine, skip the missed one and go back to your regular dosing schedule. Do not take two doses at once.

If you have overdosed, you may experience the following symptoms:

  • Restlessness
  • Muscle twitches
  • Rapid Breathing
  • Confusion
  • Hallucinations
  • Panic
  • Tremor
  • Aggressiveness
  • Muscle pain or weakness
  • Fever
  • Dark-colored urine

Other symptoms may include:

Store the medicine at room temperature and keep it away from children.

4 Precautions To Take

If you take Vyvanse, your doctor should perform routine checkups and advise you on taking precautions.

Vyvanse may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines.

Do not drive or perform other possibly unsafe tasks until you know how you react to the medicine. Inform your doctor immediately if you experience chest pain, nausea, vomiting, or shortness of breath; these are symptoms of heart failure, as this drug increases the risk of it, especially if you have a family history of heart failure.

In some cases, Vyvanse may affect growth rate and weight gain in children and teenagers. They may need regular growth and weight checks while taking lisdexamfetamine.

Vyvanse may cause circulation problems in the hands and feet. Inform your doctor immediately if you experience numbness, tingling, changes in skin color, or sores or wounds on the fingers and toes.

Before any medical, surgical, or emergency procedures, inform your doctor if you are taking Vyvanse.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Vyvanse. Some people may experience minor or no side effects. Consult your doctor if they become problematic or frequent:

The most common side effects are:

Less common side effects are:

  • Uncontrolled vocal outbursts
  • Tics (i.e., uncontrolled, repeated body movements)

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Call the doctor if you experience any of the following:

  • Chest pain
  • Lightheadedness
  • Hallucinations
  • Penile erection that lasts a long time and is painful
  • Numbness, cold feeling, or skin color changes in the fingers and toes
  • Unexplained wounds
  • New behavior problems
  • Hostility, paranoia, and aggression
  • Unexplained muscle weakness, pain, or tenderness

Serious side effects include:

  • A sudden rise in blood pressure and racing heartbeat
  • Poor circulation
  • Stunted growth in children
  • Tourette’s syndrome

One serious side effect of Vyvanse is it may slow the growth of children. It can also impair a teenager’s ability to drive, operate heavy machinery, or perform any big or dangerous tasks. However, this side effect goes away with time. A majority of people do not experience any symptoms. If you have any heart-related problems or a family history of blood pressure or heart problems, talk to your doctor. People with serious heart problems or any cardiac abnormalities have experienced stroke, heart attack, increased blood pressure, and death while taking Vyvanse. Vyvanse can increase one’s heart rate and blood pressure. The doctor should closely monitor the patient’s condition. If your child experiences chest pain, fainting, or shortness of breath while on this medication, immediately contact your doctor. 

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