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Dosage and Administration

Take VYVANSE by mouth in the morning with or without food; avoid afternoon doses because of the potential for insomnia. VYVANSE may be administered in one of the following ways:

-Swallow VYVANSE capsules whole, or

-Open capsules, empty and mix the entire contents with yogurt, water, or orange juice. If the contents of the capsule include any compacted powder, a spoon may be used to break apart the powder. The contents should be mixed until completely dispersed. Consume the entire mixture immediately. It should not be stored. The active ingredient dissolves completely once dispersed; however, a film containing the inactive ingredients may remain in the glass or container once the mixture is consumed.

-VYVANSE chewable tablets must be chewed thoroughly before swallowing.

VYVANSE capsules can be substituted with VYVANSE chewable tablets on a unit per unit/ mg per mg basis (for example, 30 mg capsules for 30 mg chewable tablet) [see Clinical Pharmacology].

Do not take anything less than one capsule or chewable tablet per day. A single dose should not be divided.

Dosage Modifications due to Drug Interactions

Agents that alter urinary pH can impact urinary excretion and alter blood levels of amphetamine.

Acidifying agents (e.g., ascorbic acid) decrease blood levels, while alkalinizing agents (e.g., sodium bicarbonate) increase blood levels. Adjust VYVANSE dosage accordingly [see Drug Interactions.

Dosage for Treatment of ADHD

The recommended starting dose is 30 mg once daily in the morning in patients ages 6 and above.

Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals up to maximum dose of 70 mg/day [see Clinical Studies

Dosage for Treatment of Moderate to Severe BED in Adults

The recommended starting dose is 30 mg/day to be titrated in increments of 20 mg at approximately weekly intervals to achieve the recommended target dose of 50 to 70 mg/day. The maximum dose is 70 mg/day [see Clinical Studies. Discontinue VYVANSE if binge eating does not improve.

Dosage in Patients with Renal Impairment

In patients with severe renal impairment (GFR 15 to < 30 mL/min/1.73 m2), the maximum dose should not exceed 50 mg/day. In patients with end stage renal disease (ESRD, GFR < 15 mL/min/1.73 m2), the maximum recommended dose is 30 mg/day [see Use in Specific Populations.

Side Effects

Vyvanse side effects may include:

 

  • Dry mouth,
  • Loss of appetite,
  • Weight loss,
  • Sleep problems (insomnia)
  • Fast heart rate, feeling jittery,
  • Dizziness,
  • Feeling anxious or irritable
  • Nausea,
  • Vomiting,
  • Stomach pain,
  • Diarrhea,

Contraindications

-Cardiovascular

Moderate to severe hypertension

Advanced arteriosclerosis

Symptomatic cardiovascular disease

-General

Hyperthyroidism

Known hypersensitivity or idiosyncrasy to the sympathomimetic amines

Allergy to amphetamines or to components of VYVANSE or its container

Glaucoma

Agitated states

Patients with a history of drug abuse.

Warnings

Children and Adolescents

Sudden death has been reported in association with CNS stimulant treatment at usual doses in children and adolescents with structural cardiac abnormalities or other serious heart problems. Although some serious heart problems alone carry an increased risk of sudden death, stimulant products generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy,serious heart rhythm abnormalities, or other serious cardiac problems that may place them at increased vulnerability to the sympathomimetic effects of a stimulant drug.

Adults

Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses for ADHD. Although the role of stimulants in these adult cases is also unknown, adults have a greater likelihood than children of having serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems. Adults with such abnormalities should also generally not be treated with stimulant drugs. WIKI

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