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lisdexamfetamine dimesylate
Vyvanse
CNS stimulant⚠ Unverified beta content
At a glance
- Class
- CNS stimulant (amphetamine prodrug); Schedule II
- Black box
- ⚠ Abuse, misuse, and addiction
- Key monitoring
- Blood pressure & heart rate
- Abuse / misuse / diversion risk
- Usual adult dose
- ADHD (label): Start 30 mg every morning; ↑ 10–20 mg weekly; recommended 30–70 mg/day; max 70 mg/day
- Call provider / escalate if
- Chest pain, shortness of breath, fainting, or racing/irregular heartbeat • New hallucinations, paranoia, or manic symptoms (very high energy, little need for sleep) • Severe headache or very high blood pressure
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- lisdexamfetamine dimesylate (Vyvanse) — cNS stimulant (amphetamine prodrug); Schedule II.
- Used for: ADHD; Moderate to severe binge eating disorder; Not indicated for weight loss.
Usual adult dosing
- ADHD (label): Start 30 mg every morning; ↑ 10–20 mg weekly; recommended 30–70 mg/day; max 70 mg/day
- Binge eating disorder (label): Start 30 mg every morning; ↑ 20 mg weekly to 50–70 mg/day; max 70 mg/day
- Renal impairment: Severe: max 50 mg/day; ESRD: max 30 mg/day
Boxed warning
- Abuse, misuse, and addiction: high potential for abuse and misuse, which can lead to substance use disorder including addiction; misuse can result in overdose and death (risk higher with higher doses or non-oral routes such as snorting/injection). Assess risk before prescribing, educate about safe storage/disposal, and reassess frequently during treatment.
Monitor
- Blood pressure & heart rate [Baseline, after dose changes, periodically]
- Abuse / misuse / diversion risk [Every visit; before refills]
Nursing priorities
- Baseline BP, HR, weight (height/growth in children), sleep, appetite.
- Cardiac history, family history of sudden death or ventricular arrhythmia.
- Give early in the day (last dose before ~6 pm) to limit insomnia, unless otherwise ordered.
- Check BP and pulse at baseline, after dose changes, and periodically; report sustained elevations.
- Monitor weight/appetite; offer meals before dose/high-calorie snacks as appropriate.
Major interactions
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days: Hypertensive crisis – contraindicated.
- Serotonergic drugs: Increased risk of serotonin syndrome.
Key teaching
- Take it exactly as prescribed, usually in the morning. Taking it late in the day can keep you awake.
- Never share it, sell it, or take extra – it can be misused and is dangerous in overdose. Keep it locked up and dispose of leftovers safely.
- It can lower your appetite, raise your heart rate and blood pressure, and make it hard to sleep. Eat regular meals and have your vitals checked.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Abuse, misuse, and addiction: high potential for abuse and misuse, which can lead to substance use disorder including addiction; misuse can result in overdose and death (risk higher with higher doses or non-oral routes such as snorting/injection). Assess risk before prescribing, educate about safe storage/disposal, and reassess frequently during treatment.
Other serious warnings
- Serious cardiovascular reactions
- Increased BP/HR
- Psychiatric adverse reactions (psychosis, mania)
- Growth suppression in children
- Peripheral vasculopathy incl. Raynaud’s
- Serotonin syndrome
- Motor/verbal tics
- Hypersensitivity (incl. anaphylaxis, SJS reported); contraindicated with MAOIs (or within 14 days)
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
- Blood pressure & heart rateWhen: Baseline, after dose changes, periodicallyReport sustained increases
- Abuse / misuse / diversion riskWhen: Every visit; before refills
- Weight / appetite (height & growth in children)When: Baseline and periodically
- Sleep / anxiety / psychiatric symptoms (mania, psychosis, tics)When: Every visit
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
Assessment
- Baseline BP, HR, weight (height/growth in children), sleep, appetite.
- Cardiac history, family history of sudden death or ventricular arrhythmia.
- Personal/family history of bipolar disorder, psychosis, tics/Tourette’s, substance use disorder.
- Current meds (MAOIs within 14 days are contraindicated), supplements, caffeine/energy-drink use.
Interventions
- Give early in the day (last dose before ~6 pm) to limit insomnia, unless otherwise ordered.
- Check BP and pulse at baseline, after dose changes, and periodically; report sustained elevations.
- Monitor weight/appetite; offer meals before dose/high-calorie snacks as appropriate.
- Controlled substance (CII): count/store/dispense per facility policy; watch for diversion, misuse, or requests for early refills.
- Screen each visit for new anxiety, agitation, psychosis or manic symptoms.
- Capsule may be swallowed whole or opened and mixed completely in yogurt, water, or orange juice and taken immediately; chewable tablets must be chewed thoroughly.
- Take in the morning; avoid afternoon doses.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Chest pain, shortness of breath, fainting, or racing/irregular heartbeat
- New hallucinations, paranoia, or manic symptoms (very high energy, little need for sleep)
- Severe headache or very high blood pressure
- Signs of misuse: taking extra doses, running out early, crushing/snorting
- Fingers or toes that turn pale, blue, cold or painful (peripheral vasculopathy)
- Erection lasting more than 4 hours
- Agitation, fever, sweating, tremor, muscle stiffness (serotonin syndrome, esp. with serotonergic drugs)
- Severe weight loss or inability to eat
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Decreased appetite, weight loss
- Insomnia
- Dry mouth
- Headache
- Increased heart rate / blood pressure
- Anxiety, irritability
- Nausea, abdominal pain, diarrhea
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days MajorHypertensive crisis – contraindicated.
- Serotonergic drugs MajorIncreased risk of serotonin syndrome.
- CYP2D6 inhibitorsMay increase amphetamine exposure.
- Urinary/GI acidifying or alkalinizing agentsAcidifying agents lower, alkalinizing agents raise amphetamine levels.
- AntihypertensivesMay decrease antihypertensive effect.
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
- Take it exactly as prescribed, usually in the morning. Taking it late in the day can keep you awake.
- Never share it, sell it, or take extra – it can be misused and is dangerous in overdose. Keep it locked up and dispose of leftovers safely.
- It can lower your appetite, raise your heart rate and blood pressure, and make it hard to sleep. Eat regular meals and have your vitals checked.
- Do not take it with, or within 14 days of, certain depression medicines called MAOIs. Tell every provider and pharmacist what you take.
- Avoid too much caffeine and energy drinks.
- Tell your provider about chest pain, fainting, strange thoughts, or if your fingers/toes turn pale or blue.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- ADHD (≥6 years and adults)
- Moderate to severe binge eating disorder (adults)
- Not indicated for weight loss
Dosing
- ADHD (label): Start 30 mg every morning; ↑ 10–20 mg weekly; recommended 30–70 mg/day; max 70 mg/day
- Binge eating disorder (label): Start 30 mg every morning; ↑ 20 mg weekly to 50–70 mg/day; max 70 mg/day
- Renal impairment: Severe: max 50 mg/day; ESRD: max 30 mg/day
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
Prescriber-oriented details; limited in this beta.
renal Adjustment
- GFR 15–<30: max 50 mg/day; ESRD: max 30 mg/day (label).
Sources: FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VY
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): VYVANSE (LISDEXAMFETAMINE DIMESYLATE) CAPSULE VYVANSE (LISDEXAMFETAMINE DIMESYLATE) TABLET, CHEWABLE [TAKED…
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified
Reviewer notes – please double-check
- Dosing from the Vyvanse label; boxed warning updated by FDA (2023) to “Abuse, Misuse, and Addiction”.