lisdexamfetamine, Vyvanse (cont.)

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PREPARATIONS: Capsules: 20, 30, 40, 50, 60, and 70 mg

DRUG INTERACTIONS: Monoamine oxidase inhibitor (MAOIs) antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane), slow the elimination of amphetamines in the body. This increases the concentration of amphetamines and their effect. This can cause serious elevations in blood pressure (hypertensive crisis) with headaches, other signs of hypertensive crisis, and even fatal reactions. Lisdexamfetamine should not be administered until 14 days after MAOIs have been discontinued in order to allow the effects of the MAOIs to dissipate.

Amphetamines increase the effect of norepinephrine. Combining both drugs may lead to serious cardiovascular toxicity.

PREGNANCY AND BREASTFEEDING SAFETY: There are no adequate studies of lisdexamfetamine in pregnant women. Amphetamines may cause premature delivery, low birth weight, and withdrawal symptoms in infants born to mothers who are dependent on amphetamines. Amphetamines are excreted in breast milk. Mothers taking amphetamines should not breastfeed.

STORAGE: Lisdexamfetamine should be stored at room temperature, 15 C to 30 C (59 F to 86 F), and protected from light.

DOSING: The recommended dose of lisdexamfetamine for adults and pediatric patients ages (6-12) is 30 mg once daily in the morning. Doses may be increased by 10-20 mg/day at weekly intervals. The maximum dose is 70 mg daily. Lisdexamfetamine should not be administered in the afternoon because it may cause insomnia. Capsules may be swallowed whole or the contents may be dissolved in a glass of water.

DRUG CLASS AND MECHANISM: Lisdexamfetamine is an oral drug used for increasing attention and decreasing impulsiveness and hyperactivity in patients with attention deficit hyperactivity disorder (ADHD). Lisdexamfetamine is a prodrug; after administration it is converted to dextroamphetamine (Adderall) in the intestines and/or liver. The dextroamphetamine, an amphetamine and stimulant for the brain, is responsible for the effect of lisdexamfetamine in ADHD. The mechanism of action of dextroamphetamine in ADHD is unknown, but scientists believe that they may stimulate the nervous system by increasing the release or reducing the inactivation of norepinephrine and dopamine in the brain. Norepinephrine and dopamine are chemicals (neurotransmitters) that nerves use for communicating with each other. The net effect of amphetamines is an increase in the effects of dopamine and norepinephrine. The FDA approved lisdexamfetamine in February 2007.

Medically reviewed by Eni Williams, PharmD

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 1/14/2016

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