Lisdexamfetamine Dimesylate (CNS Agent for ADHD)

Question 1

What are the brand names for Lisdexamphetamine Dimesylate?

Answer 1

Vyvanse

Question 2

What are the available capsule strengths of Vyvanse?

Answer 2

10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg

Question 3

What are the available doses of chewable tablet Vyvanse?

Answer 3

10 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg

Question 4

What are the two FDA approved indications for Lisdexamfetamine Dimesylate?

Answer 4

For the treatment of ADHD and patients over the age of six years:
- Dose: the recommended starting dose is 30 mg per day given as a single dose in the morning. Dosage adjustments of 10 mg to 20 mg may be made weekly intervals. The maximum recommended dose is 70 mg per day.

For the treatment of moderate to severe binge eating disorder in adults:
- Dose: the recommended starting dose is 30 mg per day with 20 mg titrations a weekly intervals to reach the target does a 50 to 70 mg per day

Question 5

What is the mechanism of action of Vyvanse?

Answer 5

In adults that causes CNS stimulation by a direct action on adrenergic receptors, releasing norepinephrine from storage sites.

Question 6

What are the drug interactions of Vyvanse?

Answer 6

• Effects may be increased when used with monoamine oxidase inhibitor’s and furazolidone.
• Urine alkalinizing agents (sodium bicarbonate) decrease excretion by GI alkalinizing agents increase absorption.
• May decrease effects of antihypertensives.
• May increase the effects of tricyclic antidepressants and meperidine.
• Chlorpromazine, haloperidol, and lithium carbonate decrease effects.

Question 7

What are the contraindications of Vyvanse?

Answer 7

• Contraindicated in advance arterial sclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hypothyroidism, known hypersensitivity or idiosyncratic reaction to sympathomimetic amines, glaucoma, agitated states, and patients with a history of drug abuse, and during or within 14 days following the administration monoamine oxidase inhibitor’s (hypertensive crisis may result).
• CNS stimulants have a high potential for abuse and dependance
• Used with caution in patients with pre-existing psychosis, bipolar illness or history of seizures.
• Pregnancy Category C

Question 8

What are the adverse effects of Vyvanse?

Answer 8

May cause decreased appetite, insomnia, dry mouth, diarrhea, nausea, anxiety, restlessness, increased blood pressure, dyspnea, and tachycardia. Rare cases of Stevens Johnson syndrome have been reported.

Question 9

What should the RPH tell the patient when counseling them on Vyvanse?

Answer 9

• May be taken with or without food.
• Take in the morning to avoid insomnia.
• Capsules may be swallowed whole or opened in the entire contents dissolved in a glass of water. If dissolved in water, the solution should be consumed immediately and should not be stored.
• May cause dizziness, use caution when performing activities that require coordination.
• Do not exceed prescribed dosages.
• This prescription cannot be refilled.
• Warning, this medication may be habit-forming.
• If a dose is missed, skip it and return to normal dosing schedule.