Lisdexamfetamine: Difference between revisions

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{{MedTemplate

| generic = Lisdexamfetamine

| generic = Lisdexamfetamine (dimesylate)

| brand = Vyvanse

| brand = Vyvanse, Elvanse (EU)

| classes = Amphetamine, ~~Psychostimulant~~

| structure =

| mechanism = ~~Prodrug~~ of dextroamphetamine

| classes = [[:Category:Psychostimulants|Psychostimulant]], [[:Category:Amphetamines|Amphetamine]], [[:Category:ADHD medicines|ADHD medicine]], [[:Category:Schedule II controlled substances|Schedule II controlled substance]]

| uses = <vote slug="adhd-lisdex-use">Attention-deficit/hyperactivity disorder (FDA, ages 6+ and adult)</vote>, <vote slug="binge-eating-disorder-use">Binge-eating disorder in adults (FDA)</vote>

| starting_dose = ADHD: 30 mg PO once daily in the morning; titrate by 10-20 mg weekly to clinical effect. Binge-eating disorder: 30 mg/day, titrate to 50-70 mg/day

| preparations = Capsules 10, 20, 30, 40, 50, 60, 70 mg; chewable tablets 10, 20, 30, 40, 50, 60 mg

| fda_max = 70 mg/day

| pill_id =

| routes = Oral

| onset = 1-2 hours (slower than immediate-release amphetamine because activation requires enzymatic cleavage in red blood cells)

| duration = 10-12 hours (smoother profile than immediate-release amphetamine salts)

| halflife = Parent lisdexamfetamine <1 hour; dextroamphetamine 10-12 hours after release<ref name="vyvanse-label">FDA Prescribing Information, Vyvanse (lisdexamfetamine dimesylate), Takeda/Shire, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021977s045lbl.pdf</ref>

| bioavailability = ~96% after red blood cell hydrolytic cleavage releases dextroamphetamine<ref name="vyvanse-label" />

| pregnancy = Limited human data; the amphetamine class is associated with intrauterine growth restriction and neonatal withdrawal symptoms.{{citation needed}}

| legal = [[USLegal:Schedule II|Schedule II controlled substance]] in US<ref name="vyvanse-label" />

| mechanism = <vote slug="lisdexamfetamine-mech-claim">Lisdexamfetamine is an inactive lysine-conjugated parent compound that requires enzymatic cleavage by red blood cell hydrolases to release active dextroamphetamine. The red-blood-cell-dependent conversion provides a slower, smoother release profile than immediate-release amphetamine salts, and is the basis of the abuse-deterrent design: IV administration bypasses the necessary RBC cleavage and produces no peak effect, and intranasal misuse offers little kinetic advantage over oral administration.</vote> Once converted, dextroamphetamine acts by displacing dopamine and norepinephrine from presynaptic vesicles via VMAT-2 and reversing DAT and NET transport, the shared mechanism of all amphetamine-class agents<ref name="vyvanse-label" />.

}}

== References ==

[[Category:Psychostimulants]]

[[Category:Amphetamines]]

[[Category:ADHD medicines]]

[[Category:Schedule II controlled substances]]

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