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Vyvanse

(lisdexamfetamine)

How does this medication work? What will it do for me?

Lisdexamfetamine belongs to the class of medications known as central nervous system stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD). It works by affecting the balance of natural chemicals in the brain. It helps to increase attention and decrease hyperactivity and impulsiveness in children with ADHD. Lisdexamfetamine should be part of a treatment plan that includes other treatments (e.g., counselling, education).

Lisdexamfetamine is also used to treat moderate-to-severe binge eating disorder (BED) in adults.

Your child's doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your child's doctor, or are not sure why your child is taking this medication, speak to their doctor. Your child should not stop taking this medication without consulting their doctor.

Do not give this medication to anyone else, even if they have the same symptoms as your child. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

For the treatment of ADHD, the usual starting dose of lisdexamfetamine is 30 mg once a day in the morning. Afternoon doses should be avoided, as this medication may cause difficulty sleeping.

Although doses larger than 30 mg have not been shown to be more effective, and often cause more side effects, your doctor may choose to increase the dose gradually if the lower dose is not fully effective. The maximum daily dose is 60 mg per day.

For the treatment of binge eating disorder, the usual starting dose of lisdexamfetamine is 30 mg once a day in the morning. Your doctor may increase your dose on a weekly basis to a usual treatment dose of 50 to 70 mg. The maximum daily dose is 70 mg per day. Afternoon doses should be avoided, as this medication may cause difficulty sleeping.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Lisdexamfetamine may be taken with or without food. The capsules may be taken whole, or the contents of the capsule can be mixed with yogurt or dissolved in a glass of water or orange juice. Any compacted powder should be broken apart with a spoon. The contents of the entire capsule should be taken immediately.

It is important for you to take this medication exactly as prescribed by your doctor. If you miss a dose in the morning, skip the missed dose and wait until the next day to continue with their regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after you miss a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?

10 mg
Each capsule with pink body and pink cap imprinted with "S489 10 mg" contains 10 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide.

20 mg
Each capsule with ivory body and ivory cap imprinted with "S489 20 mg" contains 20 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide.

30 mg
Each capsule with white body and orange cap imprinted with "S489 30 mg" contains 30 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide No. 40.

40 mg
Each capsule with white body and blue-green cap imprinted with "S489 40 mg" contains 40 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide.

50 mg
Each capsule with white body and blue cap imprinted with "S489 50 mg" contains 50 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide.

60 mg
Each capsule with aqua blue body and aqua blue cap imprinted with "S489 60 mg" contains 60 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: microcrystalline cellulose, croscarmellose sodium, and magnesium stearate; capsule shell: gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, FDA/E172 yellow iron oxide.

70 mg
Each capsule with blue body and orange cap imprinted with “S489 70 mg” contains 70 mg of lisdexamfetamine dimesylate. Nonmedicinal ingredients: croscarmellose sodium, magnesium stearate and microcrystalline cellulose. The capsule shells contain edible ink, gelatin, titanium dioxide, and one or more of the following: FD&C Yellow No. 6, FD&C Blue No. 1, FD&C Red No. 3, FDA/E172 black iron oxide, and FDA/E172 yellow iron oxide.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to lisdexamfetamine or any ingredients of the medication
  • are allergic to amphetamines or related medications (e.g., epinephrine)
  • are in an agitated state
  • have a history of drug misuse
  • have an overactive thyroid
  • have glaucoma
  • have hardened arteries (arteriosclerosis)
  • have heart disease with symptoms (e.g., chest pain, shortness of breath)
  • have moderate to severe high blood pressure
  • have taken a monoamine oxidase inhibitor (MAOI; e.g., phenelzine, tranylcypromine, moclobemide) within the last 14 days

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • anxiety
  • decreased or loss of appetite
  • diarrhea
  • difficulty sleeping
  • dizziness
  • dry mouth
  • headache
  • increased sweating
  • irritability
  • nausea
  • upper belly pain
  • vomiting
  • weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • behaviour changes (agitation, aggression, paranoia)
  • blurred vision
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • increased blood pressure
  • mania (racing thoughts, rapid talking, impulsiveness, extremely elevated mood, extremely high energy)
  • mood swings
  • pounding or fast heartbeat
  • Raynaud’s phenomenon (e.g., bluish, white or purple discolouration of fingers and toes, sensation of cold and/or numbness, pain)
  • signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • signs of heart problems (e.g., fast or irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
  • signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • slowed growth
  • swelling of the legs
  • new tics (involuntary movements or vocalizations)
  • vision changes

You should stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
  • suicidal thoughts or behaviour
  • symptoms of a severe allergic reaction (hives; difficulty breathing; swelling of the face, mouth, tongue, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, and any other significant facts about your health. These factors may affect how you should take this medication.

HEALTH CANADA ADVISORY

March 30, 2015

Health Canada has issued new restrictions concerning drugs used in the management of Attention Deficit Hyperactivity Disorder (ADHD). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Behaviour changes: This medication can cause behaviour changes such as increased aggression and agitation. If you seem more aggressive or have other behaviour changes while taking this medication, contact your doctor.

Blood pressure: Lisdexamfetamine and other stimulant medications can cause an increase in blood pressure and heart rate. Your doctor will monitor your blood pressure and heart rate while you are taking this medication.

If you have high blood pressure, heart failure, or an abnormal heart rhythm, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with moderate-to-high blood pressure should not use this medication.

Dependence: This medication has the potential to be misused. People with a history of past or current substance-use problems may be at greater risk of developing abuse or addiction while taking this medication. Abuse of medications such as lisdexamfetamine can result in serious heart problems and death.

People who have taken too much of this medication may experience difficulty sleeping, irritability, hyperactivity, and personality changes. If you notice any of these symptoms, contact your doctor immediately.

Dizziness and vision changes: This medication may cause side effects including blurred vision, trouble focusing, and dizziness. These side effects may affect your  ability to perform dangerous activities or drive. Ensure you are  not experiencing these side effects before performing such activities.

Growth and weight gain: This medication can cause children to lose weight and can slow their growth rate. The doctor will monitor them for slowed growth while they are taking this medication. Children who are not growing or gaining weight as expected may need to stop their treatment with this medication, as recommended by their doctor.

Heart effects: When given at usual doses, lisdexamfetamine and other stimulant medications can cause sudden death in children with heart defects and other serious heart problems. This medication should generally not be given to people with heart defects and other heart problems (e.g., enlarged heart, serious abnormal heart rhythms).

If you have a heart problem, exercises strenuously, or have a family history of sudden death, talk with your doctor about how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Children with heart disease or hardening of the arteries should not use this medication.

If you experience chest pain, shortness of breath, or fainting while taking this medication, contact your doctor immediately.

Lisdexamfetamine can cause increased blood pressure and heart rate in adults. There have been reports of sudden death, stroke, and heart attack among adults taking other stimulant medications. Generally, adults with heart defects and other heart problems should not take this medication.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Mental health issues: This medication can worsen mental health issues such as psychosis or bipolar disorder. Before starting this medication, people with depression (feelings of sadness, hopelessness, or worthlessness) should be properly screened to ensure they do not have or are not at risk for bipolar disorder.

If you experience hallucinations (seeing, hearing, or feeling things that are not there), distorted thoughts, or mania (racing thoughts, rapid talking, impulsiveness, extremely elevated mood, extremely high energy), contact your doctor immediately.

Seizures: This medication may increase the risk of seizures, especially for people with seizure disorders. If you have a history of epilepsy or medical conditions that increase your risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you have a seizure while taking this medication, get immediate medical attention. This medication should be stopped if seizures occur.

Suicidal or agitated behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. Suicidal thoughts or behaviours may occur at any time during treatment. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Tics: This medication may worsen motion and verbal tics, or Tourette's syndrome. If you have tics or Tourette's syndrome, discuss with your doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: Although this medication is intended to for children and adolescents 6 to 17 years of age, it may be used by older individuals with ADHD and adults with binge eating disorder. It is still important to note that this medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking lisdexamfetamine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

Seniors: Older adults are more likely to have conditions such as high blood pressure that can make taking lisdexamfetamine dangerous. This medication is not recommended for people over 55 years old.

What other drugs could interact with this medication?

There may be an interaction between lisdexamfetamine and any of the following:

  • acetazolamide
  • aliskiren
  • alpha agonists (e.g., clonidine, methyldopa)
  • ammonium chloride
  • angiotensin-converting enzyme inhibitors (ACEIs; captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., candasartan, irbesartan, losartan)
  • antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
  • antihistamines (e.g., cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • ascorbic acid (vitamin C)
  • atomoxetine
  • beta-blockers (e.g., atenolol, propranolol)
  • bromocriptine
  • fast acting bronchodilators (e.g., salbutamol, terbutaline)
  • long acting bronchodilators (e.g., formoterol, salmeterol)
  • buspirone
  • caffeine
  • calcium channel blockers (e.g., diltiazem, nifedipine, verapamil)
  • cyclobenzaprine
  • decongestant cold medications (e.g., phenylephrine, pseudoephedrine)
  • decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
  • dextroamphetamine
  • dextromethorphan
  • dipivefrin
  • diuretics (water pills; e.g., furosemide, metolazone, hydrochlorothiazide)
  • dobutamine
  • dopamine
  • epinephrine
  • ergot alkaloids (e.g., ergotamine, dihydroergotamine)
  • ethosuximide
  • hydralazine
  • linezolid
  • lithium
  • methylphenidate
  • mirtazapine
  • meperidine
  • methadone
  • methenamine
  • methylene blue
  • lithium
  • monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • multivitamins (with ADE)
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • norepinephrine
  • phenobarbital
  • phenytoin
  • proton pump inhibitors (e.g., lansoprazole, omeprazole)
  • St. John's wort
  • serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • sodium bicarbonate
  • tapentadol
  • theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
  • tramadol
  • trazodone
  • tricyclic antidepressants (e.g., amitriptyline, desipramine)
  • "triptan" migraine medications (e.g., rizatriptan, sumatriptan)
  • tryptophan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Vyvanse

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