Vyvanse: Uses, Side Effects, Dosage, & More

What Is Vyvanse Used to Treat?

Vyvanse is used to treat attention-deficit hyperactivity disorder (ADHD) and binge eating disorders. Vyvanse is one of the first-line treatments for ADHD for those 6 years of age and older. For binge eating disorders, Vyvanse is prescribed when the disorder is diagnosed to be moderate to severe in nature. Vyvanse is indicated for treating binge eating disorder in adults. Beyond the management of these orders, Vyvanse is not commonly prescribed.

Vyvanse is an FDA-approved medication to treat:¹

• Attention-deficit hyperactivity disorder (ADHD)
• Binge eating disorder

Sometimes, some medications can have an “off-label” use. This is when clinicians use their clinical judgment to use a certain medication for a condition beyond what the FDA has approved its use for. This is based on significant research done within the medical community and each clinician’s years of medical experience and expertise.

A prescriber might prescribe a medication as “off-label” because, in their professional opinion, the benefits of the medication outweigh the risk. Vyvanse is a medication that typically does not have commonly accepted “off-label” use. This does not mean that your clinician might not try to use Vyvanse to treat a condition beyond what it is typically FDA-approved for, but that this practice is very uncommon.

Who Should Not Take Vyvanse?

Vyvanse is not the right treatment for everybody – even if it is to treat and manage ADHD or binge eating symptoms. For example, those with ADHD under the age of 6 should not be treated with Vyvanse. Likewise, those with binge eating disorder under the age of 18 should not be treated with Vyvanse. Additionally, those with heart problems, such as abnormal heart rates or rhythms, are advised to avoid Vyvanse.

Vyvanse is to be used with caution in those who have a history of substance use disorder as well as it has addictive properties. Vyvanse should also be avoided by those who have had an allergic reaction to any amphetamine should not take Vyvanse. People taking other medications which increase serotonin in the central nervous system should also avoid Vyvanse. Taking these medications increases the risk of serotonin syndrome, a serious condition requiring medical care. These types of medications include selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs).

People who may need to avoid taking Vyvanse include:

• Children (under the age of 6 years for the treatment of ADHD and under the age of 18 years for the treatment of binge eating disorder)
• Those with heart problems
• Those with a history of substance abuse disorders
• Those with allergic reactions to amphetamines
• Those taking other medications that increase serotonin in the central nervous system (SSRIs, monoamine oxidase inhibitors, St. John’s Wort, tramadol, etc)
• Pregnant and breastfeeding women

Vyvanse Dosages for FDA-Approved Treatment

The right dosage of Vyvanse that is right for each individual is specific to them. You must work with your doctor once you and your doctor have decided that Vyvanse is a good medication for you to try in order to find a correct dosage that works for you. For the treatment of ADHD, Vyvanse is started at a dose of 30 mg every morning. If this dose does not adequately manage an individual’s ADHD symptoms, the dose can be increased by 10-20 mg per week by the prescribing physician until the individual reaches the correct dosage for them – a dosage that they can tolerate without the negative side effects, but is still effective.

The recommended dosage of Vyvanse for managing ADHD symptoms typically ends up being between 30 mg and 70 mg per day after the medication is appropriately titrated. 70 mg is the maximum dosage per day that is approved by the FDA for the treatment of ADHD.¹

To be approved by the FDA means that the medication has been studied and evaluated by the FDA and has been deemed appropriate for treating a certain medical condition at the dosages determined by their studies and evaluations.

For binge eating disorders, Vyvanse is also started at a dosage of 30 mg taken every morning. If this dosage is not seen as adequately managing the binge eating disorder, it can be adjusted up by 20 mg per week until a dosage that is effective but safe is reached. The recommended dosage of Vyvanse for treating binge eating disorder is 50-70 mg daily. 70 mg of Vyvanse is the maximum recommended dosage per day for the treatment of binge eating disorders as well.¹

Vyvanse Forms & Strengths

Vyvanse is only available in oral form. However, it comes as a capsule and as a chewable tablet. Both forms include a 10 mg, a 20 mg, a 30 mg, a 40 mg, a 50 mg, and a 60 mg version. Only the capsule comes in the 70 mg formulation of Vyvanse.¹ The right form and strength that is recommended for an individual can be based on different factors.

Typically, Vyvanse is prescribed with an initial dose of 30 mg daily and adjusted over the following weeks if needed and tolerated. As Vyvanse is the prodrug lisdexamfetamine, which then metabolizes to dextroamphetamine, Vyvanse is itself a long-acting stimulant (which is why it requires only 1 dosage per day). There is no other time-release version of Vyvanse itself.

As mentioned before, for treating ADHD, a patient must be at least 6 years or older for Vyvanse to be utilized. To treat binge eating disorder, the patient must be at least 18 years or older. The best way to start treatment is to always start at the lowest effective dose and then increase the dosage if and when needed.

Vyvanse is available in the following forms and strengths:

• Oral capsule: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, and 70 mg
• Oral chewable tablets: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg

Medications prescribed by your physician must be taken as they are prescribed.

How Should I Take Vyvanse?

Vyvanse is a once-a-day medication that is meant to be taken in the morning. If taken in the afternoon, it has a higher risk of causing insomnia. In the morning, Vyvanse can be taken with or without food. As Vyvanse is an extended-release medication, a single dose should not be divided. The capsules must be taken with their contents entirely. The capsules can be opened and the contents stirred into yogurt or water, but it must be consumed immediately as the active ingredient in Vyvanse dissolves quickly. The chewable tablets must be chewed thoroughly prior to swallowing for the best effect.¹

What Happens If I Miss a Dose of Vyvanse?

If you miss a dose of Vyvanse, but it is still earlier in the morning, you can consider taking your Vyvanse as soon as you remember. However, as the day progresses, the risk of insomnia increases if you take your Vyvanse later than the recommended time by your doctor. If you miss your dose of Vyvanse, but remember about it in the afternoon or evening, skip your dose for that day and restart your Vyvanse as prescribed the following morning.

Sudden discontinuation of Vyvanse after taking it for a while can cause you to experience withdrawal symptoms. This can include excessive fatigue or even symptoms of depression. Thus, discuss with your doctor prior to abruptly stopping Vyvanse if you have been taking it for a while. Additionally, if you miss a dose and try to catch up with extra doses, you might experience symptoms of overdose – such as significant anxiety, increased heart rate, increased blood pressure, or even sudden death.

Side Effects of Vyvanse

The side effects of Vyvanse typically include increased heart rate, dry mouth, irritability, restlessness, trouble sleeping, and loss of appetite.¹ This is all due to the direct stimulant effect that Vyvanse can have on your central nervous system. The side effects typically seem to be worse if you are taking a dose that is too high for you.

Common Side Effects of Vyvanse

The most common side effects of Vyvanse include dry mouth, decreased appetite, weight loss, irritability, trouble sleeping, and increased anxiety. If the side effects are minimal, sometimes they can go away on their own as you continue the medication. However, if these side effects do not go and continue to persist, are considered really significant, or get worse, you should see your health care provider immediately.

People with heart problems have an increased risk of adverse events, including death. Therefore, Vyvanse may not be the right medication for them.

Common side effects of Vyvanse include:

• Decreased appetite
• Anxiety
• Trouble sleeping
• Dry mouth
• Nausea
• Weight loss
• Insomnia

Serious Side Effects of Vyvanse

Vyvanse can cause serious side effects such as growth suppression (in children), circulation problems, heart problems, symptoms of serotonin syndrome, and possibly even death. This is why it is important that you have a doctor monitoring you while you are taking Vyvanse. This might mean frequent follow-up with in-patient visits to your doctor. If you are experiencing significant symptoms which are causing you or your loved ones concern, it is important to seek immediate medical care. Delaying immediate care can lead to worse outcomes and possibly even death.

Serious side effects of Vyvanse may include:

• Stimulant withdrawal: Suddenly stopping Vyvanse can cause stimulant withdrawal symptoms, which can include increased fatigue and symptoms of depression. It is important to check in with your doctor if you are experiencing such symptoms immediately after stopping your medication.
• Tremors: Tremors can be signed if your dosage is too high. You should revisit your doctor and consider lowering your dosage if possible.
• Delayed growth: The stimulant effect of Vyvanse can cause delayed growth in children. Thus, children taking Vyvanse should have their weight and height monitored. If a delay is noted, your doctor might consider a different medication.
• Circulation problems: Fingers and toes can become numb, cool, or painful due to poor circulation to the region when taking a stimulant medication. This may or may not be associated with color changes in the fingers and toes. If unexplained wounds begin appearing on the fingers and toes, you should contact your healthcare provider immediately.¹
• Serotonin syndrome: Serotonin Syndrome usually happens when you take Vyvanse with another serotonergic medication, such as an antidepressant or linezolid (an antibiotic with serotonergic activity). Symptoms can include agitation, increased heart rate, flushing, tremors, stiff muscle, increased blood pressure, increased body temperature, and/or seeing or hearing things that are not real (hallucinations).¹
• Cardiovascular events: Heart attacks, strokes, and sudden cardiac death have been associated with stimulant medications. Abnormal heart rhythms are a dangerous side effect that can be caused by Vyvanse. For this reason, people with problems with their heart will likely need further evaluation prior to starting Vyvanse
• Psychotic and manic symptoms: Stimulants can unmask or exacerbate underlying, sometimes even previously undiagnosed, symptoms of psychosis and/or mania. People with a pre-existing mood disorder, a history of substance abuse, and a family history of mood disorders are at increased risk.

This is not a complete list of possible side effects with Vyvanse. You should talk with your healthcare provider about all of the risks of Vyvanse before you start taking the medication.

Vyvanse Withdrawal

The continuous use of Vyvanse can create a physical dependence on the stimulant medication.¹ Suddenly stopping the medication can cause Vyvanse withdrawal symptoms such as extreme tiredness or even depression. If the symptoms are so severe that you cannot get out of bed, contact your healthcare provider immediately.

Allergic Reactions to Vyvanse

Although uncommon, there have been reports of people having allergic reactions as severe as anaphylaxis after taking Vyvanse.¹ Symptoms of an allergic reaction can include hives, swollen lips, swollen eyes, swollen face, abdominal pain, and/or itchiness of your mouth. Anaphylaxis is an immediate life-threatening allergic reaction that can cause trouble breathing, swelling of the airways, significantly decreased blood pressure, swelling of the tongue, loss of strength, and even loss of consciousness. If immediate medical attention and treatment with epinephrine are not administered right away, anaphylaxis can lead to death.

As Vyvanse is an amphetamine-based medication, those who are allergic to other amphetamine products will also likely be allergic to Vyvanse. Similarly, those who have had an allergic reaction to stimulant medication or drugs in the past are at higher risk of having an allergic reaction to Vyvanse.

Allergic reactions to Vyvanse may include:

• Trouble breathing
• Swelling
• Rash/hives
• Itchiness of the mouth
• Itchiness of the skin
• Swelling of the lips
• Loss of consciousness
• Decreased blood pressure

If and when someone experiences a severe allergic reaction, be it to Vyvanse or another medication/ substance, they should seek immediate medical attention. If you suspect that you or someone else has an allergic reaction, call 9-1-1 or go to the nearest emergency room as soon as possible.

Vyvanse Warnings & Precautions

The warnings for taking Vyvanse are warnings regarding the common side effects of Vyvanse. For example, this includes warnings regarding the effect of Vyvanse on the heart, the effect of Vyvanse on blood pressure, the risk of unmasking psychosis or mania when taking Vyvanse, and the risk of suppressing growth in children who take Vyvanse

Precautions for taking Vyvanse include: 

• Potential for misuse and addiction: Those with a history of addiction, especially a history of alcohol or drug abuse, need to be extra cautious because stimulant medications such as Vyvanse can be addicting. If you think you or your loved one is showing signs of addiction to stimulant medication, such as Vyvanse, you will need to seek professional help as soon as possible.
• Taking Vyvanse while pregnant: Taking Vyvanse during pregnancy can cause harm to the fetus, up to and including fetal death.¹ If you become pregnant or plan to become pregnant while being treated with Vyvanse, you will need to speak to your prescribing provider and your obstetrician immediately.
• Taking Vyvanse one breastfeeding: Vyvanse can pass into the breast milk and to your baby if you are breastfeeding while taking Vyvanse.¹ You should seek the advice of your healthcare provider in order to prevent harm to your baby. You will need to discuss with your physician the best approach to feeding your baby while being treated for your symptoms.
• Ability to affect your mental status: When first taking a stimulant medication like Vyvanse, you must use caution when performing tasks that require increased mental alertness. This is because you do not know the effects this medication can have on your cognitive functions, such as your reflexes. Thus, until you know how Vyvanse affects you, you should not drive, operate machinery, or participate in other dangerous activities.¹
• For those with bipolar disorder: For those with bipolar disorder, stimulant medications, such as Vyvanse, can unmask or initiate manic episodes.
• For those with pre-existing heart conditions: Stimulants, such as Vyvanse, can exacerbate already existing heart conditions. Sudden death in those with heart abnormalities has been reported.
• For those with high blood pressure: As a stimulant medication, Vyvanse will cause both increased blood pressure and heart rate. This can be especially harmful to those who already have high blood pressure prior to starting stimulant medication.
• Serotonin syndrome: Among those who are already taking a medication that can increase the amount of serotonin available in your body, taking Vyvanse can induce serotonin syndrome.¹ Symptoms of serotonin syndrome can include mental status change, increased heart rate, seizures, muscle rigidity, etc. If this occurs, Vyvanse and all other serotonergic medications (SSRIs, SNRIs, St. John’s Wort, etc) must be stopped immediately.

Interactions With Vyvanse

It is important to let your prescribing physician know every medication that you are already taking when being prescribed Vyvanse. Additionally, after being prescribed Vyvanse, it is important to let your prescribing physicians know if there are any changes to your other medications. This includes prescription medications, over-the-counter medications, herbal medications/supplements, and other supplements/vitamins.

Sometimes, your physician will make changes to the dosages or types of your other medications when you are prescribed Vyvanse.¹ This is because different medications, supplements, and other substances can have varying interactions with Vyvanse, which can cause different effects in each individual user. Some of these effects can be dangerous and scary.

There are many substances you should avoid while taking Vyvanse. Some of them are:

• Monoamine oxidase inhibitor (MAOIs) antidepressants: MAOIs are a class of antidepressants used to treat bulimia nervosa, anxiety disorders, and treatment-resistant depression. You cannot start using Vyvanse until you have stopped using an MAOI for at least 14 days. Interactions between these two medications can lead to a hypertensive crisis, which can have symptoms such as headaches, increased temperature, and sometimes even death.¹
• Tricyclic antidepressants (TCAs): TCAs are another class of antidepressants. Vyvanse and TCAs together can increase the risk of toxicity to the heart and the risk of developing serotonin syndrome.
• Medications that decrease seizure threshold: These can include antidepressants (Wellbutrin), mood stabilizers (chlorpromazine, aripiprazole), and many other commonly prescribed medications. This also includes illegal substances such as cocaine. This is because stimulant medications, such as Vyvanse, can also decrease the seizure threshold. By decreasing the seizure threshold, the risk of having a seizure increases. Thus, combining different medications/substances, which decreases the seizure threshold, increases the risk of having a seizure when combining these medications.
• Multivitamins: Multivitamins can decrease the concentration of amphetamines such as Vyvanse within the body. This includes multivitamins that contain Vitamin C, folate, iron, Vitamin A, Vitamin d, Vitamin E, and Vitamin K.
• Serotonergic Agents: SSRIs, SNRIs, Triptans, Metoclopramide, St John’s Wort, tramadol, Trazodone, cocaine, lithium, and many other medications/substances/drugs increase the amount of serotonin available in the body. Because Vyvanse is also a serotonergic medication, combining it with these substances with Vyvanse increases the risk of serotonin syndrome.

Can You Overdose on Vyvanse?

Abuse and misuse of Vyvanse can lead to accidental overdoses. After overdosing on an amphetamine medication, such as Vyvanse, a person might experience restlessness, tremor, rapid heart rate, hallucinations, extreme panic, and/or high (fever-like) temperature.¹ Overdosing on an amphetamine medication such as Vyvanse is a medical emergency as it can cause sudden death. If you or someone you know is experiencing symptoms of overdose, you need to seek immediate medical attention. If access to immediate medical care is limited, call 911 and the local poison control center.

What Should You Do If You Take Too Much Vyvanse?

If you accidentally take too much Vyvanse, you should call 911 and seek immediate medical care. If access to immediate medical care is limited, you can call your local poison control center. Accidental overdose on stimulant medications, such as Vyvanse, can have serious consequences, including sudden death.

Questions to Ask Your Healthcare Provider About Vyvanse

If you are struggling with ADHD or binge eating disorder, you might consider treatment using Vyvanse. You will need to discuss with your doctor if Vyvanse is the right treatment for you. Ask your doctor specifically about their concerns regarding starting Vyvanse for you as an individual based on your past medical history, current medications, and symptoms. People with certain predisposing factors may be predisposed to certain side effects more than others.

For problems such as ADHD and binge eating disorder, medication alone cannot solve the entire problem. Often, medication alone is not enough. Finding the right therapist can be a beneficial part of treatment for ADHD symptoms and binge eating disorder.

Questions to ask your care team about Vyvanse include:

• Can I use Vyvanse along with therapy to treat ADHD?
• How soon might I notice side effects from taking Vyvanse?
• Am I at risk for more severe symptoms if I am already taking medications for anxiety, depression, or other mental health conditions?
• What is the best dosage to ensure fewer side effects?
• Are there drugs I am taking that could have negative interactions?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Is there a medication other than Vyvanse which might be a better fit for me specifically?
• Based on my current health issues, is it safe for me to take Vyvanse as it is being prescribed to me?
• How can I recognize the symptoms of addiction/abuse/misuse when it comes to stimulant medications?
• What should I do if I’m already being treated with Vyvanse and then become pregnant or plan on becoming pregnant?
• Should I/do I need to undergo further cardiac evaluation prior to being prescribed Vyvanse based on my own past medical history and/or my family’s medical history?
• Are there coupons for Vyvanse or other types of discounts available?

How to Get a Vyvanse Prescription

In order to get a prescription for Vyvanse you will need to be evaluated by a psychiatrist or another physician who has spent time specializing in ADHD evaluations and management. There are many factors to consider when deciding if Vyvanse is the right medication for you. For this, you will need to have an open discussion with your prescribing provider. If you are not able to find a psychiatrist or physician near you who is able to manage your ADHD or binge eating disorder symptoms, there are online psychiatry services that might work for you.

In My Experience

In my experience, for those with ADHD, getting the right treatment can be life-changing. However, ADHD treatments do not come in a one size fits all type package. For this reason it is important to have nuanced discussions with your psychiatrist/physician regarding your symptoms, your other medical history, your current medications, and your goals with treatment. For the treatment of binge eating disorders, behavioral therapy has been the most effective. For someone not able to manage a binge eating disorder with behavioral therapy alone, usually, an SSRI is added to the treatment.

Typically, only for binge eating disorders that have been resistant to behavioral therapy and SSRIs will a medication like Vyvanse be added to the treatment plan. Both ADHD and binge eating disorders are conditions that can cause significant distress in an individual and their loved ones’ lives. You do not have to struggle alone. Reach out to your primary care physician, a psychiatrist, or a psychologist for help in managing your symptoms.

For Further Reading

• Adderall: Uses, Side Effects, & Interactions
• ADHD Medication Side Effects: Everything You Need to Know – Choosing Therapy
• Access FDA: Vyvanse
• CDC: ADHD