Lisdexamfetamine

Prodrug Stimulant·Psychiatry - ADHD & Stimulants

ADHD (Children > 6 years and Adults)

S8Authority requiredPBSS8 STIMULANTVyvanse+2

Max Dose

70 mg/day

Duration

10–12 h

Misuse Risk

MODERATE

Appetite Loss

COMMON

Rapid Summary

Overview

An ingenious prodrug of dexamfetamine. Inactive in the bottle, it only becomes an active stimulant once enzymes in the red blood cells cleave off an amino acid. Highly abuse-deterrent.

Maximum Dose

Max 70 mg/day.

Clinical Focus

Provides a smooth, ultra-long 12-14 hour clinical effect. Cannot be snorted or injected for a 'high'.

Bottom Line

Lisdexamfetamine is a prodrug stimulant for ADHD with smoother onset and lower abuse potential than dexamfetamine, but still carries cardiovascular risk and Schedule 8 restrictions.

Formulation & Access

Brand Names

Vyvanse

Oral Routes

Capsules (20, 30, 40, 50, 60, 70 mg). Can be opened and dissolved in water (unlike Concerta).

Prescribing & PBS

Highly Restricted (S8). Authority Required (PBS) via specialist.

Indications & Use

Primary

PBSTGA

ADHD (Children > 6 years and Adults).

Off-Label

OFF

Binge Eating Disorder (Approved in US, off-label in Aus).

Clinical Place

The gold-standard long-acting amphetamine. Vastly superior to immediate-release Dexamphetamine for maintaining steady focus and preventing drug diversion.

Quick reference

Class & Role

Prodrug Stimulant — An ingenious prodrug of dexamfetamine.

Route / Formulation

Capsules (20, 30, 40, 50, 60, 70 mg). Can be opened and dissolved in water (unlike Concerta). (Vyvanse)

Usual Dose & Max

Start PO 30 mg OD in the morning. Titrate up by 20 mg weekly. Target 30-70 mg/day. Max 70 mg/day.

Key Indication Doses

ADHD: Start PO 30 mg OD in the morning. Titrate up by 20 mg weekly. Target 30-70 mg/day. Max 70 mg/day. Binge Eating Disorder: PO 30-70 mg OD (Off-label/Specialist). Renal Impairment: Max 50 mg/day if eGFR 15-30. Max 30 mg/day if eGFR < 15.

Best Uses

Lisdexamfetamine is a prodrug stimulant for ADHD with smoother onset and lower abuse potential than dexamfetamine, but still carries cardiovascular risk and Schedule 8 restrictions.

Avoid / Cautions

Severe cardiovascular disease, advanced arteriosclerosis, hyperthyroidism, concurrent MAOIs. Pregnancy Category B3.

Key Risks

Neurological: Severe insomnia (if taken late in the day), anxiety, tics, headache. (Abuse potential is significantly lower than IR Dex). Cardiovascular: Tachycardia, hypertension. Gastrointestinal: Profound anorexia, weight loss, dry mouth.

Key Interactions

MAOIs (Hypertensive crisis). Urinary alkalizers (Ural) reduce clearance; Ascorbic acid (Vit C) accelerates clearance.

Monitoring

Monitor BP, HR, and Weight at every clinical review. Check eGFR before escalating to 70mg.

Clinical Pearl

If a drug user crushes Vyvanse and snorts it, or dissolves it and injects it into a vein, absolutely nothing happens. It REQUIRES the enzymes inside red blood cells to activate. This makes it heavily favored by prescribers.

Access

Authority requiredVyvanse70 mg

Brand: Vyvanse
PBS status: Authority required
Formulation: Capsules (20, 30, 40, 50, 60, 70 mg)

Lisdexamfetamine

Prodrug Stimulant·Psychiatry - ADHD & Stimulants

ADHD (Children > 6 years and Adults)

S8Authority requiredPBSS8 STIMULANTVyvanse+2

Max Dose

70 mg/day

Duration

10–12 h

Misuse Risk

MODERATE

Appetite Loss

COMMON

Rapid Summary

Overview

An ingenious prodrug of dexamfetamine. Inactive in the bottle, it only becomes an active stimulant once enzymes in the red blood cells cleave off an amino acid. Highly abuse-deterrent.

Maximum Dose

Max 70 mg/day.

Clinical Focus

Provides a smooth, ultra-long 12-14 hour clinical effect. Cannot be snorted or injected for a 'high'.

Bottom Line

Lisdexamfetamine is a prodrug stimulant for ADHD with smoother onset and lower abuse potential than dexamfetamine, but still carries cardiovascular risk and Schedule 8 restrictions.

Formulation & Access

Brand Names

Vyvanse

Oral Routes

Capsules (20, 30, 40, 50, 60, 70 mg). Can be opened and dissolved in water (unlike Concerta).

Prescribing & PBS

Highly Restricted (S8). Authority Required (PBS) via specialist.

Indications & Use

Primary

PBSTGA

ADHD (Children > 6 years and Adults).

Off-Label

OFF

Binge Eating Disorder (Approved in US, off-label in Aus).

Clinical Place

The gold-standard long-acting amphetamine. Vastly superior to immediate-release Dexamphetamine for maintaining steady focus and preventing drug diversion.

Quick reference

Class & Role

Prodrug Stimulant — An ingenious prodrug of dexamfetamine.

Route / Formulation

Capsules (20, 30, 40, 50, 60, 70 mg). Can be opened and dissolved in water (unlike Concerta). (Vyvanse)

Usual Dose & Max

Start PO 30 mg OD in the morning. Titrate up by 20 mg weekly. Target 30-70 mg/day. Max 70 mg/day.

Key Indication Doses

Best Uses

Lisdexamfetamine is a prodrug stimulant for ADHD with smoother onset and lower abuse potential than dexamfetamine, but still carries cardiovascular risk and Schedule 8 restrictions.

Avoid / Cautions

Severe cardiovascular disease, advanced arteriosclerosis, hyperthyroidism, concurrent MAOIs. Pregnancy Category B3.

Key Risks

Key Interactions

MAOIs (Hypertensive crisis). Urinary alkalizers (Ural) reduce clearance; Ascorbic acid (Vit C) accelerates clearance.

Monitoring

Monitor BP, HR, and Weight at every clinical review. Check eGFR before escalating to 70mg.

Clinical Pearl

Access

Authority requiredVyvanse70 mg

Brand: Vyvanse
PBS status: Authority required
Formulation: Capsules (20, 30, 40, 50, 60, 70 mg)