";s:4:"text";s:7004:" Improvements in symptoms of attention-deficit/hyperactivity disorder in school-aged children with lisdexamfetamine (NRP-104) and mixed amphetamine salts, extended-release versus placebo. From the AACAP website.
Its effects generally begin within 2 hours and last for up to 12 hours. Vyvanse Prescribing Information. ), Acidifying agents, urinary (ammonium chloride, ascorbic acid, methenamine salts, sodium acid phosphate, cranberry juice), Increased urinary excretion and decreased serum concentrations and efficacy of amphetamines1 8 48, Increase lisdexamfetamine dosage based on clinical response48, Alkalinizing agents, urinary (carbonic anhydrase inhibitors, sodium bicarbonate, some thiazides), Decreased urinary excretion and increased serum concentrations of amphetamines1 8 48, Antidepressants, SSRIs or SNRIs (e.g., fluoxetine, paroxetine), Risk of potentially life-threatening serotonin syndrome48, Fluoxetine, paroxetine: Possible increased dextroamphetamine exposure48, Use concomitantly only if potential benefit justifies potential risk48, If concomitant therapy is clinically warranted, consider lower initial lisdexamfetamine dosage and carefully observe patient, particularly during drug initiation or dosage titration48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, the antidepressant, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, Antidepressants, tricyclic (e.g., desipramine, protriptyline), Enhanced activity of tricyclic antidepressants; desipramine or protriptyline may cause striking and sustained increases in dextroamphetamine concentrations in the brain; cardiovascular effects can be potentiated48, Monitor patients frequently; adjust dosage or use alternative therapy based on clinical response48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, buspirone, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, fentanyl, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, No clinically important pharmacokinetic interaction43, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, the triptan, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, lithium, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, MAO inhibitors (e.g., isocarboxazid, linezolid, methylene blue, phenelzine, selegiline, tranylcypromine), Potentially life-threatening hypertensive crisis or serotonin syndrome1 48, MAO inhibitors slow amphetamine metabolism, increasing their effect on release of norepinephrine and other monoamines leading to headaches and other signs of hypertensive crisis48, Amphetamines contraindicated in patients currently or recently (within 14 days) receiving MAO inhibitor1 48, No clinically important pharmacokinetic interaction41 48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, quinidine, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, ritonavir, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, St. John's wort, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, tramadol, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, If serotonin syndrome occurs, immediately discontinue lisdexamfetamine, tryptophan, and any concomitantly administered serotonergic agents; initiate supportive and symptomatic therapy48, Additive effects on BP and heart rate reported42, No clinically important pharmacokinetic interaction48, No dosage adjustment necessary; monitor BP and heart rate42 48, Lisdexamfetamine (a prodrug of dextroamphetamine) is rapidly absorbed from the GI tract.1 28 Peak plasma concentrations of lisdexamfetamine occur in approximately 1 hour; concentrations are low and transient; nonquantifiable by 8 hours after administration.1 Peak plasma concentrations of dextroamphetamine occur in approximately 3.5–3.7 hours.1 3 30, Occurs within 2 hours after oral administration.3, Food (high-fat meal or yogurt) delays time to peak plasma concentration of dextroamphetamine by about 1 hour, but administration with high-fat meal, yogurt, or orange juice does not affect magnitude of peak plasma concentration or AUC of dextroamphetamine.1 48, Amphetamines readily cross the blood-brain barrier and are distributed into most body tissues.26, Amphetamines are distributed into milk in concentrations 3–7 times maternal blood concentrations.21 25, Lisdexamfetamine (a prodrug of dextroamphetamine) is converted to l-lysine and dextroamphetamine mainly via hydrolytic activity of RBCs, which have high capacity for this metabolism.1 48, Lisdexamfetamine is not metabolized by CYP isoenzymes.1, Excreted principally in urine.1 Approximately 96% of a 70-mg radiolabeled oral dose of lisdexamfetamine was recovered in urine; parent drug accounted for about 2% of the recovered radioactivity.1, Changes in urinary pH may alter excretion of amphetamines.1 (See Specific Drugs, Tests, and Foods under Interactions. is used to detect a drug for longer than a few days after its use. Revised Jan. 2017. 2016; 41:1251-60. http://www.ncbi.nlm.nih.gov/pubmed/26346638?dopt=AbstractPlus, 41. Vyvanse hasn't been tested in children under age 6 who have ADHD, or in children under age 18 with binge-eating disorder. For children or others who prefer a softer or liquid formulation, the Vyvanse capsules can be opened and taken with yogurt, water or orange juice. http://www.ncbi.nlm.nih.gov/pubmed/24839883?dopt=AbstractPlus, 46. Accessed August 5, 2019. Part I. J Am Acad Child Adolesc Psychiatry. Vyvanse can be taken with or without food. Vyvanse is an addictive substance that can be dangerous if misused. VA Class: CN801