Description
Simple
A medication used to treat mental health disorders, such as ADHD and eating disorders.
Clinical
A central nervous system (CNS) stimulant used to treat attention deficit hyperactivity disorder (ADHD) and moderate to severe eating disorders.
Overview
Also known as _Vyvanse_, lisdexamfetamine (L-lysine-d-amphetamine) is a prodrug of the psychostimulant d-amphetamine [4]. It is paired with the essential amino acid _L-lysine_. Lisdexamfetamine dimesylate increases attention span and decreases restlessness in children and adults who are overactive/hyperactive, cannot concentrate for long periods, or are easily distracted or impulsive [2].
As a central nervous system stimulant, lisdexamfetamine is utilized as an adjunct therapy in the treatment of attention deficit hyperactivity disorder (ADHD). As a prodrug, lisdexamfetamine was specifically engineered as an abuse-resistant product [10]. The mechanism by which this occurs is through delayed release after ingestion (unlike some other psychostimulant drugs, which may be abused). After oral administration and absorption, enzyme hydrolysis after contact with red blood cells metabolize lisdexamfetamine into L- lysine, a naturally occurring essential amino acid and active _d-amphetamine_, wh...
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Pharmacology
Indication
For the treatment of Attention-deficit/hyperactivity disorder (ADHD) and for moderate to severe binge eating disorder in adults [FDA label], [ Read more
Pharmacodynamic
Lisdexamfetamine dimesylate is a prodrug of _d-amphetamine_. Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulating properties [FDA label]. This agent works primarily by inducing the release of the neurotransmitters dopamine and norepinephrine from their storage areas in pres... Read more
Mechanism of action
Lisdexamfetamine is a prodrug of dextroamphetamine. The active form of this drug blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space. The parent drug, lisdexamfetamine, does not bind to the sites for... Read more
Absorption
After oral administration, lisdexamfetamine is rapidly absorbed from the gastrointestinal tract [FDA label], [8].
**Chewable tablet form:** After a single dose of 60 mg a chewable tablet in healthy subjects u...
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Protein binding
Information currently not available.
Volume of distribution
There is no accumulation of d-amphetamine (as measured by AUC) at steady state in healthy adults and no accumulation of lisdexamfetamine dimesylate after once-daily dosing for seven consecutive days [FDA label], [8 Read more
Clearance
In a study of 47 subjects aged 55 years of age or older, amphetamine clearance was approximately 0.7L/hr/kg for subjects 55-74 years of age and 0.55L/hr/kg for subjects ≥75 years of age. This is slightly reduced compared to younger adults (approximately 1L/hr/kg for subjects 18-45 years of age) [ Read more
Half life
The mean plasma elimination half-life of dextroamphetamine was about 12 hours after oral administration of lisdexamfetamine dimesylate [FDA label].
The plasma elimination half-life of lisdexamfetamine alone averaged less than one hour in studies of lisdexamfetamine dimesylate administered in vol...
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Route of elimination
After the oral administration of a 70mg dose of radiolabeled lisdexamfetamine dimesylate to six healthy subjects, about 96% of the oral dose radioactivity was recovered in the urine and only 0.3% recovered in the feces [FDA label], [ Read more
Toxicity
**Acute toxicity**: Symptoms of acute overdosage with amphetamines include restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, panic states, hyperpyrexia, and rhabdomyolysis. Fatigue and depression generally follow the symptoms central nervous system st... Read more
Adverse Effects
Effect | Regions | Age Groups | Incidences | Evidence Type |
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Decreased appetite | US |
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Dry Mouth | US |
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Decreased apetite | US |
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Insomnia | US |
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Decreased apetite | US |
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Dry Mouth | US |
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Insomnia | US |
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Insomnia | US |
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Tremor | US |
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Insomnia | US |
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Abdominal Pain Upper | US |
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Irritability | US |
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Weight decreased | US |
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Weight decreased | US |
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Vomiting | US |
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Decreased appetite | US |
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Nausea | US |
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Diarrhea | US |
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Increased heart rate | US |
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Anxiety | US |
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Feling jittery | US |
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Constipation | US |
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Nausea | US |
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Anorexia | US |
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Dizziness | US |
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Anxiety | US |
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Dry Mouth | US |
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Feelling jittery | US |
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Dry Mouth | US |
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Decreased weight | US |
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Diarrhea | US |
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Hyperhidrosis | US |
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Increased blood pressure | US |
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Agitation | US |
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Hyperhidrosis | US |
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Affect lability | US |
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Rash | US |
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Restlessness | US |
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Decreased weight | US |
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Erectile Dysfunction | US |
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Tremor | US |
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Anorexia | US |
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Anorexia | US |
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Palpitations | US |
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Pyrexia | US |
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Somnolence | US |
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Tic | US |
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Urinary Tract Infection | US |
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Energy increased | US |
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Upper Abdominal Pain | US |
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Contraindications
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Food Interactions
Avoid antacids. Urinary excretion of lisdexamfetamine is elevated when the urine is more acidic. Antacids like sodium bicarbonate alkalinize the urine; therefore, they may reduce lisdexamfetamine elimination.
Limit foods and supplements high in vitamin C. Urinary excretion of lisdexamfetamine is elevated when the urine is more acidic. Vitamin C acidifies the urine and, therefore, may increase lisdexamfetamine elimination.
Take with or without food.