Vyvanse®
Lisdexamfetamine
Version 2025-04 · Last reviewed April 1, 2025 · Methodology
List Price
$450
With Insurance
$50-100
FDA Black Box Warning
HIGH POTENTIAL FOR ABUSE
Schedule II controlled substance. Risk of dependence, cardiovascular events.
Strict Contraindications
How It Works
Vyvanse (lisdexamfetamine) is an inactive prodrug. After swallowing, it is cleaved by enzymes in the gut and blood cells into d-amphetamine — identical to half the active ingredient in Adderall. The key difference is that this cleavage step creates a controlled, gradual release of active drug.
Why the side effects happen
Identical side effect mechanism to amphetamine. The slower, smoother onset means less "crash" when the drug wears off and less initial cardiovascular spike. The inability to abuse IV or inhalation routes is the key design feature — crushing Vyvanse does not produce a faster high.
When Will I Feel It?
Slower onset than Adderall IR — requires enzymatic conversion. Effect builds over 1–2 hours and lasts 10–14 hours. One of the longest-acting ADHD medications available.
Gradual onset as lisdexamfetamine is converted to d-amphetamine. Less "hit" than Adderall IR.
Peak effect — focus, executive function, impulse control maximized.
Smooth, extended coverage through work or school day. Less afternoon drop-off than Adderall XR for many patients.
Adherence Note
Take Vyvanse in the morning — it can cause insomnia if taken after 10am. Not eating breakfast does not meaningfully affect onset, though eating may slightly slow it. Avoid taking with vitamin C (ascorbic acid) within 1 hour — acidic urine accelerates excretion.
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Common Side Effects
While taking this medication, you may experience the following common side effects. We've included tips on how to manage them.
Decreased appetite
39%Eat a nutritious breakfast before medication takes effect
Insomnia
27%Take early in the morning; the drug lasts 12-14 hours
Dry mouth
26%Sip water throughout the day; sugar-free gum helps
Increased heart rate
20%Monitor pulse; inform doctor if consistently over 100 bpm at rest
Irritability / mood swings
18%Often occurs as drug wears off ("rebound"); talk to doctor
Headache
16%Stay well hydrated; usually improves over time
Upper abdominal pain
14%Take with food or a light snack
Anxiety
12%Report to doctor; dose may need adjustment or alternative considered
Nausea
10%Take with food; improves with time
Weight loss
9%Ensure adequate nutrition; eat when hungry, even if no appetite
Serious Adverse Effects
- • Sudden cardiac death
- • Stroke
- • Serious cardiovascular events
- • Psychiatric episodes
- • Serotonin syndrome (with other drugs)
- • Growth suppression in children
Drug Interactions
Major Interactions (Avoid)
Moderate Interactions (Caution)
Food Interactions
When to Contact Your Doctor
This medication requires ongoing medical supervision. The following situations warrant a prompt conversation with your prescribing physician — do not wait for your next scheduled appointment.
Contact soon if you notice
- Sudden cardiac death
- Stroke
- Serious cardiovascular events
- Psychiatric episodes
- Extreme fatigue and hypersomnia
Also discuss if you want to
- Review whether this medication is still appropriate for you
- Consider dosage adjustments based on response
- Explore lifestyle or non-drug alternatives
- Understand stopping or tapering options
- Plan monitoring labs and follow-up
In the US, call 911 or go to the nearest emergency room for severe symptoms. Poison Control: 1-800-222-1222.
Special Populations
Safety classifications for specific groups — discuss with your provider before use.
Risk of premature birth, neonatal withdrawal.
Passes into milk; developmental risk to infant.
Estrogen directly fuels the brain's dopamine system — the same system stimulant medications work on. As estrogen drops during perimenopause, many women experience new brain fog, poor focus, mood instability, and low motivation. Some receive an ADHD diagnosis in their 40s when hormonal change — not a lifelong attention disorder — is the actual driver. Ask your doctor about ruling out perimenopause before starting a stimulant.
Monitor growth; drug holidays considered. Important: excess sugar and processed carbs cause a blood sugar spike, followed by an insulin overcorrection, followed by a blood sugar crash. The body then releases adrenaline — causing shakiness, anxiety, restlessness, and inattention that can look exactly like ADHD. Dietary clean-up should always be explored before or alongside stimulant medication in children.
Higher cardiovascular risk; start low.
FDA Adverse Event Reports
Patient-filed reports from the FDA FAERS database · refreshed daily
Community Reports
User-reported experiences — anonymous & anecdotal
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Metabolic & Lifestyle Alternatives
Non-Drug & Behavioral ADHD/BED Approaches
Behavioral therapy is comparable to medication long-term for ADHD; has established evidence for binge eating disorder
Important context: Evidence quality varies across these approaches. Some are well-studied with randomized controlled trial data; others are based on observational or smaller studies. These interventions are not guaranteed to replace medication for all patients. Discuss with your doctor whether any of these are appropriate for your clinical situation.
Global Prescribing & Pricing
Vyvanse is priced at 6–15× more in the US than in comparable countries with pharmaceutical price negotiation
United States
$350–400 (brand only until 2023)/mo
6M+ prescriptions in 2022 — heavy DTC advertising drove growth
No behavioral therapy prerequisite; marketed directly to consumers
Often requires prior authorization
United Kingdom
~$190/mo
Restricted — specialist-only prescribing
NICE requires behavioral intervention before medication for children; specialist must initiate
Covered by NHS with specialist approval
France
~$88/mo
Very low prescribing rate
Neuropsychological evaluation and therapy required first; extremely limited prescribing
Partially covered by Assurance Maladie
Germany
~$132/mo
Low prescribing — methylphenidate preferred
Multimodal evaluation required; behavioral treatment must be concurrent with medication
Covered by GKV with evaluation
Australia
~$27 (PBS)/mo
Lower prescribing — PBS restricts access
PBS requires specialist initiation (pediatrician or psychiatrist); PBS negotiates price down to AUD 40/mo
Covered by PBS with restrictions
Australia's PBS pays AUD 40/month (~$27) for the same drug that costs $350–400 in the US — the difference is government negotiating power. No clinical difference in the drug; 13× price difference explained entirely by policy.
Clinical Trials & Funding
Understanding who funds research helps contextualize results. Industry-funded trials are not automatically invalid — they undergo the same FDA review — but declared conflicts and sponsor effects are worth knowing. All linked trials can be verified on ClinicalTrials.gov.
Funding Sources
Original ADHD registration trials were primarily funded by Shire (now Takeda). The binge eating disorder indication was subsequently developed following initial ADHD approval.
Declared Conflicts of Interest
ADHD researchers receive extensive pharma funding. Vyvanse won approval for binge eating disorder — an entirely new marketing segment — expanding $2.5B revenue.
Key Efficacy Results
ADHD symptom reduction 60-70%; abuse risk marketed as lower than Adderall (debated)
Referenced Studies
Each study carries a Cochrane RoB-2 risk-of-bias badge — tap the badge for details.
Evidence & Transparency
Cochrane RoB-2 (Risk of Bias)
Badges reflect an editorial assessment using Cochrane's RoB-2 tool domains: randomization, intervention deviation, missing data, outcome measurement, and selective reporting. These are not certified Cochrane reviews. Learn more ↗
CMS Open Payments
Manufacturer payment disclosures are reported via the CMS Sunshine Act. Disclosure is legally required and does not imply bias or misconduct. Language uses "may," "suggests," or "appears" — never definitive clinical claims. CMS Open Payments ↗
Live Clinical Trials
Live from ClinicalTrials.gov · refreshed every 4 hours
Currently enrolling, active, and recently completed studies involving Lisdexamfetamine. Data is pulled directly from the U.S. National Library of Medicine.
Recent Research
Live from PubMed · peer-reviewed literature · refreshed every 4 hours
Most recently indexed clinical trials and systematic reviews mentioning Lisdexamfetamine in PubMed.
Source Documentation
Structured citations for referenced clinical trials
Each referenced trial is listed with its registry ID, funding source, and bias assessment. Use the copy button to generate a formatted citation.
| Trial | Registry ID | Cite |
|---|---|---|
| Vyvanse ADHD Adults (Shire) | NCT00877487 | |
| BED Trial (Shire) | NCT01718483 |
Bias ratings use Cochrane RoB-2 methodology. Editorial assessment — not a certified Cochrane review.
Our MethodologyMedical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Stopping This Medication Safely
As a Schedule II stimulant, Vyvanse discontinuation causes pronounced fatigue, low mood, increased appetite, and motivational deficits as the dopamine system readjusts.
What Published Research Shows About Stopping This Medication
This summarizes what published research documents — it is not personal medical advice. Any changes to your medication require discussion with your prescribing physician.
- ·Published tapering protocols describe dose reduction of 10–20mg every 2 weeks (e.g., 60mg → 50mg → 40mg → 30mg → stop)
- ·Research supports beginning regular aerobic exercise before stopping, which may help with dopamine system readjustment
- ·Research supports establishing a consistent sleep schedule (7–9 hrs) before stopping
- ·Clinical guidance suggests planning discontinuation during a lower-demand period
- ·Research supports having behavioral therapy or executive function coaching in place before stopping
Warning Symptoms — Contact Your Doctor If You Experience:
- Extreme fatigue and hypersomnia
- Low motivation or anhedonia (inability to feel pleasure)
- Significant increase in appetite
- Difficulty focusing beyond pre-medication baseline
Never change or stop a medication without consulting your prescribing physician.
Questions for Your Doctor
Questions to Ask
- 1.Has the child's diet been evaluated? Sugar and processed carbs spike blood sugar, then insulin overcorrects and the blood sugar crashes. The body releases adrenaline to fix the crash — causing shakiness, anxiety, restlessness, and inability to focus. This can look exactly like ADHD. Has a real-food, lower-sugar dietary trial been done first?
- 2.Have we tried behavioral therapy?
- 3.What cardiovascular monitoring will we do?
- 4.Is there a generic alternative that costs less?
- 5.Are drug holidays appropriate?
Lab Tests to Request
- Blood pressure
- Heart rate
- Weight/height (children)
- Fasting blood sugar — screen for reactive hypoglycemia
- Mood/anxiety screening
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
Frequently Asked Questions About Vyvanse®
- What is Vyvanse® used for?
- Vyvanse® (Lisdexamfetamine) is a CNS Stimulant manufactured by Takeda. FDA-approved indications include: ADHD (adults and children 6+); Moderate-to-severe binge eating disorder (adults).
- What are the common side effects of Vyvanse®?
- Common side effects of Vyvanse® include: Decreased appetite (39%); Insomnia (27%); Dry mouth (26%); Increased heart rate (20%); Irritability / mood swings (18%).
- How much does Vyvanse® cost?
- Vyvanse® list price is approximately $450. With insurance it typically costs $50-100; without insurance approximately $350-400.
- Who funded the clinical trials for Vyvanse®?
- Original ADHD registration trials were primarily funded by Shire (now Takeda). The binge eating disorder indication was subsequently developed following initial ADHD approval.
- How strong is the clinical evidence for Vyvanse®?
- Key studies: SPD489 studies, binge eating disorder trials. ADHD symptom reduction 60-70%; abuse risk marketed as lower than Adderall (debated) Potential conflicts of interest: ADHD researchers receive extensive pharma funding. Vyvanse won approval for binge eating disorder — an entirely new marketing segment — expanding $2.5B revenue..
- Are there non-drug alternatives to Vyvanse®?
- Behavioral therapy is comparable to medication long-term for ADHD; has established evidence for binge eating disorder See the Alternatives tab for full details.
Get notified when we update Vyvanse®
We'll email you when new evidence, safety updates, or alternatives are added.
No spam. Unsubscribe anytime.