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Vyvanse schedule: DEA schedules VYVANSE, clearing way for launc

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Vyvanse (Lisdexamfetamine) Addiction & Abuse

Vyvanse is the brand name for the prescription stimulant lisdexamfetamine, which is classified as a Schedule II controlled substance. This means that Vyvanse has a high potential for abuse, addiction and dependence. This is especially true when Vyvanse is abused for non-medical reasons.

Article at a Glance:

  • Vyvanse, the brand name for lisdexamfetamine, is a Schedule II controlled substance often prescribed for attention-deficit hyperactivity disorder or binge eating disorder.
  • Misuse is common and may increase the risk of addiction.
  • Vyvanse increases the amount of the brain’s reward chemical, dopamine, which can set the stage for addiction.

Is Vyvanse Addictive?

As a Schedule II controlled substance, Vyvanse can be highly addictive. The drug increases the amount of dopamine, a neurotransmitter in your brain. Dopamine is the brain’s feel-good chemical and helps to reinforce behaviors. Some people, primarily those with attention-deficit hyperactivity disorder, or ADHD, benefit from Vyvanse because their brains do not make enough dopamine.

However, Vyvanse can be dangerous if you take more than prescribed or if you take it for non-medical reasons. Stimulants like Vyvanse are frequently abused by college students seeking to enhance their concentration and use it recreationally.

As a long-acting stimulant, Vyvanse is less prone to abuse than shorter-acting stimulants. Addiction is most likely to occur if you misuse Vyvanse or take it when it hasn’t been prescribed to you.

What Does Vyvanse Look Like?

Currently, Vyvanse is available as a brand-name drug only. It only has one manufacturer, so it’s easier to identify than a generic drug, which may have many manufacturers. Vyvanse comes in a capsule and chewable tablet dosage form, which can be identified as follows:

How is Vyvanse Prescribed?

Because Vyvanse is a Schedule II controlled substance, doctors and pharmacies are heavily regulated in how they can prescribe and dispense the drug. According to federal law, doctors are not allowed to prescribe refills on Schedule II drugs like Vyvanse and must write a new prescription every time they are needed. Individual states may have more restrictive laws. For example, some states limit the supply of Vyvanse that a doctor can prescribe.

What is Vyvanse Used For?

Vyvanse is FDA-approved to treat ADHD and binge eating disorder. In ADHD, Vyvanse has been shown to improve both hyperactive/impulsive and inattentive symptoms in adults and children as young as six years old. For someone dealing with binge eating disorder, Vyvanse can reduce the number of binge days per week that they experience.

When people misuse Vyvanse, it is often abused to stay awake, study or focus on work. In addition to a risk of addiction, abusing Vyvanse has long-term effects, including mental health issues, heart problems, malnourishment and organ damage.

Know the Signs of Vyvanse Addiction

Signs of Vyvanse abuse can emerge when a person begins to struggle with Vyvanse. Some symptoms include:

  • Social withdrawal
  • Excessive time spent with new friends
  • Mood swings, including irritability and reckless behavior
  • Changes in sleep habits
  • Missed appointments or deadlines
  • Problems at work, school or with the law

Physical and behavioral signs and symptoms may also be linked to Vyvanse addiction like sweating, dilated pupils, loss of appetite and experiencing a crash after a Vyvanse high.

If you or someone you love is struggling with their Vyvanse use, help is available. Contact The Recovery Village to discuss customized treatment plans for your Vyvanse addiction and any co-occurring mental health conditions.

  • Sources

    U.S. National Library of Medicine. “Vyvanse.” October 30, 2019. Accessed October 10, 2020.

    U.S. Department of Justice, Drug Enforcement Administration. “Title 21 United States Code (USC) Controlled Substances Act.” Accessed October 10, 2020.

    Centers for Disease Control and Prevention. “Prescription Drug Time and Dosage Limit Laws.” March 5, 2015. Accessed October 10, 2020.

    National Institute on Drug Abuse. “Prescription Stimulants DrugFacts.” June 2018. Accessed October 10, 2020.

    Substance Abuse and Mental Health Services Administration. “Adults With Attention Deficit Hyperactivity Disorder and Substance Use Disorders.” Fall 2015. Accessed October 10, 2020.

    Bielamowicz, Kate. “America’s Workforce Runs on Uppers.” JSTOR Daily, June 1, 2016. Accessed October 10, 2020.

    National Institute on Drug Abuse. “What are some signs and symptoms of someone with a drug use problem?” Accessed October 10, 2020.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

Placement of Lisdexamfetamine Into Schedule II

FR Doc E7-8421 [Federal Register: May 3, 2007 (Volume 72, Number 85)] [Rules and Regulations] [Page 24532-24534] From the Federal Register Online via GPO Access [wais.access.gpo.gov] [DOCID:fr03my07-3]

DEPARTMENT OF JUSTICE

Drug Enforcement Administration

21 CFR Part 1308

[Docket No. DEA-301F]

Schedules of Controlled Substances: Placement of Lisdexamfetamine Into Schedule II

AGENCY: Drug Enforcement Administration, Department of Justice.

ACTION: Final Rule.

SUMMARY: With the issuance of this final rule, the Deputy Administrator of the Drug Enforcement Administration (DEA) places the substance lisdexamfetamine, including its salts, isomers and salts of isomers into schedule II of the Controlled Substances Act (CSA). As a result of this rule, the regulatory controls and criminal sanctions of schedule II will be applicable to the manufacture, distribution, dispensing, importation and exportation of lisdexamfetamine and products containing lisdexamfetamine.

EFFECTIVE DATE: June 4, 2007.

FOR FURTHER INFORMATION CONTACT: Christine A. Sannerud, PhD, Chief, Drug and Chemical Evaluation Section, Office of Diversion Control, Drug Enforcement Administration, Washington, DC 20537, (202) 307-7183.

SUPPLEMENTARY INFORMATION: Lisdexamfetamine is a central nervous system stimulant drug. On February 23, 2007, the Food and Drug Administration (FDA) approved lisdexamfetamine for marketing under the trade name Vyvanse TM. Lisdexamfetamine will be marketed as a prescription drug product for the treatment of Attention Deficit Hyperactivity Disorder (ADHD).

Lisdexamfetamine is an amide ester conjugate comprised of the amino acid L-lysine covalently bound to the amino group of d-amphetamine. The chemical name of its dimesylate salt form is (2S)-2,6-diamino-N-[(1S)- 1-methyl-2-phenethyl]hexanamide dimethanesulfonate (CAS number 608137- 32-3). Lisdexamfetamine per se is pharmacologically inactive and its effects are due to its in vivo metabolic conversion to d-amphetamine. Lisdexamfetamine is a new molecular entity and has not been marketed in the United States or other countries. Therefore, there has been no evidence of diversion, abuse, or law enforcement encounters involving lisdexamfetamine.

On November 14, 2006, the Assistant Secretary for Health, Department of Health and Human Services (DHHS), sent the Deputy Administrator of DEA a scientific and medical evaluation and a letter recommending that lisdexamfetamine be placed into schedule II of the CSA. Enclosed with the November 14, 2006, letter was a document prepared by the FDA entitled, “Basis for the Recommendation for Control of Lisdexamfetamine in Schedule II of the Controlled Substances Act (CSA). ” The document contained a review of the factors which the CSA requires the Secretary to consider (21 U.S.C. 811(b)).

After a review of the available data, including the scientific and medical evaluation and the scheduling recommendation received from DHHS, the Deputy Administrator of the DEA, in a February 22, 2007, Notice of Proposed Rulemaking (72 FR 7945), proposed placement of lisdexamfetamine into schedule II of the CSA. The proposed rule provided an opportunity for all interested persons to submit their written comments to be postmarked and electronic comments be sent on or before March 26, 2007.

Comments Received

The DEA received two comments in response to the Notice of Proposed Rulemaking. One commenter stated that monthly visits to obtain refills for Concerta [supreg]–like drugs used in children are very expensive and the law needs to be changed. DEA notes that statutory requirements for schedule II drugs do not permit prescription refills. DEA does not regulate the size of each prescription or the frequency of medical visits; these matters are within the purview of prescribing physician. DEA has no authority regarding either the cost of medical care or the cost of the medications a prescribing practitioner may prescribe. Another commenter requested the name of the company that filed the New Drug Application for lisdexamfetamine in order to obtain standard analytical reference material and/or analytical data from the company. This comment is not relevant to the present scheduling action.

Scheduling of Lisdexamfetamine

Relying on the scientific and medical evaluation and the recommendation of the Acting Assistant Secretary for Health, received in accordance with section 201(b) of the Act (21 U.S.C. 811(b)), and the independent review of the available data by DEA, and after a review of the comments received in response to the Notice of Proposed Rulemaking, the Deputy Administrator of DEA, pursuant to sections 201(a) and 201(b) of the Act (21 U. S.C. 811(a) and 811(b)), finds that:

[[Page 24533]]

(1) Lisdexamfetamine has a high potential for abuse;

(2) Lisdexamfetamine has a currently accepted medical use in treatment in the United States; and

(3) Abuse of lisdexamfetamine may lead to severe psychological or physical dependence.

Based on these findings, the Deputy Administrator of DEA concludes that lisdexamfetamine, including its salts, isomers, and salts of isomers, warrants control in schedule II of the CSA. The applicable regulations are as follows:

Registration. Any person who manufactures, distributes, dispenses, imports, exports, engages in research or conducts instructional activities with lisdexamfetamine, or who desires to manufacture, distribute, dispense, import, export, engage in instructional activities or conduct research with lisdexamfetamine, must be registered to conduct such activities in accordance with Part 1301 of Title 21 of the Code of Federal Regulations. Any person who is currently engaged in any of the above activities and is not registered with DEA must submit an application for registration on or before June 4, 2007 and may continue their activities until DEA has approved or denied that application.

Security. Lisdexamfetamine is subject to schedule II security requirements and must be manufactured, distributed and stored in accordance with Sec. Sec. 1301.71, 1301.72(a), (c), and (d), 1301.73, 1301.74, 1301.75(b) and (c), 1301.76 and 1301.77 of Title 21 of the Code of Federal Regulations on or after June 4, 2007.

Labeling and Packaging. All labels and labeling for commercial containers of lisdexamfetamine must comply with requirements of Sec. Sec. 1302.03-1302.07 of Title 21 of the Code of Federal Regulations on or after June 4, 2007.

Quotas. Quotas for lisdexamfetamine must be established pursuant to part 1303 of Title 21 of the Code of Federal Regulations.

Inventory. Every registrant required to keep records and who possesses any quantity of lisdexamfetamine must keep an inventory of all stocks of lisdexamfetamine on hand pursuant to Sec. Sec. 1304.03, 1304.04 and 1304.11 of Title 21 of the Code of Federal Regulations on or after June 4, 2007. Every registrant who desires registration in schedule II for lisdexamfetamine must conduct an inventory of all stocks of the substance on hand at the time of registration.

Records. All registrants must keep records pursuant to Sec. Sec. 1304.03, 1304.04, 1304.21, 1304.22, and 1304.23 of Title 21 of the Code of Federal Regulations on or after June 4, 2007.

Reports. All registrants required to submit reports to the Automation of Reports and Consolidated Order System (ARCOS) in accordance with Sec. 1304.33 of Title 21 of the Code of Federal Regulations must do so for lisdexamfetamine.

Orders for Lisdexamfetamine. All registrants involved in the distribution of lisdexamfetamine must comply with the order requirements of part 1305 of Title 21 of the Code of Federal Regulations on or after June 4, 2007.

Prescriptions. All prescriptions for lisdexamfetamine or prescriptions for products containing lisdexamfetamine must be issued pursuant to 21 CFR 1306.03-1306.06 and 1306.11-1306.15.

Importation and Exportation. All importation and exportation of lisdexamfetamine must be in compliance with part 1312 of Title 21 of the Code of Federal Regulations on or after June 4, 2007.

Criminal Liability. Any activity with lisdexamfetamine not authorized by, or in violation of, the Controlled Substances Act or the Controlled Substances Import and Export Act shall be unlawful on or after June 4, 2007.

Regulatory Certifications

Executive Order 12866

In accordance with the provisions of the CSA (21 U. S.C. 811(a)), this action is a formal rulemaking “on the record after opportunity for a hearing.” Such proceedings are conducted pursuant to the provisions of 5 U.S.C. 556 and 557 and, as such, are exempt from review by the Office of Management and Budget pursuant to Executive Order 12866, section 3(d)(1).

Regulatory Flexibility Act

The Deputy Administrator, in accordance with the Regulatory Flexibility Act (5 U.S.C. 605(b)), has reviewed this final rule and by approving it certifies that it will not have a significant economic impact on a substantial number of small entities. Lisdexamfetamine products will be prescription drugs used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Handlers of lisdexamfetamine also handle other controlled substances used to treat ADHD which are already subject to the regulatory requirements of the CSA.

Executive Order 12988

This regulation meets the applicable standards set forth in sections 3(a) and 3(b)(2) of Executive Order 12988 Civil Justice Reform.

Executive Order 13132

This rulemaking does not preempt or modify any provision of state law; nor does it impose enforcement responsibilities on any state; nor does it diminish the power of any state to enforce its own laws. Accordingly, this rulemaking does not have federalism implications warranting the application of Executive Order 13132.

Unfunded Mandates Reform Act of 1995

This rule will not result in the expenditure by State, local and tribal governments, in the aggregate, or by the private sector, of $120,000,000 or more in any one year, and will not significantly or uniquely affect small governments. Therefore, no actions were deemed necessary under provisions of the Unfunded Mandates Reform Act of 1995.

Congressional Review Act

This rule is not a major rule as defined by section 804 of the Small Business Regulatory Enforcement Fairness Act of 1996 (Congressional Review Act). This rule will not result in an annual effect on the economy of $100,000,000 or more; a major increase in costs or prices; or significant adverse effects on competition, employment, investment, productivity, innovation, or on the ability of United States-based companies to compete with foreign-based companies in domestic and export markets.

List of Subjects in 21 CFR Part 1308

Administrative practice and procedure, Drug traffic control, Narcotics, Prescription drugs.

  • Under the authority vested in the Attorney General by section 201(a) of the CSA (21 U.S.C. 811(a)), and delegated to the Administrator of DEA by Department of Justice regulations (28 CFR 0.100), and redelegated to the Deputy Administrator pursuant to 28 CFR 0.104, the Deputy Administrator hereby amends 21 CFR part 1308 as follows:

PART 1308–SCHEDULES OF CONTROLLED SUBSTANCES

Authority: 21 U. S.C. 811, 812, 871(b) unless otherwise noted.

  • 2. Section 1308.12 is amended by adding a new paragraph (d)(5) to read as follows:

Sec. 1308.12 Schedule II.

* * * * *

(d) * * *

[[Page 24534]]

(5) Lisdexamfetamine, its salts, isomers, and salts of its isomers–1205.

* * * * *

Dated: April 25, 2007.

Michele M. Leonhart, 
Deputy Administrator.

[FR Doc. E7-8421 Filed 5-2-07; 8:45 am]

BILLING CODE 4410-09-P

NOTICE: This is an unofficial version. An official version of this publication may be obtained directly from the Government Publishing Office (GPO).

Vyvanse® Dosage Range, Starting Dose, How to Take It

What is the most important information I should know about VYVANSE?

VYVANSE is a federally controlled substance (Cll) because it can be abused or lead to dependence. Keep VYVANSE in a safe place to prevent misuse and abuse. Selling or giving away VYVANSE may harm others, and is against the law.

Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines or street drugs.

VYVANSE is a stimulant medicine. Some people have had the following problems when taking stimulant medicines such as VYVANSE:

1. Heart-related problems including:

  • sudden death in people who have heart problems or heart defects
  • sudden death, stroke and heart attack in adults
  • increased blood pressure and heart rate

Tell your doctor if you have any heart problems, heart defects, high blood pressure, or a family history of these problems.

Your doctor should check you carefully for heart problems before starting VYVANSE.

Your doctor should check your blood pressure and heart rate regularly during treatment with VYVANSE.

Call your doctor right away if you have any signs of heart problems such as chest pain, shortness of breath, or fainting while taking VYVANSE.

2. Mental (psychiatric) problems including:

    In Children, Teenagers, and Adults:

  • new or worse behavior and thought problems
  • new or worse bipolar illness

    In Children and Teenagers

  • new psychotic symptoms such as:
    • hearing voices
    • believing things that are not true
    • being suspicious
  • new manic symptoms

Tell your doctor about any mental problems you have, or if you have a family history of suicide, bipolar illness, or depression.

Call your doctor right away if you have any new or worsening mental symptoms or problems while taking VYVANSE, especially:

  • seeing or hearing things that are not real
  • believing things that are not real
  • being suspicious

3. Circulation problems in fingers and toes [Peripheral vasculopathy, including Raynaud’s phenomenon]:

  • Fingers or toes may feel numb, cool, painful
  • Fingers or toes may change color from pale, to blue, to red

Tell your doctor if you have numbness, pain, skin color change, or sensitivity to temperature in your fingers or toes.

Call your doctor right away if you have any signs of unexplained wounds appearing on fingers or toes while taking VYVANSE.

How Long Does Vyvanse® Last? See Clinical Results for Adult ADHD

What is the most important information I should know about VYVANSE?

VYVANSE is a federally controlled substance (Cll) because it can be abused or lead to dependence. Keep VYVANSE in a safe place to prevent misuse and abuse. Selling or giving away VYVANSE may harm others, and is against the law.

Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines or street drugs.

VYVANSE is a stimulant medicine. Some people have had the following problems when taking stimulant medicines such as VYVANSE:

1. Heart-related problems including:

  • sudden death in people who have heart problems or heart defects
  • sudden death, stroke and heart attack in adults
  • increased blood pressure and heart rate

Tell your doctor if you have any heart problems, heart defects, high blood pressure, or a family history of these problems.

Your doctor should check you carefully for heart problems before starting VYVANSE.

Your doctor should check your blood pressure and heart rate regularly during treatment with VYVANSE.

Call your doctor right away if you have any signs of heart problems such as chest pain, shortness of breath, or fainting while taking VYVANSE.

2. Mental (psychiatric) problems including:

    In Children, Teenagers, and Adults:

  • new or worse behavior and thought problems
  • new or worse bipolar illness

    In Children and Teenagers

  • new psychotic symptoms such as:
    • hearing voices
    • believing things that are not true
    • being suspicious
  • new manic symptoms

Tell your doctor about any mental problems you have, or if you have a family history of suicide, bipolar illness, or depression.

Call your doctor right away if you have any new or worsening mental symptoms or problems while taking VYVANSE, especially:

  • seeing or hearing things that are not real
  • believing things that are not real
  • being suspicious

3. Circulation problems in fingers and toes [Peripheral vasculopathy, including Raynaud’s phenomenon]:

  • Fingers or toes may feel numb, cool, painful
  • Fingers or toes may change color from pale, to blue, to red

Tell your doctor if you have numbness, pain, skin color change, or sensitivity to temperature in your fingers or toes.

Call your doctor right away if you have any signs of unexplained wounds appearing on fingers or toes while taking VYVANSE.

What happens when you mix Vyvanse and alcohol?

Vyvanse (lisdexamfetamine dimesylate) is a popular prescription stimulant used to treat attention deficit hyperactivity disorder (ADHD) in adults and children 6 years and older, as well as binge eating disorder (BED) in adults. The most recent prescribing statistics show that almost 1.5 million Americans take Vyvanse. 

Many patients want to know: Can I mix Vyvanse and alcohol? First, it’s important to know how this medication works and other safety information. 

How does Vyvanse work?

Vyvanse is a prodrug. This means that the ingredient, lisdexamfetamine, is inactive until it is metabolized in the body into its active form, dextroamphetamine. The exact way it works for ADHD and BED is not understood. It is a central nervous system (CNS) stimulant, a medication that increases levels of dopamine and norepinephrine in the brain. It’s thought that the increased levels of dopamine and norepinephrine help improve alertness, attention, energy, and activity. 

Is Vyvanse a controlled substance?

Vyvanse is a Schedule II controlled substance. Schedule II drugs are considered dangerous and have a high potential for abuse and dependence. Vyvanse also has a black box warning, which is the strongest warning required by the FDA. Before prescribing Vyvanse, the healthcare provider will assess the patient for risk of substance abuse. The patient should tell the prescriber if they have ever abused or been dependent on alcohol, street drugs, or prescription drugs. During treatment, the healthcare provider will monitor the patient for signs of abuse and dependence.

In cases of long-term use, it’s important to not abruptly stop Vyvanse, as it can cause withdrawal symptoms. Talk to a healthcare provider or mental health professional for medical advice before discontinuing Vyvanse.

Can you mix Vyvanse and alcohol?

The prescribing information of Vyvanse does not list alcohol as an interaction. However, there are four reasons that you should not mix Vyvanse and alcohol.

1. Heart risks

Vyvanse (and any CNS stimulant) can cause sudden death, heart attack, stroke, high blood pressure, and chest pain. Long-term use of Vyvanse can cause cardiomyopathy, or heart muscle disease. Excess alcohol use can also cause high blood pressure and heart problems, including cardiomyopathy. Mixing Vyvanse and alcohol can potentiate these side effects on the heart. 

2. Alcohol poisoning

While Vyvanse stimulates the nervous system, alcohol has the opposite effect. Alcohol is a depressant. Because the depressant effects of alcohol counteract the stimulant effects of Vyvanse, it can take longer to feel the effects of alcohol. So, people who combine alcohol and Vyvanse may take much longer to feel the effects of alcohol and end up drinking an excessive amount of alcohol. Excess drinking can lead to alcohol poisoning, which is a medical emergency. Symptoms include confusion, seizures, vomiting, and passing out. Alcohol poisoning can also affect breathing and heart rate and can lead to a coma and death.  

3. Vyvanse overdose

Since alcohol is a depressant, and Vyvanse is a stimulant, drinking alcohol can counteract Vyvanse’s effects. This may make it feel like the Vyvanse is not working. Then a person may disregard the directions, and take more Vyvanse, which can increase the risk for overdose. An overdose may manifest as a variety of symptoms which may include:

  • Tremor
  • Restlessness
  • Overactive reflexes
  • Fast breathing
  • Confusion 
  • Hallucination 
  • Panic 
  • Nausea, vomiting, diarrhea, and cramping
  • Life-threatening very high fever
  • A life-threatening syndrome due to muscle breakdown
  • Irregular heart rate and blood pressure
  • Shock 

Convulsions and coma may even occur and can lead to death. 

4. Risk for substance abuse

Certain people have a higher risk for substance abuse problems than others, including those with ADHD. Both ADHD and alcohol use disorder can lower inhibition. Lowered inhibition can lead to risky behaviors such as driving while intoxicated, violence or criminal behaviors, or unsafe sexual situations.   

RELATED: Common Vyvanse side effects

What about other ADHD medication and alcohol?

Other stimulant medications such as Adderall (mixed amphetamine salts), Ritalin (methylphenidate), and Concerta (methylphenidate extended-release) should not be mixed with alcohol for the same reasons listed above. 

Help is available 

If you or a loved one need help with alcohol abuse or substance use, help is always available. The U.S. Department of Health & Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) offers many resources for addiction treatment programs on its website, or you can call the national helpline at 1800-662-HELP (4357). 

Vyvanse (lisdexamfetamine) dosing, indications, interactions, adverse effects, and more

  • acetazolamide

    Monitor Closely (1)acetazolamide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • albuterol

    Monitor Closely (2)albuterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    albuterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • alfentanil

    Monitor Closely (1)alfentanil increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • almotriptan

    Monitor Closely (1)almotriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • alprazolam

    Monitor Closely (1)alprazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • aluminum hydroxide

    Monitor Closely (1)aluminum hydroxide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • amantadine

    Minor (1)amantadine, lisdexamfetamine.
    Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.

  • American ginseng

    Minor (1)American ginseng increases effects of lisdexamfetamine by pharmacodynamic synergism. Minor/Significance Unknown.

  • amitriptyline

    Monitor Closely (2)amitriptyline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    amitriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)amitriptyline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • ammonium chloride

    Monitor Closely (1)ammonium chloride decreases levels of lisdexamfetamine by increasing renal clearance. Use Caution/Monitor.

  • amobarbital

    Monitor Closely (1)amobarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • amoxapine

    Monitor Closely (2)amoxapine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    amoxapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)amoxapine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • ansofaxine

    Monitor Closely (1)ansofaxine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • arformoterol

    Monitor Closely (2)arformoterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    arformoterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • aripiprazole

    Monitor Closely (1)aripiprazole increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • armodafinil

    Monitor Closely (1)armodafinil and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

  • aspirin/citric acid/sodium bicarbonate

    Monitor Closely (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • azelastine

    Monitor Closely (1)azelastine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • belladonna and opium

    Monitor Closely (1)belladonna and opium increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • benazepril

    Monitor Closely (1)lisdexamfetamine decreases effects of benazepril by pharmacodynamic antagonism. Use Caution/Monitor.

  • benperidol

    Monitor Closely (1)benperidol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • benzhydrocodone/acetaminophen

    Monitor Closely (1)benzhydrocodone/acetaminophen, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

  • benzphetamine

    Monitor Closely (2)lisdexamfetamine and benzphetamine both decrease sedation. Use Caution/Monitor.

    benzphetamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • brinzolamide

    Monitor Closely (1)brinzolamide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • bromocriptine

    Monitor Closely (1)bromocriptine, lisdexamfetamine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.

  • brompheniramine

    Monitor Closely (1)brompheniramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • buprenorphine buccal

    Monitor Closely (1)buprenorphine buccal increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • buprenorphine subdermal implant

    Monitor Closely (1)lisdexamfetamine, buprenorphine subdermal implant.
    Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

  • buprenorphine, long-acting injection

    Monitor Closely (1)lisdexamfetamine, buprenorphine, long-acting injection.
    Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

  • bupropion

    Monitor Closely (1)lisdexamfetamine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.

  • buspirone

    Monitor Closely (1)buspirone, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • butabarbital

    Monitor Closely (1)butabarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • butalbital

    Monitor Closely (1)butalbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • butorphanol

    Monitor Closely (1)butorphanol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • cabergoline

    Serious – Use Alternative (1)cabergoline, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • caffeine

    Monitor Closely (1)caffeine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

  • calcium carbonate

    Monitor Closely (1)calcium carbonate will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • captopril

    Monitor Closely (1)lisdexamfetamine decreases effects of captopril by pharmacodynamic antagonism. Use Caution/Monitor. Lisdexamfetamine may decrease antihypertensive effects of ACE Inhibitors.

  • carbinoxamine

    Monitor Closely (1)carbinoxamine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • celandine

    Minor (1)celandine increases effects of lisdexamfetamine by unspecified interaction mechanism. Minor/Significance Unknown. Based on animal studies.

  • chloral hydrate

    Monitor Closely (1)chloral hydrate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • chlordiazepoxide

    Monitor Closely (1)chlordiazepoxide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • chlorpheniramine

    Monitor Closely (1)chlorpheniramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • chlorpromazine

    Monitor Closely (2)chlorpromazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    chlorpromazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • cinnarizine

    Monitor Closely (1)cinnarizine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • citalopram

    Monitor Closely (2)citalopram, lisdexamfetamine.
    Either increases effects of the other by unknown mechanism. Use Caution/Monitor. Risk of serotonin syndrome.

    citalopram, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • clemastine

    Monitor Closely (1)clemastine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • clomipramine

    Monitor Closely (2)clomipramine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    clomipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)clomipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • clonazepam

    Monitor Closely (1)clonazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • clorazepate

    Monitor Closely (1)clorazepate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • clozapine

    Monitor Closely (1)clozapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • codeine

    Monitor Closely (1)codeine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • cyclizine

    Monitor Closely (1)cyclizine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • cyproheptadine

    Monitor Closely (1)cyproheptadine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • desflurane

    Serious – Use Alternative (1)desflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

  • desipramine

    Monitor Closely (2)desipramine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    desipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)desipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • desmopressin

    Minor (1)desmopressin increases effects of lisdexamfetamine by pharmacodynamic synergism. Minor/Significance Unknown.

  • desvenlafaxine

    Monitor Closely (1)desvenlafaxine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • dexchlorpheniramine

    Monitor Closely (1)dexchlorpheniramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dexfenfluramine

    Monitor Closely (2)lisdexamfetamine and dexfenfluramine both decrease sedation. Use Caution/Monitor.

    dexfenfluramine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dexlansoprazole

    Minor (1)dexlansoprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • dexmedetomidine

    Monitor Closely (1)dexmedetomidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dexmethylphenidate

    Monitor Closely (2)dexmethylphenidate and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    dexmethylphenidate and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dextroamphetamine

    Monitor Closely (2)dextroamphetamine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    dextroamphetamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dextromoramide

    Monitor Closely (1)dextromoramide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • diamorphine

    Monitor Closely (1)diamorphine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • diethylpropion

    Monitor Closely (2)lisdexamfetamine and diethylpropion both decrease sedation. Use Caution/Monitor.

    diethylpropion and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • difenoxin hcl

    Monitor Closely (1)difenoxin hcl increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dihydroergotamine

    Serious – Use Alternative (1)dihydroergotamine, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • dihydroergotamine intranasal

    Serious – Use Alternative (1)dihydroergotamine intranasal, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • dimenhydrinate

    Monitor Closely (1)dimenhydrinate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • diphenhydramine

    Monitor Closely (1)diphenhydramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • diphenoxylate hcl

    Monitor Closely (1)diphenoxylate hcl increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dipipanone

    Monitor Closely (1)dipipanone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • dobutamine

    Monitor Closely (2)dobutamine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    dobutamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dopamine

    Monitor Closely (2)lisdexamfetamine and dopamine both decrease sedation. Use Caution/Monitor.

    dopamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dopexamine

    Monitor Closely (2)dopexamine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    dopexamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • dorzolamide

    Monitor Closely (1)dorzolamide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • doxapram

    Serious – Use Alternative (1)doxapram increases effects of lisdexamfetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.

  • doxepin

    Monitor Closely (2)doxepin, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    doxepin increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)doxepin, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • droperidol

    Monitor Closely (1)droperidol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • droxidopa

    Monitor Closely (1)lisdexamfetamine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension

  • duloxetine

    Monitor Closely (1)duloxetine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • eletriptan

    Monitor Closely (1)eletriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • ephedrine

    Monitor Closely (2)ephedrine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    ephedrine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • epinephrine

    Monitor Closely (2)epinephrine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    epinephrine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • epinephrine inhaled

    Monitor Closely (1)lisdexamfetamine, epinephrine inhaled.
    Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • epinephrine racemic

    Monitor Closely (2)epinephrine racemic and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    epinephrine racemic and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • ergoloid mesylates

    Serious – Use Alternative (1)ergoloid mesylates, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • ergotamine

    Serious – Use Alternative (1)ergotamine, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • escitalopram

    Monitor Closely (1)escitalopram, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • esketamine intranasal

    Monitor Closely (1)esketamine intranasal, lisdexamfetamine.
    Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .

  • esomeprazole

    Minor (1)esomeprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • estazolam

    Monitor Closely (1)estazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ethanol

    Monitor Closely (1)ethanol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ether

    Serious – Use Alternative (1)ether increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

  • ethosuximide

    Minor (1)lisdexamfetamine decreases levels of ethosuximide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

  • eucalyptus

    Minor (1)eucalyptus increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

  • fenfluramine

    Monitor Closely (2)lisdexamfetamine and fenfluramine both decrease sedation. Use Caution/Monitor.

    fenfluramine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • fentanyl

    Monitor Closely (1)fentanyl, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • fluoxetine

    Monitor Closely (1)fluoxetine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • fluphenazine

    Monitor Closely (2)fluphenazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    fluphenazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • flurazepam

    Monitor Closely (1)flurazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • fluvoxamine

    Monitor Closely (1)fluvoxamine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • formoterol

    Monitor Closely (2)formoterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    formoterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • frovatriptan

    Monitor Closely (1)frovatriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • green tea

    Monitor Closely (1)green tea, lisdexamfetamine. Other (see comment). Use Caution/Monitor.
    Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.

  • guarana

    Minor (1)guarana increases effects of lisdexamfetamine by pharmacodynamic synergism. Minor/Significance Unknown.

  • haloperidol

    Monitor Closely (1)haloperidol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • hydralazine

    Monitor Closely (1)hydralazine, lisdexamfetamine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.

  • hydrocodone

    Monitor Closely (1)hydrocodone, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

  • hydromorphone

    Monitor Closely (1)hydromorphone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • hydroxyzine

    Monitor Closely (1)hydroxyzine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • iloperidone

    Monitor Closely (1)iloperidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • imipramine

    Monitor Closely (2)imipramine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    imipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)imipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • iobenguane I 123

    Contraindicated (1)lisdexamfetamine decreases effects of iobenguane I 123 by receptor binding competition. Contraindicated. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results.

  • iobenguane I 131

    Serious – Use Alternative (1)lisdexamfetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

  • isocarboxazid

    Contraindicated (1)isocarboxazid, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • isoflurane

    Serious – Use Alternative (1)isoflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

  • isoproterenol

    Monitor Closely (2)isoproterenol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    isoproterenol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • ketotifen, ophthalmic

    Monitor Closely (1)ketotifen, ophthalmic increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • lansoprazole

    Minor (1)lansoprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • levalbuterol

    Monitor Closely (2)levalbuterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    levalbuterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • levomilnacipran

    Monitor Closely (1)levomilnacipran, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • levorphanol

    Monitor Closely (1)levorphanol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • linezolid

    Contraindicated (1)linezolid increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

  • lithium

    Monitor Closely (1)lithium, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • lofepramine

    Monitor Closely (1)lofepramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)lofepramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • lofexidine

    Monitor Closely (1)lofexidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • loprazolam

    Monitor Closely (1)loprazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • lorazepam

    Monitor Closely (1)lorazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • lorcaserin

    Serious – Use Alternative (1)lisdexamfetamine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

  • lormetazepam

    Monitor Closely (1)lormetazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • loxapine

    Monitor Closely (1)loxapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • loxapine inhaled

    Monitor Closely (1)loxapine inhaled increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • magnesium oxide

    Monitor Closely (1)magnesium oxide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • maprotiline

    Monitor Closely (1)maprotiline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)maprotiline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • marijuana

    Monitor Closely (1)marijuana increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • melatonin

    Monitor Closely (1)melatonin increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • meperidine

    Monitor Closely (1)meperidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • meprobamate

    Monitor Closely (1)meprobamate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • metaproterenol

    Monitor Closely (2)metaproterenol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    metaproterenol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • methadone

    Monitor Closely (1)methadone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • methamphetamine

    Monitor Closely (2)lisdexamfetamine and methamphetamine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • methazolamide

    Monitor Closely (1)methazolamide will increase the level or effect of lisdexamfetamine by passive renal tubular reabsorption – basic urine. Use Caution/Monitor.

  • methoxyflurane

    Serious – Use Alternative (1)methoxyflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

  • methyldopa

    Monitor Closely (1)methyldopa increases effects of lisdexamfetamine by unknown mechanism. Use Caution/Monitor.

  • methylenedioxymethamphetamine

    Monitor Closely (2)lisdexamfetamine and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • methylergonovine

    Serious – Use Alternative (1)methylergonovine, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

  • methylphenidate

    Monitor Closely (1)lisdexamfetamine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.

  • midazolam

    Monitor Closely (1)midazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • midodrine

    Monitor Closely (2)lisdexamfetamine and midodrine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • milnacipran

    Monitor Closely (1)milnacipran, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • mirtazapine

    Monitor Closely (1)mirtazapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • modafinil

    Monitor Closely (1)lisdexamfetamine and modafinil both decrease sedation. Use Caution/Monitor.

  • morphine

    Monitor Closely (1)morphine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • motherwort

    Monitor Closely (1)motherwort increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • moxonidine

    Monitor Closely (1)moxonidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • nabilone

    Monitor Closely (1)nabilone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • nalbuphine

    Monitor Closely (1)nalbuphine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • naratriptan

    Monitor Closely (1)naratriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • nateglinide

    Monitor Closely (1)lisdexamfetamine decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor. Coadministration may reduce nateglinide’s hypoglycemic action.

  • norepinephrine

    Monitor Closely (2)norepinephrine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    norepinephrine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • nortriptyline

    Monitor Closely (2)nortriptyline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    nortriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)nortriptyline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • olanzapine

    Monitor Closely (1)olanzapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • omeprazole

    Minor (1)omeprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • opium tincture

    Monitor Closely (1)opium tincture increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • oxazepam

    Monitor Closely (1)oxazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • oxycodone

    Monitor Closely (1)oxycodone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • oxymorphone

    Monitor Closely (1)oxymorphone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • oxytocin

    Monitor Closely (1)oxytocin increases effects of lisdexamfetamine by pharmacodynamic synergism. Use Caution/Monitor.

  • ozanimod

    Serious – Use Alternative (1)ozanimod increases toxicity of lisdexamfetamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

  • paliperidone

    Monitor Closely (1)paliperidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • pantoprazole

    Minor (1)pantoprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • papaveretum

    Monitor Closely (1)papaveretum increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • paroxetine

    Monitor Closely (1)paroxetine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • pentazocine

    Monitor Closely (1)pentazocine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • pentobarbital

    Monitor Closely (1)pentobarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • perphenazine

    Monitor Closely (2)perphenazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    perphenazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • phendimetrazine

    Monitor Closely (2)lisdexamfetamine and phendimetrazine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • phenelzine

    Contraindicated (1)phenelzine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • phenobarbital

    Monitor Closely (1)phenobarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • phentermine

    Monitor Closely (2)lisdexamfetamine and phentermine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • phenylephrine

    Monitor Closely (2)lisdexamfetamine and phenylephrine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • phenylephrine PO

    Monitor Closely (2)lisdexamfetamine and phenylephrine PO both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • pholcodine

    Monitor Closely (1)pholcodine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • pimozide

    Monitor Closely (1)pimozide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • pirbuterol

    Monitor Closely (2)pirbuterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    pirbuterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • primidone

    Monitor Closely (1)primidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • procarbazine

    Contraindicated (1)procarbazine increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

  • prochlorperazine

    Monitor Closely (2)prochlorperazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    prochlorperazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • promazine

    Monitor Closely (1)promazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

  • promethazine

    Monitor Closely (2)promethazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    promethazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • propylhexedrine

    Monitor Closely (2)lisdexamfetamine and propylhexedrine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • protriptyline

    Monitor Closely (2)protriptyline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    protriptyline increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)protriptyline, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • pseudoephedrine

    Monitor Closely (1)lisdexamfetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • quazepam

    Monitor Closely (1)quazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • quetiapine

    Monitor Closely (1)quetiapine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • rabeprazole

    Minor (1)rabeprazole, lisdexamfetamine. Other (see comment). Minor/Significance Unknown.
    Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

  • rasagiline

    Contraindicated (2)rasagiline increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Coadministration is contraindicated during or within 14 days following the administration of MAOIs.

    rasagiline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • risperidone

    Monitor Closely (1)risperidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • rizatriptan

    Monitor Closely (1)rizatriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • safinamide

    Contraindicated (2)lisdexamfetamine, safinamide.
    Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

    safinamide, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • sage

    Minor (1)sage increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

  • salmeterol

    Monitor Closely (2)salmeterol and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    salmeterol and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • scullcap

    Monitor Closely (1)scullcap increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • secobarbital

    Monitor Closely (1)secobarbital increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • selegiline

    Contraindicated (2)selegiline increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Coadministration is contraindicated during or within 14 days following the administration of MAOIs.

    selegiline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • selegiline transdermal

    Contraindicated (2)selegiline transdermal increases effects of lisdexamfetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

    selegiline transdermal, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • sertraline

    Monitor Closely (1)sertraline, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • sevoflurane

    Serious – Use Alternative (1)sevoflurane increases toxicity of lisdexamfetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

  • shepherd’s purse

    Monitor Closely (1)shepherd’s purse increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • sodium acid phosphate

    Monitor Closely (1)sodium acid phosphate decreases levels of lisdexamfetamine by increasing renal clearance. Use Caution/Monitor.

  • St John’s Wort

    Monitor Closely (1)St John’s Wort, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • sufentanil

    Monitor Closely (1)sufentanil increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • sufentanil SL

    Monitor Closely (1)sufentanil SL, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

  • sumatriptan

    Monitor Closely (1)sumatriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • sumatriptan intranasal

    Monitor Closely (1)sumatriptan intranasal and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

  • tapentadol

    Monitor Closely (1)tapentadol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • tedizolid

    Serious – Use Alternative (1)tedizolid, lisdexamfetamine.
    Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

  • temazepam

    Monitor Closely (1)temazepam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • terbutaline

    Monitor Closely (2)terbutaline and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

    terbutaline and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • thioridazine

    Monitor Closely (2)thioridazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    thioridazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • thiothixene

    Monitor Closely (1)thiothixene increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • topiramate

    Monitor Closely (1)topiramate increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

  • tramadol

    Monitor Closely (2)tramadol, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    tramadol increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • tranylcypromine

    Contraindicated (1)tranylcypromine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Contraindicated. Do not use amphetamines during and within 14 days of discontinuation of monoamine oxidase inhibitors. .

  • trazodone

    Monitor Closely (1)trazodone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)trazodone, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • triazolam

    Monitor Closely (1)triazolam increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • triclofos

    Monitor Closely (1)triclofos increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • trifluoperazine

    Monitor Closely (2)trifluoperazine, lisdexamfetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

    trifluoperazine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • trimipramine

    Monitor Closely (2)trimipramine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

    trimipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious – Use Alternative (1)trimipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

  • triprolidine

    Monitor Closely (1)triprolidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • venlafaxine

    Monitor Closely (1)venlafaxine, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).

  • vilazodone

    Monitor Closely (1)vilazodone, lisdexamfetamine.
    Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s).Serious – Use Alternative (1)lisdexamfetamine, vilazodone.
    Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

  • xylometazoline

    Monitor Closely (2)lisdexamfetamine and xylometazoline both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • yerba mate

    Minor (1)yerba mate increases effects of lisdexamfetamine by pharmacodynamic synergism. Minor/Significance Unknown.

  • yohimbe

    Serious – Use Alternative (1)yohimbe, lisdexamfetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

  • yohimbine

    Monitor Closely (2)lisdexamfetamine and yohimbine both decrease sedation. Use Caution/Monitor.

    lisdexamfetamine and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

  • ziconotide

    Monitor Closely (1)ziconotide increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • ziprasidone

    Monitor Closely (1)ziprasidone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

  • zolmitriptan

    Monitor Closely (1)zolmitriptan and lisdexamfetamine both increase serotonin levels. Use Caution/Monitor.

    • 18VAC110-20-290. Dispensing of Schedule II drugs.

    18VAC110-20-290. Dispensing of Schedule II drugs.

    A. A prescription for a Schedule II drug shall be dispensed in good faith but in no case shall it be dispensed more than six months after the date on which the prescription was issued.

    B. A prescription for a Schedule II drug shall not be refilled except as authorized under the conditions for partial dispensing as set forth in 18VAC110-20-310.

    C. In case of an emergency situation, a pharmacist may dispense a drug listed in Schedule II upon receiving oral authorization of a prescribing practitioner provided that:

    1. The quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period;

    2. The prescription shall be immediately reduced to writing by the pharmacist and shall contain all information required in § 54.1-3410 of the Drug Control Act, except for the signature of the prescribing practitioner;

    3. If the pharmacist does not know the practitioner, the pharmacist shall make a reasonable effort to determine that the oral authorization came from a practitioner using the practitioner’s phone number as listed in the telephone directory or other good-faith efforts to ensure the practitioner’s identity; and

    4. Within seven days after authorizing an emergency oral prescription, the prescribing practitioner shall cause a written prescription for the emergency quantity prescribed to be delivered to the dispensing pharmacist. In addition to conforming to the requirements of § 54.1-3410 of the Drug Control Act, the prescription shall have written on its face “Authorization for Emergency Dispensing” and the date of the oral order. The written prescription may be delivered to the pharmacist in person or by mail postmarked within the seven-day period or transmitted as an electronic prescription in accordance with federal law and regulation to include annotation of the electronic prescription with the original authorization and date of the oral order. Upon receipt, the dispensing pharmacist shall attach the paper prescription to the oral emergency prescription, which had earlier been reduced to writing. The pharmacist shall notify the nearest office of the Drug Enforcement Administration and the board if the prescribing practitioner fails to deliver a written prescription to the pharmacist. Failure of the pharmacist to do so shall void the authority conferred by this subdivision to dispense without a written prescription of a prescribing practitioner.

    D. When presented a prescription written for a Schedule II controlled substance, a pharmacist may add or correct the patient’s address upon verification, correct the patient’s name upon verification, or add the prescriber’s DEA registration number to the prescription. The pharmacist may add or change the dosage form, drug strength, directions for use, drug quantity, or issue date only after oral consultation directly with and agreement of the prescriber. Such consultations and corresponding changes shall be noted by the pharmacist on the prescription. The pharmacist shall not add or change the prescriber’s signature or make changes to the controlled substance prescribed, except for dispensing therapeutically equivalent drugs as permitted by law.

    Statutory Authority

    §§ 54.1-2400 54.1-3307 of the Code of Virginia.

    Historical Notes

    Derived from VR530-01-1 § 6. 3, eff. October 25, 1989; amended, Virginia Register Volume 9, Issue 4, eff. December 16, 1992; Volume 10, Issue 1, eff. November 4, 1993; Volume 11, Issue 21, eff. August 9, 1995; Volume 12, Issue 21, eff. August 7, 1996; Volume 15, Issue 8, eff. February 3, 1999; Volume 26, Issue 22, eff. August 4, 2010; Volume 36, Issue 6, eff. December 11, 2019.

    Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader’s convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

    As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.

    90,000

    Clinical Study Attention Deficit Hyperactivity Disorder: Vyvanse – Clinical Trials Registry

    Detailed Description

    This is a simple blinded study to evaluate the safety and efficacy of Vyvanse ™ and provide pilot data in two areas: (1) on the use of near infrared spectroscopy for drug detection. effects in children with ADHD; and (2) the effect of Vyvanse ™ on reading fluency and comprehension over approximately 6 weeks.the subjects will be 6 years of age or older. and 12 at the start of the study. The study will consist of periods detailed below: Screening and laundering. Subjects will be screened four weeks prior to baseline. the washout period is 3 days for most ADHD-stimulating drugs (half-life is about 3-5 days). hours and the duration of the washout is at least 5 half-lives). discussed during the visit. A screening visit will take place at the UCI Child Development Center and will determine the appropriateness of including each subject in the study.The investigator or his / her designee must obtain the subject’s written consent, dated and signed. to participate in the research from the parent (s) of the subject (s) / legal representative, and consent must be given by the subject before any research-related procedures are performed. This visit is expected to last 3-4 hours and can be completed in more than one day. During the screening visit, the following procedures will be carried out: – Informed consent / consent obtained – Psychiatric evaluation using the Childhood Affective Disorders Schedule and Schizophrenia – Present and Lifetime Version (K-SADS-PL) and according to DSM-IV-TR ™ criteria – Inclusion criteria / exceptions confirmed – Demographic data collected – Medical and medical history – Physical examination including height (using a calibrated height meter), weight (using a calibrated scale) – Sedentary vital signs after 5 minutes of rest (temperature of the mouth or tympanic membrane, pulse, blood pressure and respiratory rate) – 12-lead ECG after 5 minutes rest – Kaufman Brief Intelligence Test 2 (KBIT2): used to assess both Verbal and Non-verbal Cognitive Ability.- Review of concomitant medications – Review of adverse events In addition, the subject will be asked to provide a small blood sample for safety checks. for laboratory procedures (approximately 2 teaspoons) The following laboratory procedures will be performed: – Hematology with complete blood count (CBC) – Serum chemistry – Urinalysis and microscopic examination (if during urinalysis) – Serum pregnancy test for all FOCPs – A negative serum pregnancy test must be documented for inclusion in this study – Basic urine drug testing procedures.completed, subjects will return to the site for a basic visit that will last approximately 5-6 hours. Subjects will be provided with a weekly supply of VyvanseTM 30 mg / day. treatment in the morning before visiting baseline and continue taking the same dose for the next week. The first dose of medication will be administered locally and the next dose will be given. the subject’s parent (s) / legal guardian who will be required to administer the study drug to the subject upon awakening. During the visit, subjects will perform the Attention Task during the NIRS recording and will also be given Gray’s oral message.Reading test before medication administration. The subject will remain in place until a second NIRS measurement is taken a second time. They will be provided with food and activities while waiting. During the baseline visit, the following procedures will be carried out: – Proof of permanent eligibility (i.e. in relation to inclusion / exclusion criteria and treatment history) – Sedentary vital signs (oral or tympanic membrane temperature, pulse, blood pressure and respiratory paths).score) – Attention Deficit / Hyperactivity Rating Scale-IV-Parent: Investigator Administered and Assessed (ADHDRS-IV-Parent: Inv): Primary performance indicator used to rate 18 ADHD symptoms. – Global Clinical Impression Severity Scale (CGI-S): This measure is used to assess the severity of a subject’s symptoms. – Concomitant medications will be reviewed with the subject. – Adverse Events – Drugs are injected on the spot – NIR Spectroscopy and Attention is performed twice, once before taking drugs.and again 3-4 hours after the first dose of medication. – Conduct the Gray Oral Reading Test-4 (GORT-4), which is used to test oral reading speed, accuracy, fluency, and comprehension prior to taking medication. – Distribution of open-label investigational drug – A weekly supply of Vyvanse ™ 30 mg capsules will be dispensed, including the locally injected dose. Dose optimization. During the dose optimization period, subjects will visit the office once. per week so that the investigator can determine if the subject is tolerating the study and if she / she sees any benefit.These visits will last approximately 45 minutes. The investigator will analyze AEs, ADHD-RS-IV and CGI-I scores and use clinical data. judgment to ensure that subjects are titrated to an acceptable dose of VyvanseTM for evaluation. At each visit, the following procedures will be performed to optimize the dose: – Sedentary vital signs (temperature of the mouth or eardrum, pulse, blood pressure and airway). score) – Object weight (using a calibrated scale) – Investigator dose assessment – ADHD-RS-IV – Clinical Improvement Overall Impression (CGI-I) scale.- Investigational drug accountability and compliance assessed – Distribution of open investigational drug – Concomitant medications – Adverse events Dose-optimized NIRS and GORT testing This visit will be similar to the baseline visit, with subjects arriving early in the morning. and drugs will be administered locally. They will remain in place for the next 4 hours, so that the dose will be maximized prior to GORT or NIRS. During this visit, the following procedures will take place: – Sedentary vital signs after 5 minutes of rest (oral and eardrum temperature, pulse, blood pressure and respiratory rate) – Object weight (using a calibrated scale) – An electrocardiogram will be taken.- Serum pregnancy test for all FOCPs – A negative serum pregnancy test should be documented at the end of the study. – ADHD-RS-IV – CGI-I – Evaluated accountability and compliance of investigational drugs – Concomitant medications – Adverse events – Medications are injected on site – NIR spectroscopy and Attention task are performed once. – Take the Gray Oral Reading Test. – Physical examination including height (using a calibrated height meter) – Follow-up phone call with 12-lead ECG for 30 days.

    Vyvanse Side Effects and How to Avoid Them – Product Information

    Product Information

    Vyvanse Side Effects | The collapse of Vyvanse | Weight Loss | Anxiety | Conclusion | How long do the side effects last? | Warnings | Interactions | Avoiding Side Effects

    Vyvanse (active ingredient: lisdexamphetamine dimesylate) is a brand-name prescription drug that treats attention deficit hyperactivity disorder (ADHD) in adults and children over 6 years of age.It is also approved for the treatment of binge eating disorder (BED) in adults, but is commonly used as a second line therapy.

    Vyvanse belongs to a class of central nervous system stimulants called amphetamines. Its main effect is to speed up the brain. Unlike most other stimulant medications, Vyvanse is a prodrug, which means it doesn’t work until it is metabolized by the body to its active form. dextroamphetamine. Like all stimulant medications, Vivance may not be suitable for everyone.Side effects, warnings, and drug interactions should be discussed with your doctor before starting this medication.

    RELATED: Learn more about Vyvanse | Get Discounts Vyvanse

    Common Vyvanse Side Effects

    Vyvanse side effects will vary from patient to patient. Stimulants reduce hyperactivity, inattention, and impulsivity in ADHD patients, but may have the opposite effect in patients.misdiagnosed ADHD. Someone who takes Vyvanse but does not need it may experience anxiety, anxiety, agitation, nervousness, heart palpitations, or excessive sweating.

    In the treatment of ADHD, the most common side effects of Vivance are:

    • Decreased appetite
    • Loss of appetite
    • Weight loss
    • Diarrhea
    • Nausea
    • Vomiting
    • Pain in the upper stomach
    • Dry mouth
    • Insomnia
    • Irritability
    • Anxiety

    When taking for binge eating, the most common side effects of Vivance are:

    • Decreased appetite
    • Constipation
    • Dry mouth
    • Increased heart rate
    • Anxiety

    Serious side effects Vyvanse

    All drugs that affect the central nervous system can cause serious and even life-threatening side effects.Many of the serious side effects of Vyvanse are related to its effects on speeding up the brain and nervous system.

    The most serious side effects of Vyvanse include:

    • Psychiatric problems such as anxiety, aggression or mania
    • Neurological disorders such as tics, seizures or serotonin syndrome
    • Heart problems such as heart palpitations , heart attack and sudden death in people with heart problems
    • Circulatory problems such as high blood pressure, stroke, damage to peripheral blood vessels, discoloration of the skin and Raynaud’s phenomenon
    • Severe allergic reactions
    • Addiction, abuse drugs and withdrawal symptoms with abrupt discontinuation

    Crash Vyvanse

    The effect of a morning dose of Vyvanse usually wears off in the afternoon or evening.When they do this, some patients experience a Vyvanse accident characterized by fatigue, fatigue, depression, irritability, anxiety, nervousness, and mood swings. The symptoms of Vyvanse collapse are very similar to Vyvanse withdrawal syndrome.

    The Vyvanse crash is not always avoidable, but it can be dealt with successfully:

    • Plan Your Schedule : Plan the most important activities of the day during the hours when Vyvanse is most active in the body.Plan a long break around the time of day when a Vyvanse accident usually occurs.
    • Avoid depressants : Symptoms of Vyvanse collapse may worsen if you take other drugs that depress the central nervous system, such as alcohol, sedatives, muscle relaxants, anticonvulsants, and sleeping pills.
    • Practice good sleep hygiene : Lack of sleep also contributes to the collapse of Vyvanse.There are several good habits you can use to ensure you get enough sleep at night, such as doing relaxing activities before bed, going to bed at the same time every night, and eliminating distractions when you go to bed.
    • Talk to your doctor : Vyvanse is not necessary for everyone. Your healthcare provider may suggest alternatives, such as changing your dose, changing your dosing schedule, or switching to a different medication.

    Weight Loss

    Two prominent side effects of Vyvanse are decreased appetite and weight loss. Although decreased appetite is equally common in adults and children, weight loss is the more common side effect of Vyvanse in children. In the initial clinical trials of Vyvanse, nearly one in ten children who took Vyvanse for four weeks lost weight in proportion to dose: the higher the dose, the greater the weight loss on average. Children on Vyvanse also grow more slowly than other children.

    Only 3% of adults taking Vyvans for ADHD lost weight in the same four-week period. However, when Vyvanse is taken for binge eating disorder, weight loss was observed in 4% of patients. More recent research shows that a clinically significant number of people with binge eating disorder lose weight while taking Vivanse by reducing their appetite and the number of binge eating episodes each week.

    Because decreased appetite and weight loss are side effects of Vyvanse, some doctors prescribe Vyvanse off-label.severe obesity in children and adolescents.

    Anxiety

    In previous studies, 5% to 6% of adults reported anxiety as a side effect of Vyvanse. Children are less likely to experience anxiety as a side effect of Vivanse. In one study, anxiety and agitation were observed in less than 1% of children.

    Generally stimulants such as Vyvanse speed up and energize the brain, so alertness, energy, nervousness, restlessness, agitation, jumpy thoughts, and anxiety are common side effects.However, in people with ADHD, certain stimulants increase alertness, attention, and impulse control, while reducing hyperactivity, anxiety, and anxiety. These stimulants increase the levels of certain chemicals in the brain – dopamine and norepinephrine. Because ADHD patients don’t produce enough of these chemicals, stimulants improve their ability to manage hyperactivity and attention.

    Too much dopamine and norepinephrine, a chemical similar to adrenaline, overexcites the brain and causes increased energy, inattention, nervousness, agitation, excitability, or euphoria.If a person with normal dopamine and norepinephrine levels is experiencing anxiety, Vyvans is likely to exacerbate the anxiety. Side effects such as anxiety, nervousness, and tension may indicate that either Vyvanse or the prescribed dose is inappropriate.

    Conclusion

    Vyvanse is a Schedule II controlled substance, which means a high potential for abuse and dependence. With long-term use, Vyvanse may cause withdrawal symptoms if the dose is reduced or the drug is suddenly stopped.These symptoms include:

    • Fatigue
    • Excessive sleep
    • Depression
    • Mood swings
    • Increased appetite
    • Cravings

    Most Vyvanse withdrawal symptoms resolve within five to seven days. Your healthcare provider may use a gradually tapering dose to prevent or reduce withdrawal symptoms. There are certain side effects, such as serotonin syndrome or heart problems, that will require you to stop taking Vivance immediately.

    How long do the side effects last?

    Vivance remains active in the body for eight to 14 hours, so the side effects should disappear during this time. However, Vyvanse withdrawal symptoms can last for up to seven days. If the side effects persist after you stop taking Vivance, consult your doctor.

    Vyvanse Contraindications and warnings

    Vyvanse is not for everyone. People with the following medical conditions should not take Vyvanse:

    • Hypersensitivity to amphetamines or any other ingredient in Vyvanse.
    • Pregnant or lactating women
    • Heart disease, heart defects, arrhythmias or coronary artery disease.

    There are other caveats as well.

    People taking monoamine oxidase inhibitors (MAOIs), a class of drugs that include certain types of antidepressants, antibiotics, or drugs that treat Parkinson’s disease, will not be prescribed Vivans until they stop taking MAO inhibitors for at least 14 days.

    Growth retardation in children

    Vyvanse has been approved by the FDA as a safe treatment for ADHD in children aged 6 to 17 years.However, Vyvanse inhibits growth in children, so height and weight must be carefully monitored. If growth inhibition is too severe, Vivance therapy may need to be changed.

    Pregnancy and breastfeeding

    Insufficient data to determine the safety of using Vivanse in pregnant or lactating mothers. Dextroamphetamine crosses the placenta and is present in small amounts in breast milk. However, if you have been taking Vyvanse, do not suddenly stop without talking to your healthcare provider.

    Elderly

    The safety of using Vyvanse in people over 65 years of age is not well understood. If considered safe by a healthcare professional, older adults often start with a low dose of Vivanse.

    Vyvanse Interactions

    Vyvanse has clinically significant interactions with over 200 medications and other substances. Most of these interactions are not dangerous, but people may find that Vyvans or other drugs are less effective when taken together.

    MAO inhibitors

    Vyvanse should never be taken for at least 14 days after taking monoamine oxidase inhibitors (MAOIs), including certain types of antidepressants, antibiotics, and drugs for Parkinson’s disease, such as:

    • Tranylcypromine
    • Marplan (isocarboxazid)
    • Nardil (radio) phenelzine)
    • Linezolid
    • Selegiline
    • Xadago (safinamide)
    • Methylene blue for injection

    These drugs can cause dangerously high blood pressure when combined with Vivans.

    Stimulants

    Vivance may enhance the effects of other CNS stimulants, including increased blood pressure and heart rate. CNS stimulants include:

    • Caffeine, cocaine, or ginseng
    • Other ADHD medications
    • Certain nasal decongestants
    • Appetite suppressants, such as phendimetrazine
    • Wakefulness drugs that treat narcolepsy
    • Steroids such as epinephrine or norepinephrine.

    Depressants

    In general, combining stimulants with depressants is rarely recommended. Amphetamines, such as Vyvanse, usually reduce the effects of depressants, but some combinations of amphetamines and depressants can be dangerous. Vyvanse should not be used with depressants such as:

    • Alcohol, marijuana or cannabinoids
    • Cough medicines
    • Narcotics
    • Sedatives
    • Barbiturates
    • Anxiety medications
    • Nervous pain medications

      • to

    • Anxiety medications
    • Anticonvulsants
    • Certain drugs for Parkinson’s disease

    Antidepressants and serotonergic drugs

    If your healthcare provider does not think it is safe to do so, do not use Vyvanse in combination with any other drug that alters serotonin levels.Antidepressants, certain migraine medications, and certain appetite suppressants taken in combination with Vyvanse increase the risk of serotonin syndrome.

    Blood Pressure Medications

    Amphetamines, such as Vyvanse, increase blood pressure, so they block the effects of medications designed to lower blood pressure. Combining amphetamines with blood pressure medications will require careful monitoring and possibly modification of therapy.Avoid amphetamines in combination with blood pressure medications.

    Acidifying or alkylating agents

    Medicines that increase (acidify) or decrease (alkylate) the acid content in the stomach or urine, reduce the body’s ability to absorb vivance and prevent its excretion. In particular, avoid antacids, acidic foods, citrates, and diuretics while taking Vyvanse. Certain multivitamins should also be avoided.

    Ask your healthcare professional for a complete list of drug and food interactions.

    Avoiding Vyvanse Side Effects

    Stimulants such as Vyvanse usually cause side effects. Because Vyvanse speeds up the brain, it is not uncommon to experience side effects such as decreased appetite, insomnia, high blood pressure, increased heart rate, agitation, or anxiety. Some patients experience Vyvanse collapse, similar to withdrawal, where the drug is discontinued later in the day.

    Here are a few tips to help you manage the side effects of Vyvanse:

    • Take Vyvanse as directed. Do not increase or decrease the dose. If the medicine does not work or if side effects occur, talk with your doctor about changing the dose or switching to a new medicine. Always follow the directions in the medication guide.
    • Take Vyvanse at the same time every morning. Vyvanse should be taken early in the morning.Pick a time at least an hour before vigilance and attention is required, and stick to that schedule. If you miss an appointment, take it later in the morning. However, do not take the dose in the afternoon to avoid sleeplessness before bed.
    • Report all of your medical conditions and medications. This will prevent side effects and dangerous interactions.
    • Find an alternative to coffee. Other stimulants may increase the risk and severity of Vyvanse side effects, so it is advised to avoid them.Besides some medications, stimulants also include caffeine. You may need to find an alternative to your daily cup of coffee that will cheer you up.
    • Practice good sleep hygiene. Sleep problems are one of the most common side effects of Vyvanse. The first step in overcoming medication-induced insomnia is to practice good daily sleep hygiene. Avoid TV or video games before bed, develop a nighttime relaxation routine, and go to bed at the same time every night.
    • Take medication leave (if approved by your doctor). If side effects occur with ADHD stimulants, your doctor may advise you to take a dispensing drug when the drug is stopped or the dose is reduced for several days, weeks, or even months.

    Medication dispensing is not suitable for everyone, however. Patients with moderate to severe symptoms of ADHD may require a strict dosing schedule. Taking binge-eating medications on vacation will increase your risk of heavy binge eating.Seek professional medical attention first; there may be alternative treatments with fewer side effects.

    Resources:

    • Binge Eating, StatPearls
    • Vyvanse, Epocrates
    • Prescribing Information Vyvanse, FDA
    • Overview of Lisdexamphetamine Dimesylate in Adults with Attention Deficit Hyperactivity Disorder, Journal of Central Nervous System Disease

      • Central Nervous System Diseases

      Overeating, Takeda

    • Vyvanse for ADHD, Takeda
    • Lisdexamphetamine in the treatment of moderate to severe binge eating in adults, Neuropsychiatric diseases and treatment
    • Use of lisdexamphetamine for the treatment of obesity in adolescents with severe obesity and binge eating3, 9037
    • Reducing the risk of anxiety with psychostimulant treatment in children with attention deficit hyperactivity disorder, Journal of Child and Adolescent Psychopharmacology
    • Yes Are the Long-Term Damage Risks of Vyvanse Abuse? , American Narcology Centers
    • Transfer of dexamphetamine into breast milk during treatment of attention deficit hyperactivity disorder, British Journal of Clinical Pharmacology

    Best Biotech Stories Monday: Milan, Abbott, Shire, Excelixis, Progenics

    Let’s take a quick look at five stocks – Mylan

    (NASDAQ: MYL)

    Abbott Laboratories

    (NYSE: ABT)

    Shire

    (NASDAQ: SHPG)

    Exelixis

    (NASDAQ: EXEL)

    and Progenics

    (NASDAQ: PGNX)

    – which could all make headlines in the health news Monday morning.

    Mylan acquires Abbott non-patent portfolio for $ 5.3 billion
    90,024

    Milan just now

    agreed to purchase non-US specialist and branded company Abbott Laboratories for $ 5.3 billion. The deal will be closed through a share deal of 105 million common shares, representing 21% of Mylan’s shares. Mylan shares are up nearly 2% since the announcement.

    The assets included in the transaction include more than 100 drugs, which generate about $ 1.9 billion a year.The deal will also include about 2,000 sales representatives in over 40 markets outside the US and two manufacturing sites. Mylan is expected to take advantage of the deal to move its US tax address to Switzerland and lower the corporate tax rate. Milan expects the deal to be profitable immediately, adding roughly $ 0.25 per diluted share in the first year.

    Abbott intends to use the proceeds from the sale to invest in other opportunities.

    Main competitors of Milan,

    Teva Pharmaceutical

    and

    Actavis

    respectively reside in Israel and Ireland, which have lower corporate tax rates than the United States. Milan previously tried to acquire Swedish pharmacist

    Meda AB

    for the same purpose earlier this year, but was rejected.

    Wider may finally concede fifth offer to AbbVie

    Abbvie

    (NYSE: ABBV)

    has

    raised its bid for Shire for the fifth time with a takeover bid of $ 53.7 billion.USD, which provides Shire

    shareholders
    £ 90,006 £ 24.44 in cash and 0.896 shares in new AbbVie shares. The new deal, if accepted, would result in Shire investors holding approximately 25% of the combined company. Shire said he is now ready to recommend the new proposal to shareholders.

    AbbVie is interested in acquiring Shire for two main reasons – to move its US tax address to Ireland and diversify its portfolio with its $ 10.7 billion arthritis drug Humira.Dollars in revenue (57% of AbbVie’s revenue) last year, but will lose patent protection in Europe in 2016 and in the US in 2018.

    Shire’s portfolio mainly consists of attention deficit hyperactivity disorder (ADHD) and rare disease drugs. Sales of its most popular drug, ADHD Vyvanse, were up 19% year-over-year to $ 1.23 billion.

    Exelixis takes off for phase 3 positives

    Shares of Exelixis are up 12% in premarket this morning at a good level

    news about cobimetinib, the MEK research inhibitor with which the company has partnered

    Roche

    Genentech.

    A phase 3 trial, which tested the combination of cobimetinib and Genentech Zelboraf’s BRAF inhibitor, achieved its primary endpoint of helping patients with advanced melanoma live significantly longer without worsening condition (progression-free survival) compared with Zelboraf alone. MEK and BRAF inhibitors block certain proteins along the signaling pathway that regulates cell division and survival. If cobimetinib is approved, Maxim Group analysts expect it to generate maximum sales of $ 700 million, resulting in Exelixis in $ 150-200 million in revenue.

    While this is a positive development, investors should keep in mind that Exelixis’s most closely watched drug is Cometriq, an FDA-approved drug for the treatment of metastatic medullary thyroid cancer (MTC) in 2012. Cometriq only brought in $ 15 million in 2013 sales, but if the drug is approved for other indications – such as prostate, liver and lung cancer – Piper Jaffrey believes the drug could generate $ 1.7 billion in sales by 2020.

    Progenics rides sNDA tag extension Relistor

    Last but not least, the FDA just notified

    Salix Pharmaceuticals

    that the data provided for its new drug supplemental use (sNDA) for subcutaneous Relistor to include opioid constipation (OIC) patients taking opioids for chronic non-cancerous pain are sufficient for approval.

    The

    Relistor was developed by Progenics, which signed a worldwide licensing agreement with Salix in 2011.The drug was originally approved in 2008 for the treatment of opioid-induced constipation and was originally commercialized by Wyeth Pharmaceuticals prior to its acquisition of by Pfizer .