Patient Instructions for Taking Vyvanse

It is impossible to predict what the best dose of Vyvanse will be for you. It may be as little as 15 milligrams per day or over 200 mg per day. The dose depends on how your body absorbs, metabolizes, and uses the medication.

The best approach to finding the right dose is to start with a low dose and gradually increase it, unless there are significant side effects, until the right dose is found.  As you slowly increase the dose as directed below, once you have what seems to be a good response and the effect of a higher dose is about the same as the previous dose, go back to the lower dose. 

If you experience significant side effects, or the medication is not effective, you may need to try another medication.

Instructions for starting Vyvanse

The effect that you are looking for is an improvement in your ability to focus, concentrate, and remember.  While the medication may make you feel less depressed or more energetic, do not judge your improvement solely on how it affects your emotional state or energy but rather on how it helps you think, plan, and organize. 

On days 1, 2, 3: take1 pill (30 mg) a day in the morning. If you have any disturbing side effects, notify me. Otherwise, if you want to try a higher dose, then...

On days 4, 5, 6: take 2 pills a day in the morning. If you have any disturbing side effects, notify me. Otherwise,  if you want to try a higher dose, then...

On days 7, 8, 9: take 3 pills a day in the morning. If you have any disturbing side effects, notify me. Otherwise, if you want to try a higher dose, then...

On day 10 until our next meeting: 4 pills per day in the morning

If you want to change the dose by more or less than a full pill, you can open a pill and pour it into a glass of water, where it will dissolve. Drink part of the water to get a partial dose. Save the rest in the refrigerator and use within the next few days.

Do not to take a dose any higher than the maximum amount prescribed.

Side effects

The most common side effects are mild and often disappear within a few days. They include minor nervousness, irritability, mild difficulty sleeping, appetite loss, stomach ache, headache, emotionality, cold fingers or toes, and mood changes.  Don’t increase the dose if a side effect makes you uncomfortable.

If you become irritable or depressed each day as the beneficial effects of the medication wear off, you may need to take a short acting stimulant later in the day.

Some side effects tend to persist. These include dry mouth, nervousness, mild difficulty urinating, feeling of tenseness sometimes most marked in the jaw muscles, decrease in sexual functioning or feeling, and semen in men’s urine (causing cloudy urine). Some patients experience over-seriousness, with a loss of sense of humor, and excessive work orientation. Side effects can often be relieved by reducing the dose.

Adverse reactions and cautions

Stop taking the medication and contact me if you experience more serious side effects such as more than mild difficulty urinating, persistent diarrhea, suspiciousness, over-talkativeness, moderate to severe tenseness of your jaw, significant loss of sleep, a significant increase in blood pressure, unusual heart rhythms, very fast heart rate, panicky feelings, overly elevated mood and self-esteem, excitability, poor judgment, sleeplessness, or strange behavior. If you experience heart related problems or chest pain on exertion, or faintness, contact the nearest emergency room, or 911. While fatalities among patients taking stimulants is very rare, a small number of deaths have been reported. These have largely been in patients with pre-existing heart conditions, some of which were unrecognized, and in patients with a family history of early death from heart disease. Another population at risk are those who engage in heavy physical activity in hot conditions, for example football players. Under these circumstances, fatal or non-fatal rhabdomyolysis (breakdown of muscle tissue) has occurred.

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Marc D. Schwartz, MD                     5 South Main Street Branford CT 06405                     (203) 488-4700