Lisdexamfetamine
Lisdexamfetamine, most commonly sold under the brand name Vyvanse (in the United States and Canada) and Elvanse (in most European countries) among others, is a stimulant medication that is used to treat attention deficit hyperactivity disorder (ADHD) in children and adults, cognitive disengagement syndrome, and for moderate-to-severe binge eating disorder in adults. Lisdexamfetamine is taken by mouth. Its effects generally begin within two hours and last for up to 14 hours. In the United Kingdom, it is usually less preferred to methylphenidate for the treatment of children.
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| Trade names | Vyvanse, Tyvense, Elvanse, others |
| Other names | L-Lysine-d-amphetamine; (2S)-2,6-Diamino-N-[(2S)-1-phenylpropan-2-yl]hexanamide N-[(2S)-1-Phenyl-2-propanyl]-L-lysinamide |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a607047 |
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| Dependence liability | Moderate |
| Addiction liability | Moderate |
| Routes of administration | By mouth |
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| Bioavailability | Oral: 96.4% |
| Protein binding | 20% (as dextroamphetamine) |
| Metabolism | Hydrolysis by enzymes in red blood cells initially, subsequent metabolism follows |
| Metabolites | Dextroamphetamine (and its metabolites) and L-lysine |
| Onset of action | Oral: <2 hours |
| Elimination half-life | Lisdexamfetamine: <1 hour Dextroamphetamine: 10–12 h |
| Duration of action | 10–12 hours |
| Excretion | Kidney: ~2% |
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| Formula | C15H25N3O |
| Molar mass | 263.385 g·mol−1 |
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Common side effects of lisdexamfetamine include loss of appetite, anxiety, diarrhea, trouble sleeping, irritability, and nausea. Rare but serious side effects include mania, sudden cardiac death in those with underlying heart problems, and psychosis. It has a high potential for substance abuse per the US Drug Enforcement Administration (DEA). Serotonin syndrome may occur if used with certain other medications. Its use during pregnancy may result in harm to the baby and use during breastfeeding is not recommended by the manufacturer.
Lisdexamfetamine is an inactive prodrug that works after being converted by the body into dextroamphetamine, a central nervous system (CNS) stimulant. Chemically, lisdexamfetamine is composed of the amino acid L-lysine, attached to dextroamphetamine.
Lisdexamfetamine was approved for medical use in the United States in 2007, and in the European Union in 2012. In 2021, it was the 69th most commonly prescribed medication in the United States, with more than 9 million prescriptions. It is a Class B controlled substance in the United Kingdom and a Schedule II controlled substance in the United States.