Vyvanse Dosage: How to Get the Right Dose

Vyvanse is the newest medicine for ADD or ADHD in the USA. I have written several articles on this blog on Vyvanse, and have had great feedback and comments from readers of this blog. For example – if you want to find out if vyvanse works, visit this post to read many people’s first hand experiences.
One question which many people ask is about the dosing of Vyvanse.
This article will provide you with the answers you need to get the right dosage of Vyvanse.

Research studies compared the dosing of Vyvanse with Adderall XR. What this research showed was the following:

  • Vyvanse 30 mg = Adderall XR 10 mg
  • Vyvanse 50 mg = Adderall XR 20 mg
  • Vyvanse 70 mg = Adderall XR 30 mg

The recommendations for the starting doses of Vyvanse are as follows: Doctors should start Vyvanse at 30 mg, and then gradually increase the dose to 50 mg, and then up to 70 mg if needed. Of course the doctor would monitor response to the medicine (i.e. if there is a great response and ADHD is controlled at 50 mg, then there is no need for 70 mg of Vyvanse). The doctor will also monitor for side effects – i.e. if there are too many side effects at 70 mg, then the dose may need to be dropped to 50 mg of Vyvanse.

The importance of the ‘conversion’ dosing listed above relates to those people who may switch from one stimulant medicine to Vyvanse. Using the information above, you can figure out how to change your dose of Adderall XR to Vyvanse.

When it comes to the available strenghts of Vyvanse, Vyvanse is now available in the US in the following dosage strengths:

  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg
  • 70 mg

In Canada, all of the dosage strenghts are available except for the 70 mg dose. The dosage recommendations above are the general recommendations for dosage. That said, your doctor may start lower, and may take a different approach to your dosing. When Vyvanse was first release, there were fewer strengths of the medicine available – i.e. only 30mg, 50 mg and 70 mg. Now, there are the ‘in between’ doses as well (the 20 mg, 40 mg, 60 mg). This does give doctors more flexibility in adjusting the dose to tailor it to suit you.

If you are switching from Concerta to Vyvanse, then you will need to follow these rough guidelines (and of course, talk to your doctor – who can personalize the information to suit your treatment):

  • Concerta 36 mg = approx. Vyvanse 30 mg
  • Concerta 72 mg = approx. Vyvanse 50 mg

I have to say that the dose changes from Concerta to Vyvanse are based on logic, and not on research.
Here is the logic:

  1. Concerta 36 mg works out to approx. 8 mg of regular ritalin three times daily.
  2. That is approximately 5 mg of regular adderall twice daily.
  3. That works out to approximately Adderall XR 10 mg once daily.
  4. Since Adderall XR 10 mg daily is equal to Vyvanse 30 mg, once can guess that Concerta 36 is equal to approximately Vyvanse 30 mg.

[Click here for a full review of how to calculate concerta doses.]

There are two important points to remember here:

  1. Even though I can suggest what the equal doses are, you may react differently to any one medicine. Only testing, monitoring and talking to your doctor will help to sort out what the right dose is for you.
  2. Please talk to your doctor about your individual care. Even though this blog article may help you to find the right dose of Vyvanse based on a combination of my review of the research and my opinion, your doctor is an expert in your care.

Thank you for reading, and please post any comments or your experiences with the dosing of Vyvanse in the comments below.

Dr. Kenny

(Updated May 2010)

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Comments

  1. My 10 year old was diagnosed with Sensory Processing Dirsorder at 5 years old. After evaluation I am now being told by his neurologist that the has ADD as well. We went for an EEG today not sure what that has to do with it ? We tried Focalin 5mg for 10 days and did not notice much positive improvement at all but, we did see every negative side effect continue to worsen. He was not behaving like my son at all his rebound was anger, rage, unable to focus at all it was scarey. I stopped the Focalin and now the doctor wants me to try Vyvanse 20mg once a day. I am very concerned about the side effects because of the horrible reaction he had with Focalin. Does anyone know if Vyvanse has as many problems with these horrible side effects. I’m afraid to start the Vyvanse cause I couldn’t bear to see my son suffer like he did with the Focalin. I’ve filled the RX for Vyvanse but, have not started it yet. Any info. would be appreciated. I’m new to this whole ADD and medication situation for a child. Thanks for your help !!!!!

    • my son has been takeing vyvance since he was 5 1/2 yrs old and he is now 9 he started out with 20mg and it seemed to work for a while then we bumped him up to 30mg when he was 6 1/2 hes been on that for a while when his dose was to low at 20mg he sniffed all the time which was weird but when he went to the 30mg it stoped he starting doing better in school when he started the medicine but on vyvance the child doesent like to eat verry well on it but thats pretty much with any adhd or add medicine when they first start it they may feel sick to the stomache but that will go away in about a week now my son is on 30mg and hes haveing trouble in school not focusing and not paying attetion acting out so i went to the doctor today and they up his medicine to 50mg which worries me he going from 30mg to 50mg which seems like a big jump if you have any info on mine that im worried about you can also leave a reply and also on vyvance you have to be carefull not to mix the medicine with other medinces that are not compatable ask doctor and see which ones i hope any of the info help you and if not im so sorry but thank you and you have a wonderful day

    • My son is the same age and had a horrible reaction to Focalin as well. They called his response “Oppositional Defiance Disorder” – it very negative. Your story sounded VERY familiar so I thought I would just responsd with our success with Vyvanse. My son took Concerta XR for approx. 3 years but when it came time to increase dosage, I noticed things weren’t quite right. After expressing my concern, his doctor prescribed Vyvanse and it’s been wonderful. Although he’s only been on it for a week now, it feels like I have my son back!!! I can’t belive we waited this long! I hope it’s been successful for you as well.

    • My 16 year old daughter had been on aderall XR at various dosages for eight years her maximum dose was 30 mg (she’s tiny), but she always had many effects: anxiety, frequent stomach aches, headaches. It was suggested we switch to vyvanse. She started on lowest dose, 20 mg at the start of this school year. I was troubled by her change in behaviour. Very disconnected and somber, almost zombie like and she said she felt ‘nothing’. It showed. The other physical side effects were not present. The doctor said it would be several weeks before we would see any change but these effects were immediate. Within two weeks we were back in the Docs office to discuss it. Given her age we were willing to give it a little more time. Gradually, those ‘moody’ symptoms subsided a bit but she noticed no advantage over aderall xr in keeping her focused in school. She is currently failing 3 classes because of poor test grades and her inability to focus, and retain what is studied. We have an appointment to get her back on Aderall or try something else. She said she would rather put up with the side effects and do better in school than continue on vyvanse. She is typically a b/c student with an occassional A here and there. I have read that Aderall does better with keeping patients focused than vyvanse long term because of it’s composition.

      • Hello gina, I also was put on adderall at age 16, I’m now 21 (you posted this comment on my birthday :) ). The adderall was effective helping me stay focusedd in school but the ups and downs t that the drug caused (peaks and valleys as my doctor called it) would give me bursts of anxiety. My doctor advised I try the newest add medicine, Vyvanse, I believe it’s in a sense “the organic form of adderall”. I started out on 30 mg and was very happy with the result, when I increased the dosage to 50mg I knew I had found the perfect medication and dosage. Just like my doctor told me, with the t vyvanse I no longer was experiencing the “peaks and valleys” and general shakeyness that the adderall can cause. I would reccomend vyvanse over adderall any day. Vyvanse is consistent, it is very similar to adderall but with out the ups and downs. On vyvanse I feel stable, focused, and most importantly anxiety free. I would suggest you try and stick with the Vyvanse, especially if your daughter is bothered by the side affects, like I was. Perhaps talking to her doctor about increasing the dosage would help her. There is now a wide range of dosages available of vyvanse which is great, the dosages available are 20mg, 30mg, 40mg, 50mg, 60mg, and 70mg being the highest. Originally it only came in 30, 50, and 70mg, now with the much larger range of dosages available doctors can adjust a patients dosge more specifically to the patient needs. If this helps, since your daughter used to take Adderall Xr: vyvanse 30mg is equivalent to adderall 10mg, vyvanse 50mg= adderall 20mg, and vyvanse 70mg= adderall 30mg.
        As with most amphetamines, the only side affect I notice with vyvanse is a decrease in my appetite. This is normal and should only be a concern if your daughter expieriences a very dramatic weight loss (as im sure youre aware of since adderall and other ADD and ADHD medications can also cause a decrease in appetite)
        I hope my story is helpful to you, best wishes to you and your daughter :D

    • My son is 15. He has been diagnosed with severe ADHD, ODD(oppostional defiancy disorder), and depression. He started on concert when he was 9, which at the time was wonderful, but as he grew, they upped the dose, and we started having problems. We tried Adderall. Didn’t seem to help him at all. We started on vyvanse about 2 years ago. We went from 40mg, gradually to 70, and are now back to 60. He does well on this. About 6 months ago we added 1mg of Intuniv. This seems to be our magical combination. The vyvanse last longer than concerta, the behaviour that comes with ODD has diminished. It hasnt gone, but he can control it better. I think and important part of this treatment, along with meds, is seeing a counselor/psychiatrist/therapist. It will help tremendously. My son has seen one for a few years…psychotherapist and psychiatrist. BUT, really watch the psychiatrist. While the therapist has a whole hour committed to talking to my son, and listening to him, the psychiatrist doesnt. The first one we had would spend maybe 10 minutes with him….basic, how are things, school ok? Heres your new prescrip. The one we have now will sit and talk to him alone, then me alone, or the both of us together. He schedules 30 minutes for us….and is great. We have been there longer, and when things got really bad for us, he had us in his office that day. So just finding one that will work with you, and seem to care will help.
      As far as side effects, when he was on a higher dose, he would get light headed, obviously his appetite…but that is all meds like this. he still eats, but just a smaller amount. He has lost maybe 10lbs over the last few years….sometimes even gained. Those shakes….slim fast/ensure?meal replacement kinds…..are always good for an extra nutrition add on. I do keep his meds in my purse. They are an addictive drug, and apparently sell well at high schools. It is like speed if you do not have ADHD. The kids take them and can stay up all night and study and do homework. Just a warning…I have a houseful of teenage boys all the time, so I like to play it safe.
      Sorry this was so long….but I like the meds, I like how they help my son, and he is old enough to let me know what works and what doesnt.
      Hope you find an answer among this site that will help you.

  2. Dr. Kenny:

    My six year old son was just perscribed Vyvance 20mg. I absolutely did not see any results from that dose. I will be calling today to ask to bump him up to the next dose (30mg) to see how he does on that. I have been reading the comments on this drug, and I’m a little concerned. Are “neck tics” a common side effect to this medication, and if so that’s enough to stop him before I start him on it.
    Thanks,
    Kristie

    • Kristie,
      Tics are a possible side effect to any stimulant medication. They aren’t that common – but they are possible.
      The medicine brings out tics in people who are prone to them.
      I wouldn’t not increase the dose just because of that concern.
      Good luck.

  3. Im a 15 year old girl who takes adhd medications daily. i am perscribed one 27mg concerta (taken once in the a.m.) But i also take adderall and vyvanse illegally throughout the day. i dont really have adhd,i just convinced my doc. that i had it for the meds. i take about 8 pills total a day. for instance, today i took my 27 mg concerta, a 20mg adderall XR, a 50mg vyvanse, and three 30mg vyvanse. is this unhealthy? keep in mind, im a 15 yr old girl. about 5’3 and 120 pounds.

    • How is your heart still beating? Im not being sarcastic or anthing. It’s just that i’m a 21 year old male, I weigh 140 lbs. My doctor prescribes me 70 mg Vyvanse and 20 mg of Adderall per day and I am sped up to 100 m.p.h. I can barely handle the rush. How do you do all of that in 1 combination? I am 90 percent sure that what you are taking is dangerous. I just looked it up on Google,and Vyvanse has a recommended dose of no more than 70 mg. Be careful.

    • Gianna , my name is james and I’m 16 and i take it under the table too.. you shouldnt take more thanabout 120 mg of any add or adhd meds because all of them are lesser forms of meth.. did you know that? and especially at your size and weight thats a problem that will get out of control very fast.. only take you a little bit and pace yourself the most i have done at once is two or 3 adderall (20mgs) or 100 mgs of vyvanse

      • Neither of you need to be taking ad/hd meds under the table!!! I am 21 years old, was diagnosed with ADD inattentive type back in march.. but i was convinced i had it by january. i was tempted to take the meds under the table before i was officially diagnosed b/c i was worried about failing out of school but i didn’t do it.
        i decided i wanted vyvanse b/c it lasts 10-14 hours a day. even when i was diagnosed i still hated taking the meds bc it meant i couldnt drink caffeine all day and sometimes i just preferred laying around daydreaming all day instead of doing my schoolwork but the meds make it hard to do that (obv).
        i go to one of the top universities in the school and they paid for me to be diagnosed (i was poor enough for a scholarship) and we have free ad/hd counselors (which i haven’t seen all semester- i regret that now actually but i will go back next semester.) soo if i could make it here being poor AND having undiagnosed add there is no reason highschoolers should be taking the meds illegally.
        YOU ARE NOT PSYCHIATRISTS. you are only 15 or 16 years old you did not spend 5+ years in graduate school studying your ass off learning about ad/hd. you could have something else and not even realize it and the whole time you have been taking the wrong meds which could mess you up.
        so if you can’t afford to have a proper diagnosis, you can still use the internet to help you find plenty of tools to sort out your life.
        google ad/hd time management tips or check out books from a library. trust me, as a college student, just the medicine itself will not help you. i can’t speak for the hyperactive kids, but for me yes i’m not daydreaming 24/7 when i’m on it, but that doesn’t mean my life is any more organized. that’s what the time management tips are for! they are more important than the meds so try using them and do your best to stick to it.

    • That is a dangerous combination…..have you looked at the side effects for a vyvnase overdose? My son OD’d on vyvanse….it is dangerous. If you get through the OD part, it can leave long term serious heart problems. If you are finding that the 27mg of concerta doesnt help, ask your doc for something different. I have an 18 yr old that takes 40mg of vyvanse. He is 6’3 and 170…..if you are taking it for the rush then you are on a dangerous path, if you are really in need of help for ADHD, talk to the doc. I am not saying that to sound mean and hateful, I have 4 teenagers, I know what is easily available to you guys at school, but I dont think you (kids in general) understand the ramifications of taking all those meds.

    • Sweetheart, I am 47 and have been taking these meds for several years. I also was a rep for one of them so please listen to me when I tell you…You need to stop taking more than what your dr. Prescribes for you! Much research goes into what the body can handle with these drugs. They are not toys. Yes, they have one good side effect (losing weight) but that is it! There are toooooo many bad side effects for you to be taking these risks! You are weakening your eyes, heart, and who knows what else. concerta alone has six mechanisms of action. When you add vyvance to it plus adderal, which is the same thing as vyvance, just not long acting, you are way too over dosed! stop and think. Get some help.

  4. Dr. Kenny,
    I’m a 22 year old female. Last Wednesday (2/16), at an appointment to address that I can only sleep for around 3-4 hours at a time my doctor suggested she felt I might have ADD (or maybe ADHD? though I’m not really what I would consider a hyperactive person). She subsequently prescribed me 3mg of Lunesta to take at night and 30mg of Vyvanse to take in the morning. It’s now four/five days later and I have had almost no side effects of either medication (with the exception of decreased appetite). I sleep the night through and am now able to wake up without immediately thinking about getting home to sleep that night. I have noticed that the first two days I took the Lunesta I fell asleep within 20 minutes. However the last three times I’ve taken it (even though I take the Vyvanse around 7-8am and the Lunesta around 10-11) It has taken 1+ hours for me to begin feeling the effects of it. I feel the Vyvanse helps me make it through the day without getting drowsy. I do feel somewhat more focused but I know I still don’t focus, or remember things, or organize (my thoughts and life alike), like normal people. How would you suggest bringing this up with my physician? Thanks! Jenna

    Also, I know the above is a little hard to read. Sorry for the disorganization.

  5. I have been taking Vayvanse 20mg for one week and 3 days. I am zoned out. My body hurts all over and I have no desire to do anything. Dr. Kenny, will this get better or should I stop taking them?

    • MY ENTIRE BODY ACHES TOO ! WTH ? This also happened when I was taking regular adderall ( not xr ) No joke, I ache in my ears, toes, arms legs, and my fingers seem to be the worst however it does stop shortly after you stop taking the vyvanse. It really stinks because I like the vyvanse so much more then the adderall. Im not as bitchy with the vyvanse ( lol ) Maybe I can just take it as needed, prn ??? I dont know .

  6. Dr. Handelman,

    I was recently prescribed 40mg of Vyvanse. However, I just don’t feel like it’s strong enough; at that dosage I just don’t feel that my symptoms are under control. I’m pretty sure I would benefit from increasing the dosage. Does this sound accurate or might there be something else going on?

  7. Dr. Kenny… My 10 year old son has been on 20mg of Vyvanse for about a month. He takes it at 7am his teachers say he is more focused in school and stays on task better. However, when he gets home by 3pm he has no impulse control and is all over the place also very argumentative with me about everything. We are constantly fighting. The only other side effects are lack of appetite and trouble sleeping. I have started him on liquid Melatonin before bed recommended by his therapist. Which has helped with the sleeping. I don’t know if I need to have his dosage of Vyvanse increased or if no matter what the dose it will wear off by the afternoon ? Just trying to see if there is any help to make our family time quality instead of battles about everything. I would appeciate any input you can provide me on this. Thank you.

    • Vyvance is (Lisdexamfetamine), which ultimately means it is dextroamphetamine. They some how thought that by calling it Lisdexamfetamine, people would not associate it with the common street drug, methamphetamine.

      Dextroamphetamine is the dextrorotatory, or “right-handed”, stereoisomer of the amphetamine molecule. The amphetamine molecule has two stereoisomers; levoamphetamine and dextroamphetamine.

      Adderall contains a mixture of l-amphetamine and d-amphetamine. You should ask your doctor about possibly using a combination of both of these such as in Adderall as this works better for some patients. Vyvance, or dextroamphetamine can cause anti-social behavior and may present different side effects in patients than Adderall. Adderall has a higher abuse potential because the drug can be used more directly and does not require metabolizing.

      I am not a doctor but I do have ADD myself and have done research into both Adderall and Vyvanse. Above is some of the information I have found on the two drugs.

    • Hi Karen– Our 61/2 yr old has been on Vyvanse for over 3 weeks, started on 20 mg, upped to 30 mg, dealing with the exact same issues you menioned. He’s just not fun to be around, downright nasty sometimes. It’s very painful for our family. We are about to increase the dose of to 40 mg Vyvanse and then add a short-acting dose, 5mg of Adderalll that we will give him at 4pm. I’m feeling nervous about upping the meds, wondering if maybe we should be trying a different med, but I just don’t know. The trial and error is very disconcerting. Please let us know if you found a solution. We also are planning to start Melatonin too.

      • My son has been on vyvanse for nearly a year, 20 mg then upped to 30. He’s had issues at home but is doing very well in school… Has a hard time falling asleep, combative, tunes me out…. Ect… We were given INTUNIV. 1 mg to take about an hour before bedtime… It has helped his overall day… His sleeping habits are normal, he’s more agreeable and is happier with his progress than just on the vyvanse alone…

      • I agree with another reply to this….we added 1mg of intuniv and it made a huge difference. Although I give it in the morning with his vyvanse. My son is 15, and we have tried 4 different meds…vyvanse combined with intuniv is what works for us. Although as they grow things change….talk to your doc about intuniv.

  8. Hi Dr. Kenny,
    My son who is six has been on Vyvanse 40mg. now for about one month. He seems to be doing great on it with little to no side effects. I give it to him once a day in the morning before school. The only down side to that is it seems to wear off by 2 or 3pm in the day. I was wondering how do I know if he is a good candidate for a mid-day dose or not? I mean by the time it wears off the majority of his school day is over and that’s where it really counts. Yes it can, and does get a bit challenging in the evenings to control him during his after school tutoring, homework, dinner, bath, and bed…… BUT I am use to it and can learn to deal with it. Here’s my thing I don’t want to have to give him another does if it is not TRULY needed. By giving him another dose in the mid-day means the longer it’s going to stay in his system and now we would be running into his bed time hour which will interfere with him sleep. I already give him something to help with that as it. Dr. Kenny I need your help! Please share some of your words of wisdom!
    Thanks for listening,
    A Concerned Mom

  9. Dear Dr. Kenny,
    My son is 12 years old (will be 13 in about two months) and I am thinking of switching him from 20mg to 30mg. Just recently, he has stopped having motivation to do/focus on things like homework, and has lost some focus in school. Before about…. a week ago he was doing well in school and getting all his homework done. Can you tell me what happened? Is this normal?I would really like to know. He is acting like is when every once in a while he has to go somewhere and forgets to take his pill.
    Thanks!
    - Randy P.

  10. Dr. Hadelman,

    I am currently taking Vyvanse 40mg once a day (although most of the time I take 1.5 capsules a day b/c 40 isn’t really working). However, no matter the dosage, when it begins to wear off I become very irritable, sometimes almost to the point of rage. I’ve read that irritability can be because the dosage is too high, however if I don’t take 1.5 capsules my ADHD symptoms aren’t managed. Do you have any reccomendations of what I can do to help this?

  11. Dr. Kenny,
    My son is almost 14. In December we switchd him from 30mg Metadate CD to Vyvanse 30mg. He said he could now hear the teachers and understand what they were talking about and was quite excited. Said that school was much easier. He’s now unmotivated, doesn’t turn in assignments, and doesn’t want to study for tests. I’m not sure if he is deliberately not trying as hard because school is easier, or if his dosage should be changed. Do you have any thoughts?

  12. Dear Dr. Kenny,
    I sure hope you can help. My dr. put me on 30mg of vyvanse 12 months ago. it was amazing, 2.weeks later I enrolled in a 9 month xray program and excelled in everything I did graduating with a 4.0. We kept incresing my dosage cause it seemed to be wearing off. I am now on 70mg for the past 2 months and am getting extreme side effects such as irritibility, nausea, stomach pain and panic attacks. I am wondering if my dosage is too high or if I just plateued? I am very scared that something is dreadfully wrong. Any advice would be greatly appreciated. My dr. doesnt seem concerned. Thanks

    • Jennifer, if you are having side effects after increasing the dose, you may have to lower the dose. And if the lower dose doesn’t work, then you should consider trying a different treatment (maybe a methylphenidate medicine – like concerta or metadate)
      Talk to your doctor about that…

  13. My son of 14 yrs old just diagnosed adhd(non hyper kind) we have been on 20 mg of vyvanse for 6 days he missed one dose. He says he feels jittery and a little anxious and extremely tired. He says he is a little more focused at school of course have not seen the affects from his grades as of yet. He seems a little numb at times kind of just coasting through the day withdrawn. He is not to motivated to do much. It is very early to see whether this is working or not but feel bad to watch him and explain to him that he needs to be patient . He was not on vyvnace yesterday and just seemed so alive and in a really good place, and today back to lieing around he seems to have highs and lows with his spirits, just looking for some insight to something I know very little about.
    Thanks,
    Mindy

  14. I have a 11yr old son who is on vyvanse 40 when he comes home he is all out of control. He is on the honor roll at school but our home life is a mess…im thinking of giving him meletonin are does he need a dose when he comes home and also he is a narcaleptic. Please help our family…thank you so much!

  15. I am taking 36 mg of concerta and want to change to Vyvanse due to cost….my dr says 50 mg of vyvanse is equivalent to 36 mg of conconcerta? I am just not sure…

  16. Hello all. I have been reading about the side effects of Vyvanse , My grandson has ADHD and was diagnosed 20 mg in the morning .. I went to visit the other day and he was extremley moody and very angry at everyone. My daughter told me that he was extremley upset and angry and started to throw a major tantrum saying everyone hated him and that he hated everyone too. No matter what my daughter tried to do he scramed elled and threw things . He went outside to get some fresh air and then started to scream at his friends too ,, My daughter was worried and stopped giving it to him .. We are very scared . He seemed in a much better mood tonight with no pills .. Dr Kenny do you have any suggestions?

  17. I was on 70mg of vyvanse. But after a cpl mnot work at all after about 6hrs. I told my doctor and she switched me to d-amphetamine salt combo 20mg tabs. I take twice a day. But I don’t feel it working half as good as the vyvanse and found myself getting irritable and b**chy. This is only my 2nd day taking this but the down fall is very unpleasant for me and my daughter. I don’t like to be crabby due to a high that I didn’t even feel. I’m told to give it a cpl days but I don’t think its normal when starting a new medication. Please help.

  18. good afternoon to everyone,my 6yr old overweight daugther has been taking vyvanse 20 mg for only two days now the first day she was ok for awhile then after about 5 or 6 hours started to get bored the 2nd day which was today back to from easter break school they called around 11 said she had a headache but was ok i gave her the pill in the am before school then her teacher called back around 2;30 and said that my daughter is cyring like crazy and fighting with her shoes and taking them off over and over screaming about the velcro being to tight she been wearing these sneakers for almost 3 weeks now it was no problem before they said she had a glazed spaced out look as if she were looking through them she continued this even on to the school bus til she got home she got off the bus barefoot even they driver and matron never seen her act like this before she continued to fight with her sneakers til we got in the house she sat on the bed looking out of it said her head still hurts drank some water told me she didnt wanna go back to school again the went to sleep at 3:45 pm i called her neurologist he said give her a break start again on the weekend and if it happens again call him so he can see her my daughter is also tall for her age should i not try the meds again and just ask him to try somthing else or should i try it again and see what happens like he said and call him if she flips out again she is supposed to take 20 mg of vyvanse for 2 weeks once a day in the am them start with 30 mg for another 2 weeks then see him after that please advice to a new mom who is stressed out and scared my parents have dealt with this before with my foster cousins and growing up watching that was a nightmare she said just dont give her anymore til i can see the doctor Dr kenny any advice please ?

  19. Hello Dr. Kenny,

    You have mentioned in one of your posts that 70mg is the max dosage, but you also say 30mg is a starter dose. How can this be? Do you mean to say that one can not be prescribed over 70mg?

    Thanks,
    Kenneth

  20. Dr. Kenny:

    Is it ok for me to take my 10 year old son off 30mg on vyvanse on the weekends? He does well on it during the week at school but is very irritible on the weekends.

    He does have trouble at night during the week before bedtime. Everything bothers him.

    thank you for your help.

    • Carol – some people do fine without their medication on the weekends. As long as there aren’t significant ADHD symptoms interfering with social and emotional functioning – it is probably OK. BUT – you need to check with your child’s doctor!

  21. My name is Camille and I am on vyvanse 40mg and it’s seems to be working great. I can do my job better get things done better and focus great. I have been on vyvanse for a month now. I don’t seem to notice any side effects.

  22. Dr. Kenny-

    I am a 39 year old female and have been taking Vyvanse 70mg for about 3 months. It was working pretty well, but I would sometimes have to take a 10mg. generic ritalin for really long days. However, because it is so expensive, I talked to my doctor and she switched me to the new generic Concerta 54mg. I live in the US and it is my understanding that this just came out. Anyway, I started taking it two days ago and I feel groggy, fog-brained and totally scattered. I feel worse than before I started taking meds for ADHD which was just last fall. Do you think it could be too low of a dose? The Vyvanse is so expensive on my insurance. I have also tried Adderall xr, but it made me very irritable. Also, the bottle says “methylphenidate”, but the pills say “alza” on them.

    My 9 year old son also takes 36mg. of concerta and it works great for him….I was going to switch him when his RX ran out due to the cost…but now I am worried…

  23. i have a 11 yr, old that has went down the scale of vyvanse an he went from 30mg-70mg.an was also put on intunive 1mg-3mg an all we got was a kid that shut down .. an it was a great drug in the begainin an became a nitemare..so to thoughs who are thinking of increasing there kids meds. better do ur research frist… cause the other drug intunive is just to hide the over dose…an melatonin for sleep 3mg so ur kid will sleep ..thats nice but really it is for to bring ur kid down cause its a natural cheimcal ur brian makes before u go to sleep.i have been down this road for 6 yrs. an my son is off the scale but really u need to start payin attention an start asking for drug facts on ur meds.. we have been almost on every drug they have put on the market they have used for adhd…vyvanse was the closes drug that helped but with so many side effects…but it became a nitemare for us..just putting this out here for parents that need to pay attention …..an get a note book an take notes of what ur son /daughter reactions to meds .an how many side effects they have an if they have 50%or more effects an depending on where the side effects are effecting u should seek medicail treatment an take him /her to his pedt. doc. then they probley shouldn’t be taking it.. my son had 8 out the fact sheet i got from the pharmacy …i let it go an that was my misteak an when he got to 70 mg he shut down … my son is a healthy kid an it could of costed his life …just remeber u always have the right to seek a sec. opp.from another doc.

  24. I have a 9 yr old son who just started taking Vyvance 20mg. When he took the Vyvance it made him talk non stop like he was on speed. I called the dr and he told me to give him two pills a day 40mg. How can that be??? Wouldnt more mgs casue more of a problem????

  25. If a person with ADHD takes this med or any stimulant the affect is a slowing down, which is the reverse affect of a person who does not have ADHD. I can drink coffee or a cola and then fall asleep. Most people who do not have ADHD could not.

  26. Dear Doctor (anyone available)
    Just a month ago I was officially diagnosed with ADHD and my Dr subctibrd a one month of 70mg capsules. He told me to start with 10 mg first week and increase to 20mg following week, and so on until I felt where I’d need to be. The end of the 30mg week, I had the feel of a lump in my throat, nicotine craving, worsening vision, heart palpitations and swelling of my feet. By 40mg week, these became worse and I emailed by Doc (I also read these can be sign of overdose and the swelling and vision problems are listed as serious. I wanted to try 35mg and level off. He insisted I continue to increase my dose and these affects were diminish. This week I am at 50mg, I actually bought a pack of cigarettes (I am a non smoker), my throat continues to tighten and my peers say I seemed more pleasant and mellow about 2 weeks ago. I see him next week and will be at 60mg. Although I look young, I am 48 and 5’2″ 110 lbs. Before this med, I would hardly even take aspirin and am have not been on any meds of any kind before. I drink coffee or sodas less than once weekly, I am concerned and worried. PLEASE reply. Thank you!

  27. Dr. Handelman, sorry don’t mean to make this long winded, but my med’s ran out about an hour ago haha

    My daily dosage is 8AM 20mg Dexedrine SR, 2PM 10mg Dexedrine IR & 10PM 40mg Celexia. Because Dexedrine, and Vyvanse are both amphetamine, would this make my daily dose of Vyvance something about 40-50mg, after taking into account the approx 10% loss and the 2-4 extra hours, and that SR only lasts about 4.5 hrs and IR about 3. So now in which case i can use the other formula from your other page. to convert to 15-25mg Addrell XR, 54-72mg Concerta, 30-40mg Biphentin, 20-40mg Ritalin SR(x2) & would Strattera be a replacement for the Celexia? I weigh 150lbs

    I want to go to school and work without having to take pills in the middle of the day and have them being not so consistent, any higher is of no added benefit.

    • Jamie – probably the dose conversion would be around 50-70 mg per day of vyvanse- but your doctor would have to start the dose low and gradually build it up – monitoring for side effects and benefits.

  28. I am wondering if anyone has really stop to think why doctors push for drugs so quickly and easily. Do you that many doctors receive gifts, free lunch, money to speak at functions on behalf their drugs, along with many other things. There are some good doctors out there who truly do care about the patients well being not lining there pockets or the pharmaceutical’s pocket with money either from you or medicaid, or the other insurance companies out there. Do your research and if you have doubts or questions speak to a therapist or a patient advocate. We have become a country that believes in pushing drugs and many times for the wrong reason. Is putting your child or whom ever is in your care on medication being done to help the child or just give you break. All I am saying is consider your alternative medicinal routes first. Educate yourself on all the possibilities as well as the side effects. Medication is only a band-aid that leaves the true culpert in the dark waiting to pounce on you at any given time.

    • I’m not a Dr. or a pharma. rep. but I know quite a few. The money and speeches at functions also come with long hours of paperwork and questionaires. They spend hundreds of thousands of dollars to become family Doctors. They get paid very little in comparision along with much longer then 40 hour weeks. The work they do for the pharmaceutical companies is very important in understanding effectiveness and side effects of those drugs. Are you suggesting they should spend 6-10 hours a week and get paid nothing for their time? What you’re suggesting is dangerous. Some people need medication. Don’t make people who really need help feel bad because of your beliefs. I respect your right to voice you opinion and everyone should make that decision for themselves. But, don’t suggest that all medications are bad. Vyvanse has been a saving grace for me. I am healthier and can read and do things I have always want to do. Ritalin and Adderall never did those things for me. Are drugs overused in some cases? I’m sure they are. But, that doesn’t mean they don’t help save peoples careers and families. Please don’t take this as mean spirited. Have a wonderful holiday season… Consider yourself lucky that you have no need for help.

  29. I use to take 60mg of generic Adderall XR 30 mg twice a day. It worked great at first, but then started wearing off quick. I started splitting an additional capsule at the end of the day just to be able to finish my day. I picked at my face terribly so I came off. I now take one 60mg of vyvanse in the morning but it wears off by noon. I started splitting the first dose into a 40ish mg dose and take rest later. By 4PM i just want to sleep. What should I do? While on ADD meds I have gone from last to first on my sales team, but don’t want to have to split because I am afraid I will take too much. I’ve taken as much as 90mg of adderall before and was fine. What should I do?

  30. ive been dealing with meds since i was 14, im 24 now. It has been a serious struggle trying to find out what was wrong with me. My sever anxiety attacks, mood swings, fits of rage. I have been mainly put on many anti depressents only to make things worse. Finally I explained to my doctor that im failing my college courses and i cant concentrate but i never bothered to speak of this when i was younger bc my mom always said i was un motivated and lazy. I didnt realize i could be ADD. I was prescribed Concerta OMG horrible mistake. i was seeing things that were not there and screaming at my friends for no reason. Now im on 30 of vyvance and i must say i love it. But my concentration isnt all the way there. However, i dont have anxiety attacks and my mind has come to a slow tolerable pace. My main question is i want all these meds to come to a stop and just have ONE to work with so i can get on with my life. Will the 30 work or will i end up having to up my dose? if im not able to concentrate fully does that mean i need a higher or lower dose? im just dont want to hurt my body or my brain.

  31. hi i am currently on 30mg of vyvanse a day but it seemed to be running out about 4 pm so then today i took another 3omg tab at 2 .i do drink coffee and now an very nervous is this normal

  32. Dr. kenny,

    I was recently switched to vyvanse from adderall, but I don’t think I was prescribed the correct dosage of vyvanse. I was taking 20 mg adderall twice daily (40 mg total per day). I am now taking 40 mg vyvanse once daily. I feel tired, hungry, lazy, etc. Do you think I should be taking a higher dosage of vyvanse?

  33. My daughter switched from Concerta to Vyvanse. As I was coming up a few days before her refill, I call to find her doctor is unavailable and who I can get her new Rx from is too far away. I do not want to send her to school without her Rx. Would it hurt for the two days until the doctor returns to give her some of her concerta that I still have? Would using that two days inbetween the vyvanse hurt?

  34. Hi.

    Since no one has mentioned it, a study shows that the 70mg dosage works for about 14 hours, making it the longest lasting ADD drug (or at least it was at the time of the study) on the market. This means that you really shouldn’t take it later in the day or twice a day.

    Personally, I take the 60 mg dose and find that it works for about 12 hours. A GABA supplement seems to help with occasional “moodiness” when the effects are wearing off.

    When I switched from the 30 to the 50, and again when I switched from the 50 to the 60mg dose, I found that there was an adjustment period of about 2 weeks where my symptoms were worse, but after those two weeks they lessened (even afterwards the symptoms were still slightly worse than those experienced at the previous dosage, and yet other symptoms dissapeared altogether after the first 2 weeks).

    Actually, I didn’t experience much at all at the 30mg dose. It helped a little with my concentration and had no side effects.

    At 50 there was a big boost in concentration, but some side effects, irritation, initial nausea and motor mouth (it went away), and sometimes insomnia (it lasted longer after all, but still not long enough to last through a 6pm class unless I took it an hour or two later in the morning)

    On the 60mg dose I took a couple night classes (until 9pm) and had a similar problem. The 60mg dose also caused a slight increase in insomnia, which I treat with either a sleeping pill or by taking a supplement called 5htp around 6 or 7pm.

    I’m not on the 70mg (my doctor tried me on it before the 60mg dosage because that dosage wasnt available at the time and then dropped the dosage back to 50mg) because 70mg was too high for me.

    In summation, while everyone is different, some symptoms are very common, so I hope my experiences are helpful to someone, as I’ve tried in this post to describe some of my experiences that paralleled those of other posters.

    • Your post was very helpful to me. I just started 30 mg a few days ago and am here trying to fgure out what to expect. At this point it’s hard to even know exactly what it is or isn’t doing for me yet so it helped tremendously to read about your experience at different levels. Thanks for the detailed post!

  35. Dr.Kenny, My 7 year old son started Vyvanse Sept. 2010. We have titrated up to 40mg dose. It was working very well but lately he is starting with the same problems ie not sitting still in class, impulsive, very hyper day and night. Is 50mg too much of a dose for his age? Should we switch, if so what medication would you recommend? We have an appointment next month and trying to get as much infor as I can. Thanks.
    Angie Goins

  36. my son is 9 yrs old and he was on 30mg of vyvance and he was not focusing or paying attention in school and talk nonstop now the doctor switch him to 50mg is that safe to jump so far up from 30mg to 50mg

  37. I’m on 30mg of Vyvanse and loving it. Works amazingly, literally only side effect is loss of appetite. There is no crash, but I can always notice when the effects have worn off because there is a drastic different of how focused my conversations are on and off Vyvanse. I love my dose now and wouldn’t want to raise it, but it only lasts about 6 hours. I end up needing to take a second pill at about 4:00 so I can do my HW at night. I know raising the dosage makes the effects last longer, but won’t it also increase the potency? Suggestions? Concerta-type medications don’t work as well and other amphetamine medications make me feel “zombie-like”

  38. My 21 year old daughter has been seeing a psychiatist for several years for depression. The dr.she is seeing at this time seems to think that she is suffering from ADD. The dr. put her on 120mg of vyvanse a day. 60 mg in morn. and 60mg midafternnon. Now the dr. wants to double her dose; that would be 240 mg a day of Vyvanse. I am so concerned because it seems like such a high dose. Dr. seems to think that my daughters body is processing meds too fast. What should I do? Please help me

  39. I have a question. My son has been on the Aderall XR 40mg a day with some sucess. years ago we tried to switch to Vyvanse but he would get very depressed. Due to the manufacturerer cutting off the supply of adderall until after the first of the year. We had a hard time getting his RX filled in our area so we decided to try Vyvanse again. The doctor gave me the 20mg tablets and told me to titrate up to an effective dose. First day on 20mg is was like he had nothing. I realized why when I saw your conversion dosage chart. So I increased it to 40mg still not touching the ADHD symptoms but am pleased he seems to eat more. How long should I wait before increasing it again? Does it have a time period to build up in your system?

  40. Just last week my doctor switched me from 20 mg of Adderall XR once per day to 40mg of Vyvanse once per day. The Vyvanse makes me feel wierd, disconnected, anti-social, and my eyes and mouth are really dry. I can handle the dry mouth. Maybe my dosage isn’t right, not sure, but I don’t like the zombie-like feeling. I prefer the Adderall XR and plan to ask my doctor to switch me back.

    • We’ve had a similar experience with vyvanse:

      My 16 year old daughter had been on aderall XR at various dosages for eight years her maximum dose was 30 mg (she’s tiny), but she always had many effects: anxiety, frequent stomach aches, headaches. It was suggested we switch to vyvanse. She started on lowest dose, 20 mg at the start of this school year. I was troubled by her change in behaviour. Very disconnected and somber, almost zombie like and she said she felt ‘nothing’. It showed. The other physical side effects were not present. The doctor said it would be several weeks before we would see any change but these effects were immediate. Within two weeks we were back in the Docs office to discuss it. Given her age we were willing to give it a little more time. Gradually, those ‘moody’ symptoms subsided a bit but she noticed no advantage over aderall xr in keeping her focused in school. She is currently failing 3 classes because of poor test grades and her inability to focus, and retain what is studied. We have an appointment to get her back on Aderall or try something else. She said she would rather put up with the side effects and do better in school than continue on vyvanse. She is typically a b/c student with an occassional A here and there. I have read that Aderall does better with keeping patients focused than vyvanse long term because of it’s composition.

  41. I was on Vyvnase 70mg for a year then due to insurance reasons I was changed to Adderall 30mg.The Vyvanse kept me focused and on track. After taking the Adderall for 9 months I decided to change back to the Vyvanse and pay out of pocket. I have been taking the Vyvanse now for about 2 weeks and honsetly dont feel much different then I did on the Adderall. What could be the problem?

  42. my son was diagnosed with adhd . they started him on vyvanse 2 weeks ago 20 mg for 5 days then 30 mg for 5 days then 40 mg he is now started the 40 mg i have asked him does he feel anything and he said no but does have problem sleeping at night , i want to know if maybe they should up the mg and when should i notice a difference and change in him??

  43. Dr. Kenny,
    My 6 yr old son was recently prescribed Vyvanse 20 mg for ADHD. But we only gave it to him once, as it made him completely manic and emotionally unstable. We are now very discouraged because the Psychiatrist has decided against stimulants, and prescribed Strattera. We are very sad to think our wonderful child can never fulfill his potential because his body is unable to take the medications.
    Thoughts or opinions?
    Elise

    • I know this is a site for Vyvanse but my son was on Strattera for 4 1/2 years and it was great while it lasted. He had an almost overnight change. His grades went from failing to passing within a matter of a few weeks and his attention in the classroom was identifiable by every teacher. Since he has grown and he missed a weeks worth due to the fires in Bastrop it stopped working. We are now switched to Vyvanse, so I’m waiting to see what happens with it.

  44. My 5 year old is currently on 40mg of Vyvanse. He refuses to eat at all, would it be appropriate to ask to lower his dose to 20 mg? Without the meds, he is insane with his ADHD, with it, he is well behaved but refuses to eat. He has been on the meds for about 2 mos and has already lost 3 lbs. he only weighs 44 lbs as is.

  45. A bit of backstory first. I was prescribed Adderall for ADD in 2001. After taking it as prescribed for about 6 months I began to increase the dosage myself (huge mistake). For the next four years I abuse it (managed to convince two people to get scripts from their doc’s so at my peak I was taking 270mg a day). Eventually I admitted my problem, got help, and got clean. Fast forward to last year when I began to have problems with my antidepressant Effexor (300mg/day as prescribed). Doctor switched me to Pristiq, which works fine at 100mg. After switching to Pristiq my ADD reared it’s ugly head. Spoke with my doctor about it (this is NOT the same doctor who was prescribing Adderall). I told her of my past problems with addictions so as not to deceive her. She prescribed 30mg Vyvanse. I’ve been on it for about 10 months with no abuse or thoughts of abusing it. But I’ve noticed in the last month or two that my ADD is breaking through. I want to talk to her about it, but because of my past I honestly don’t know how to approach it without feeling like an active addict. I guess I’m wondering if there is a way to tell if it’s an honest to goodness tolerance or if it’s the addict in me trying to get out. Any thought? I’m 6’1 and 300lbs, which I only add because while abusing adderall I was down to 180. So the vyvanse is definetely not giving me any huge burst of energy or appetite suppression. Ok, that’s all.

  46. Im 15 years old and have been opn Vyvanse for about 3 weeks. over the opast week or sop i have developed i guess a “tic”. I have constant pain in the back of my neck and i am always “Rolling” my neck.
    For now i have opted to stoop taking it to see if this tic goes away.

    • The tic is normal… Just let it ride for a bit… Our son sniffles alot, that is his tic… Some have twinges… … What mg are you taking? And are you taking anything else with it?

  47. Dr. Handelman -

    Doing well for the last 6 months on 100 mg of vyvanse. (I’m 6’4″ 280 lbs.) my doctor had to provide a letter to my prescription benefit provider (Express Scripts) in order for them to cover a dosage over 70 mg. So far so good. Then my company changed insurance providers (to RxPartners) because Express Scripts and Walgreens could not agree on a fee schedule. The new provider will not cover more than 70 mg, even with a note from the doctor (unless he can provide evidence that it is OK with the FDA…!). So now I am back on 70 mg, which wasn’t sufficient on the way up, so not likely to work better on the way back down. Anyone have any experience dealing with a situation like this? The prescribing guide says that it hasn’t been studied at doses over 70mg, but isn’t it reasonable to expect that someone weighing 280 might need a higher dose than the maximum dosage allowed for a 6-12 year old child?
    Thanks.

  48. i take 70 mg vyvanse and im 14 and weigh 170, 5’10 and ive only been on them for 3 months and my immunity has already built up. idk what to do now. switch to adderall now lol.

  49. I found your comments about tics a little concerning. My son has been dealing with ADHD, central processing disorder and mild Aspergers. We thought we were dealing with sinus problems for many years as he also had eustation tube problems when younger with ear infections and tubes. When he hit 12yrs old he was diagnosed with Tourettes and it turns out that the primary tic was sniffing then vocal tics followed with now some neck and back spasms. Yes he has had his share of struggles but continues to achieve for his age level.
    When we introduced him to Vyvance a little over six months ago he did fine on it although we did not see the improved appetite suggested by our doctor. Maybe slightly more even dosing throughout the day and into evening for homework and able to sleep a bit better. Three months ago his tics became unrelenting and we wondered if he’d be able to return to school. I took him off the Vyvance and his tics diminished to almost complete arrest. He is now back on Concerta at lower dose and managing both attention and tics well.
    There is often co morbidity with ADHD and Tourettes. Best of luck to all.

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