Classifications: cerebral stimulant; amphetamine; anorexigenic; Therapeutic: cerebral stimulant
Pregnancy Category: C
Controlled Substance: Schedule II
30 mg, 50 mg, and 70 mg capsules
An isomer of amphetamine that has anorexigenic action; this is thought to result from CNS stimulation and possibly from
loss of acuity of smell and taste. CNS stimulating effect is approximately twice that of racemic amphetamine.
In hyperkinetic children, amphetamines reduce motor restlessness by an unknown mechanism.
Treatment of attention-deficit hyperactivity disorder (ADHD).
Hypersensitivy to sympathomimic amines, or amphetamine; advanced arteriosclerosis; structural cardiac abnormalities, cardiomyopathy,
cardiac arrhythmias, or symptomatic cardiovascular disease; moderate to severe hypertension; glaucoma; agitated states;
patients with history of drug abuse; during or within 14 d of administering MAOIs; hyperthyroidism; history of depression
or suicide; seizure disorders; tics or Tourette syndrome; pregnancy (category C); lactation; children <3 y.
Controlled hypertension, heart failure, recent MI, or recent ventricular arrhythmia; preexisting psychotic disorder; bipolar
disorder; history of aggressive or hostile behavior.
Route & Dosage
|Attention-Deficit Hyperactivity Disorder
Child (612 y): PO 30 mg q.d. in a.m.; may increase to 5070 mg q.d. at weekly intervals (max: 70 mg q.d.)
- Give daily dose in the morning.
- Capsule may be taken whole or opened and dissolved in a glass of water.
- Store at 15°30° C (59°86° F) and protect from light.
Adverse Effects (≥1%) Body as a Whole:
Affect lability, dizziness, headache, insomnia, irritability,
somnolence, tic. GI: Abdominal pain,
dry mouth, nausea, vomiting. Metabolic:
Decreased appetite, weight loss. Skin:
Diagnostic Test Interference
Lisdexamfetamine can cause a significant elevation in plasma corticosteroid levels and may interfere with urinary steroid determinations.
inhibit the CNS
stimulant effects of amphetamines. Furazolidone
decreases amphetamine metabolism and can increase adverse effects. Lithium
may inhibit the effects of lisdexamfetamine. monoamine oxidase inhibitors
will increase plasma levels of lisdexamfetamine. Propoxyphene
can potentiate the CNS
stimulation of lisdexamfetamine. Compounds that acidify the urine lower the plasma levels of lisdexamfetamine.
Lisdexamfetamine inhibits the actions of adrenergic blockers.
Co-administration of antihistamines
with lisdexamfetamine can counteract desired sedative effects. Lisdexamfetamine may antagonize the hypotensive effects
of antihypertensive agents
. Lisdexamfetamine may delay the absorption of ethosuximide
Lisdexamfetamine may potentiate the actions of tricyclic antidepressants
Rapidly absorbed from GI tract. Peak:
1 h. Distribution:
Extensive throughout body. Metabolism:
Prodrug converted in liver to dextroamphetamine. Elimination:
Urine (96%). Half-Life:
1 h (lisdexamfetamine) 68 h (dextroamphetamine).
Assessment & Drug Effects
- Monitor children, adolescents, and adults for signs and symptoms of adverse cardiac reactions (e.g., hypertension, arrhythmias).
Report promptly exertional chest pain or syncope.
- Monitor closely growth rate in children.
- Typically therapy is interrupted or dosage reduced periodically to assess effectiveness in behavior disorders.
- Monitor children and adolescents for development of aggressive or abnormal behaviors.
Patient & Family Education
- Do not drive or engage in other potentially hazardous activities until response to drug is known.
- Report promptly any of the following: chest pain with activity, new or worse behavior or thought problems, psychotic symptoms
(e.g., hearing voices, believing things that are not true).
- Taper drug gradually following long-term use to avoid extreme fatigue, mental depression, and prolonged abnormal sleep pattern.