Vyvanse®
Lisdexamfetamine
Version 2025-04 · Last reviewed April 1, 2025 · Methodology
List Price
$450
With Insurance
$50-100
The Short Version
Plain-language summary
Vyvanse (Lisdexamfetamine) is a prodrug, your body has to convert it before it works, which gives it a smoother, longer-lasting effect than Adderall. It treats ADHD and is the only stimulant FDA-approved for binge eating disorder.
How it works: Vyvanse (lisdexamfetamine) is an inactive prodrug. After swallowing, it is cleaved by enzymes in the gut and blood cells into d-amphetamine, identical to half the active ingredient in Adderall. The key difference is that this cleavage step creates a controlled, gradual release of active drug.
What people most commonly report
Eat a nutritious breakfast before medication takes effect
Check the evidence section for details on who funded the research.
What Else the Evidence Supports
Non-drug options with clinical backing
Behavioral therapy is comparable to medication long-term for ADHD; has established evidence for binge eating disorder
Equal to medication in long-term MTA follow-up.
Acute improvement in executive function.
Remission in 50-60%.
Reduces binge frequency significantly.
What This Really Costs
Long-term cost projection based on current pricing
Monthly
$375
$75 w/ insurance
without insurance
Annual
$4.5K
$900 w/ insurance
without insurance
10 Years
$45K
$9K w/ insurance
without insurance
30 Years
$135K
$27K w/ insurance
without insurance
Lifestyle alternative: $0/month in prescriptions. CBT for ADHD - Equal to medication in long-term MTA follow-up.
The average American retiree spends $165,000 on healthcare after retirement (Fidelity, 2024). Informed choices today compound over decades.
Related Evidence
Explore related medications reviewed on EvidentMeds
FDA Black Box Warning
HIGH POTENTIAL FOR ABUSE
Schedule II controlled substance. Risk of dependence, cardiovascular events.
Strict Contraindications
Metabolic & Lifestyle Alternatives
Non-Drug & Behavioral ADHD/BED Approaches
Behavioral therapy is comparable to medication long-term for ADHD; has established evidence for binge eating disorder
Important context: Evidence quality varies across these approaches. Some are well-studied with randomized controlled trial data; others are based on observational or smaller studies. These interventions are not guaranteed to replace medication for all patients. Discuss with your doctor whether any of these are appropriate for your clinical situation.
Global Prescribing & Pricing
Vyvanse is priced at 6–15× more in the US than in comparable countries with pharmaceutical price negotiation
United States
$350–400 (brand only until 2023)/mo
6M+ prescriptions in 2022, heavy DTC advertising drove growth
No behavioral therapy prerequisite; marketed directly to consumers
Often requires prior authorization
United Kingdom
~$190/mo
Restricted, specialist-only prescribing
NICE requires behavioral intervention before medication for children; specialist must initiate
Covered by NHS with specialist approval
France
~$88/mo
Very low prescribing rate
Neuropsychological evaluation and therapy required first; extremely limited prescribing
Partially covered by Assurance Maladie
Germany
~$132/mo
Low prescribing, methylphenidate preferred
Multimodal evaluation required; behavioral treatment must be concurrent with medication
Covered by GKV with evaluation
Australia
~$27 (PBS)/mo
Lower prescribing, PBS restricts access
PBS requires specialist initiation (pediatrician or psychiatrist); PBS negotiates price down to AUD 40/mo
Covered by PBS with restrictions
Australia's PBS pays AUD 40/month (~$27) for the same drug that costs $350–400 in the US, the difference is government negotiating power. No clinical difference in the drug; 13× price difference explained entirely by policy.
Clinical Trials & Funding
Understanding who funds research helps contextualize results. Industry-funded trials are not automatically invalid - they undergo the same FDA review - but declared conflicts and sponsor effects are worth knowing. All linked trials can be verified on ClinicalTrials.gov.
Key Efficacy Results
ADHD symptom reduction 60-70%; abuse risk marketed as lower than Adderall (debated)
Referenced Studies
Each study shows its evidence level and Cochrane RoB-2 risk-of-bias rating - tap the bias badge for details.
Evidence & Transparency
Cochrane RoB-2 (Risk of Bias)
Badges reflect an editorial assessment using Cochrane's RoB-2 tool domains: randomization, intervention deviation, missing data, outcome measurement, and selective reporting. These are not certified Cochrane reviews. Learn more ↗
CMS Open Payments
Manufacturer payment disclosures are reported via the CMS Sunshine Act. Disclosure is legally required and does not imply bias or misconduct. Language uses "may," "suggests," or "appears", never definitive clinical claims. CMS Open Payments ↗
Live Clinical Trials
Live from ClinicalTrials.gov · refreshed every 4 hours
Currently enrolling, active, and recently completed studies involving Lisdexamfetamine. Data is pulled directly from the U.S. National Library of Medicine.
Recent Research
Live from PubMed · peer-reviewed literature · refreshed every 4 hours
Most recently indexed clinical trials and systematic reviews mentioning Lisdexamfetamine in PubMed.
Source Documentation
Structured citations for referenced clinical trials
Each referenced trial is listed with its registry ID, funding source, and bias assessment. Use the copy button to generate a formatted citation.
| Trial | Registry ID | Cite |
|---|---|---|
| Vyvanse ADHD Adults (Shire) | NCT00877487 | |
| BED Trial (Shire) | NCT01718483 |
Bias ratings use Cochrane RoB-2 methodology. Editorial assessment - not a certified Cochrane review.
Our MethodologyCommon Side Effects
While taking this medication, you may experience the following common side effects. We've included tips on how to manage them.
Decreased appetite
39%Eat a nutritious breakfast before medication takes effect
Insomnia
27%Take early in the morning; the drug lasts 12-14 hours
Dry mouth
26%Sip water throughout the day; sugar-free gum helps
Increased heart rate
20%Monitor pulse; inform doctor if consistently over 100 bpm at rest
Irritability / mood swings
18%Often occurs as drug wears off ("rebound"); talk to doctor
Headache
16%Stay well hydrated; usually improves over time
Upper abdominal pain
14%Take with food or a light snack
Anxiety
12%Report to doctor; dose may need adjustment or alternative considered
Nausea
10%Take with food; improves with time
Weight loss
9%Ensure adequate nutrition; eat when hungry, even if no appetite
Serious Adverse Effects
- • Sudden cardiac death
- • Stroke
- • Serious cardiovascular events
- • Psychiatric episodes
- • Serotonin syndrome (with other drugs)
- • Growth suppression in children
Drug Interactions
Major Interactions (Avoid)
Moderate Interactions (Caution)
Food Interactions
When to Contact Your Doctor
This medication requires ongoing medical supervision. The following situations warrant a prompt conversation with your prescribing physician - do not wait for your next scheduled appointment.
Contact soon if you notice
- Sudden cardiac death
- Stroke
- Serious cardiovascular events
- Psychiatric episodes
- Extreme fatigue and hypersomnia
Also discuss if you want to
- Review whether this medication is still appropriate for you
- Consider dosage adjustments based on response
- Explore lifestyle or non-drug alternatives
- Understand stopping or tapering options
- Plan monitoring labs and follow-up
In the US, call 911 or go to the nearest emergency room for severe symptoms. Poison Control: 1-800-222-1222.
Special Populations
Safety classifications for specific groups - discuss with your provider before use.
Risk of premature birth, neonatal withdrawal.
Passes into milk; developmental risk to infant.
Estrogen directly fuels the brain's dopamine system, the same system stimulant medications work on. As estrogen drops during perimenopause, many women experience new brain fog, poor focus, mood instability, and low motivation. Some receive an ADHD diagnosis in their 40s when hormonal change, not a lifelong attention disorder, is the actual driver. Ask your doctor about ruling out perimenopause before starting a stimulant.
Monitor growth; drug holidays considered. Important: excess sugar and processed carbs cause a blood sugar spike, followed by an insulin overcorrection, followed by a blood sugar crash. The body then releases adrenaline, causing shakiness, anxiety, restlessness, and inattention that can look exactly like ADHD. Dietary clean-up should always be explored before or alongside stimulant medication in children.
Higher cardiovascular risk; start low.
FDA Adverse Event Reports
Patient-filed reports from the FDA FAERS database · refreshed daily
Community Reports
User-reported experiences - anonymous & anecdotal
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Stopping This Medication Safely
As a Schedule II stimulant, Vyvanse discontinuation causes pronounced fatigue, low mood, increased appetite, and motivational deficits as the dopamine system readjusts.
What Published Research Shows About Stopping This Medication
This summarizes what published research documents, it is not personal medical advice. Any changes to your medication require discussion with your prescribing physician.
- ·Published tapering protocols describe dose reduction of 10–20mg every 2 weeks (e.g., 60mg → 50mg → 40mg → 30mg → stop)
- ·Research supports beginning regular aerobic exercise before stopping, which may help with dopamine system readjustment
- ·Research supports establishing a consistent sleep schedule (7–9 hrs) before stopping
- ·Clinical guidance suggests planning discontinuation during a lower-demand period
- ·Research supports having behavioral therapy or executive function coaching in place before stopping
Warning Symptoms, Contact Your Doctor If You Experience:
- Extreme fatigue and hypersomnia
- Low motivation or anhedonia (inability to feel pleasure)
- Significant increase in appetite
- Difficulty focusing beyond pre-medication baseline
Never change or stop a medication without consulting your prescribing physician.
Questions for Your Doctor
$2.99, printable guide for your next appointment
Questions to Ask
- 1.Has the child's diet been evaluated? Sugar and processed carbs spike blood sugar, then insulin overcorrects and the blood sugar crashes. The body releases adrenaline to fix the crash, causing shakiness, anxiety, restlessness, and inability to focus. This can look exactly like ADHD. Has a real-food, lower-sugar dietary trial been done first?
- 2.Have we tried behavioral therapy?
- 3.What cardiovascular monitoring will we do?
- 4.Is there a generic alternative that costs less?
- 5.Are drug holidays appropriate?
Lab Tests to Request
- Blood pressure
- Heart rate
- Weight/height (children)
- Fasting blood sugar, screen for reactive hypoglycemia
- Mood/anxiety screening
Medical Disclaimer
The information on this page is compiled from publicly available clinical trial data, FDA prescribing information, and peer-reviewed literature. It is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendations. Individual responses to medications vary. Always consult a qualified healthcare provider before starting, stopping, or changing any medication.
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