Lisdexamfetamine
- Atc Codes:N06BA12
- CAS Codes:608137-33-3#608137-32-2
- PHARMGKB ID:608137-33-3#608137-32-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
North America
Canada: Vyvanse; USA: Vyvanse.
Drug combinations
Chemistry
Lisdexamfetamine Dimesylate: C~15~H~25~N~3~O (CH~4~O~3~S)~2~. Mw: 455.59. (1) Hexanamide, 2,6-diamino-N-[(1S)-1-methyl-2-phenylethyl]-, (2S)-, dimethanesulfonate; (2)(2S)-2,6-Diamino-N-[(1S)-1-methyl-2-phenylethyl]hexanamide dimethanesulfonate. CAS-608137-33-3; CAS-608137-32-2 (lisdexamfetamine)(2005).
Pharmacologic Category
Anorexigenic Agents and Respiratory and Cerebral Stimulants; Amphetamines Stimulant. (ATC-Code: N06BA12).
Mechanism of action
Prodrug converted to active component dextroamphetamine (a noncatecholamine, sympathomimetic amine). CNS-stimulant effects result from interference of norepinephrine and dopamine reuptake into presynaptic neurons as well as increasing their release from nerve terminals. Inhibits actions of monoamine oxidase. Peripheral actions include increase in systolic and diastolic blood pressure as well as weak bronchodilator and respiratory stimulant action.
Therapeutic use
Treatment of attention-deficit hyperactivity disorder.
Pregnancy and lactiation implications
Animal studies have shown that amphetamines may cause embryotoxic and teratogenic effects and that pre- or early postnatal exposure to amphetamines may lead to lasting changes in behavior, including impaired learning, memory, and motor skills, as well as changes to libido. There are no adequate, well-controlled studies in pregnant women. Use not recommended while breast-feeding.
Unlabeled use
Contraindications
Known hypersensitivity or idiosyncratic reaction to sympathomimetic amines. Advanced arteriosclerosis, symptomatic cardiovascular disease, moderate-to-severe hypertension. Hyperthyroidism. Glaucoma. Agitated states. History of drug abuse. Concurrent use or within 2 weeks of use of MAOIs.
Warnings and precautions
Use of CNS stimulants associated with serious cardiovascular events, including sudden death in pre-existing structural cardiac abnormalities or other serious heart problems (sudden death in children and adolescents; sudden death, stroke and MI in adults). Amphetamines may impair ability to engage in potentially hazardous activities. Visual disturbance (difficulty in accommodation and blurred vision) reported. Potential for drug dependency exists (use contraindicated in history of ethanol or drug abuse). Use with caution in hypertension and other cardiovascular conditions which might be exacerbated by increases in blood pressure or heart rate (use contraindicated in moderate-to-severe hypertension, arteriosclerosis, hyperthyroidism, or symptomatic CVD). Use with caution in pre-existing psychosis, bipolar disorder (may induce mixed/manic episode), aggressive behavior, or hostility. Use with caution in history of seizure disorder. Use with caution in Tourette’s syndrome. Amphetamines not recommended in children <3 years of age (appetite suppression, slowing of growth rate). Abrupt discontinuation following high doses or for prolonged periods may result in withdrawal symptoms.