Pre-treatment Screening: Prior to treating patients with VYVANSE, assess: for the presence of cardiac disease (i.e., perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) [see Risks to Patients with Serious Cardiac Disease under Precautions]; the family history and clinically evaluate patients for motor or verbal tics or Tourette's syndrome before initiating VYVANSE [see Motor and Verbal Tics, and Worsening of Tourette's Syndrome under Precautions].
General Administration Information: Take VYVANSE orally in the morning with or without food; avoid afternoon doses because of the potential for insomnia. VYVANSE may be administered in the following ways: Swallow VYVANSE capsules whole; or Open capsules, empty and mix the entire contents with yogurt, water, or orange juice. If the contents of the capsule include any compacted powder, a spoon may be used to break apart the powder. The contents should be mixed until completely dispersed. Consume the entire mixture immediately. It should not be stored. The active ingredient dissolves completely once dispersed; however, a film containing the inactive ingredients may remain in the glass or container once the mixture is consumed.
Do not take anything less than one capsule per day. A single dose should not be divided.
Dosage for Treatment of ADHD: The recommended starting dosage in adults and pediatric patients 6 years and older is 30 mg once daily in the morning. Dosage may be adjusted in increments of 10 mg or 20 mg at approximately weekly intervals up to maximum recommended dosage of 70 mg once daily [see Pharmacology: Pharmacodynamics: Clinical Studies under Actions].
Dosage in Patients with Renal Impairment: In patients with severe renal impairment (GFR 15 to <30 mL/min/1.73 m2), the maximum dosage should not exceed 50 mg once daily. In patients with end-stage renal disease (ESRD, GFR <15 mL/min/1.73 m2), the maximum recommended dosage is 30 mg once daily [see Renal Impairment under Precautions].
Dosage Modifications due to Drug Interactions: Agents that alter urinary pH can impact urinary excretion and alter blood levels of amphetamine. Acidifying agents (e.g., ascorbic acid) decrease blood levels, while alkalinizing agents (e.g., sodium bicarbonate) increase blood levels. Adjust VYVANSE dosage accordingly [see Drugs Having Clinically Important Interactions with Amphetamines under Interactions].
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