Guidelines for Switching Adults from Adderall to Vyvanse

Conversion Dosing

For an adult currently receiving a total daily dose of 20 mg Adderall (10 mg twice daily), initiate Vyvanse at 30 mg taken once each morning; this dose provides comparable therapeutic exposure given the pro‑drug nature of lisdexamfetamine. 1

Discontinue the immediate‑release Adderall regimen and start Vyvanse 30 mg the following morning; no wash‑out period or taper is required because both agents are amphetamine‑based stimulants with overlapping mechanisms. 1

Maintain the initial 30 mg Vyvanse dose for at least one week before assessing efficacy or adverse effects, allowing steady‑state plasma concentrations to be reached. 1

If symptom control is inadequate after the first week, increase the Vyvanse dose by 10–20 mg increments each week, guided by clinical response, up to a maximum of 70 mg daily for adults with ADHD. 1
During titration, obtain weekly ADHD symptom ratings (from the patient or a close informant) to objectively track improvement and inform dose adjustments. The American Academy of Child and Adolescent Psychiatry recommends this systematic rating approach. 2
If the maximum tolerated dose of 70 mg does not achieve satisfactory control, consider switching to a methylphenidate‑based stimulant; approximately 90 % of patients respond to at least one stimulant class when both are tried. 2

Measure blood pressure and pulse at baseline (prior to the switch) and at every subsequent dose‑adjustment visit, as amphetamine stimulants can cause modest increases in these vital signs. 1
At each visit, assess for common adverse effects (e.g., decreased appetite, insomnia, headache, dry mouth, anxiety, irritability) that occur in more than 5 % of adults treated with amphetamines. 1