Placental Transfer of Vyvanse

Clinical Implications for Pregnancy

The American College of Obstetricians and Gynecologists indicates that amphetamines cross the placental barrier, and this information should be applied when considering lisdexamfetamine use in pregnancy, with limited published information existing specifically on lisdexamfetamine use during pregnancy 1, 2
Amphetamines do not appear to be associated with major congenital malformations, including cardiac malformations, or other significant adverse developmental outcomes 1

There is a possible increased risk for gastroschisis (adjusted odds ratio 3.0; 95% CI, 1.2-7.4) and preeclampsia (adjusted relative risk 1.29; 95% CI, 1.11-1.49) associated with lisdexamfetamine use during pregnancy, though these risks appear to be small 1, 2
Continued stimulant use in the second half of pregnancy may be associated with a small increased risk of preterm birth (adjusted relative risk 1.30; 95% CI, 1.10-1.55) 1

Monitor infants carefully for irritability, insomnia, and feeding difficulties if the mother was taking amphetamines during pregnancy 1

Information provided regarding amphetamine use during pregnancy applies to therapeutic use and does not apply to non-prescribed amphetamine use in persons with stimulant use disorder 1

Lisdexamfetamine is a prodrug that is converted to dextroamphetamine after ingestion, as stated by the American College of Obstetricians and Gynecologists 3, 4, 5

The usual starting dose of lisdexamfetamine is 20-30 mg once daily in the morning, with titration typically involving increasing by 10 mg weekly to a maximum of 70 mg daily, according to the American College of Obstetricians and Gynecologists 3, 5

The American Academy of Pediatrics suggests that lisdexamfetamine may be preferred over other stimulants in adolescents due to its lower abuse potential 6
The pharmacokinetic properties of lisdexamfetamine make extraction of the stimulant component more difficult compared to other stimulant medications, as noted by the American Academy of Pediatrics 6

The American College of Obstetricians and Gynecologists states that limited published information exists on lisdexamfetamine use during pregnancy, and pregnancy risk information for amphetamines should be considered when evaluating use in pregnant patients 3, 4, 7

Amphetamines, including Adderall, have been associated with a possible increased risk for spontaneous abortion, though confounding by indication cannot be ruled out 8
Limited published information exists specifically on amphetamine use during pregnancy and its direct causal relationship to miscarriage 9, 10

Consider non-pharmacological interventions for ADHD during pregnancy, as recommended by the American College of Obstetricians and Gynecologists 8