Adderall to Vyvanse Conversion Guidelines

Introduction to Conversion

The American Academy of Child and Adolescent Psychiatry recommends converting Adderall 15mg twice daily to Vyvanse 70mg once daily, following a 2.5:1 ratio, which translates to approximately 75mg of Vyvanse, but the maximum FDA-approved dose is 70mg daily 1

Calculate total daily amphetamine dose: 15mg BID = 30mg total daily amphetamine salts, which is within the typical adult therapeutic range of 10-50mg daily for mixed amphetamine salts 2, 3
Apply conversion factor: 30mg Adderall × 2.5 = 75mg Vyvanse, but initiate at 70mg once daily due to maximum dose limitations 1

The National Comprehensive Cancer Network recommends avoiding methylphenidate and dextroamphetamine in patients with uncontrolled hypertension, underlying coronary artery disease, and tachyarrhythmias 5
Monitor blood pressure and pulse at baseline and regularly during treatment, as rare but serious cardiovascular side effects include hypertension, palpitations, and arrhythmias 3, 5
Long-acting formulations like Vyvanse have lower abuse potential and are resistant to diversion compared to immediate-release stimulants 3

Expect therapeutic effects within hours of the first Vyvanse dose, with peak plasma concentrations of d-amphetamine occurring approximately 1 hour later than immediate-release amphetamine 4, 3
Vyvanse provides full-day coverage with once-daily dosing, eliminating the need for afternoon doses and improving medication adherence 3

If 70mg provides inadequate symptom control after 1 week, do not exceed the maximum dose of 70mg daily, and consider switching to methylphenidate class rather than exceeding recommended amphetamine doses 1, 3
Dosage adjustments can be made in 10mg increments at weekly intervals if starting below 70mg 1

Do not use weight-adjusted dosing for this conversion, as current research does not uniformly support titrating with weight-adjusted doses 2
Do not combine Vyvanse with MAO inhibitors due to risk of severe hypertension and potential cerebrovascular accidents 3

Monitor blood pressure and heart rate at each visit, as well as weight and appetite changes, sleep quality and timing, and ADHD symptom response using standardized rating scales within the first week 2, 3, 5