Switching from Vyvanse to Concerta: Recommended Dose Conversion

Dose Conversion Rationale

The American Academy of Child and Adolescent Psychiatry recommends an amphetamine to methylphenidate conversion ratio of approximately 1:1.2 to 1:2 to achieve equivalent therapeutic effect 1
Vyvanse 30mg is converted to approximately 8.9mg of active dextroamphetamine after metabolism, which is equivalent to Concerta 36mg 2
Concerta 36mg provides methylphenidate coverage equivalent to approximately 12mg of immediate-release methylphenidate given three times daily, making it a reasonable match for Vyvanse 30mg 1

No washout period is required when switching between stimulant classes, as both medications have short half-lives and can be transitioned directly 3

Assess response after 1 week at the initial 36mg dose before making any adjustments, with a strength of evidence based on clinical guidelines from the American Academy of Child and Adolescent Psychiatry 1
If symptom control is inadequate after 1 week, increase to Concerta 54mg, as recommended by the American Academy of Child and Adolescent Psychiatry 1
Allow at least 4 weeks at a therapeutic dose before determining treatment failure, representing an adequate trial period 1

For patients requiring coverage beyond 12 hours, consider adding a small immediate-release methylphenidate dose, as recommended by the American Academy of Child and Adolescent Psychiatry 1
Cardiovascular monitoring should continue as with any stimulant therapy, with guidelines from the American Journal of Obstetrics and Gynecology 2
The American Academy of Child and Adolescent Psychiatry and Praxis Medical Insights recommend monitoring for nausea during the first week, which occurs in up to 25% of patients starting methylphenidate-based medications 3