甲磺酸赖右苯丙胺

id: lisdexamfetamine
brandNames:
  US:
    - Vyvanse
  CN: []
  EU:
    - Elvanse
  JP:
    - ビバンセ (Vyvanse)
  UK:
    - Elvanse
    - Elvanse Adult
  AU:
    - Vyvanse
  CA:
    - Vyvanse
genericName:
  en: lisdexamfetamine dimesylate
  zh: 甲磺酸赖右苯丙胺
  ja: リスデキサンフェタミンメシル酸塩
manufacturers:
  - name: Takeda (formerly Shire)
    region: US
    product: Vyvanse
  - name: Takeda
    region: EU
    product: Elvanse
  - name: Shionogi
    region: JP
    product: ビバンセ
chemicalStructure:
  smiles: C[C@@H](CC1=CC=CC=C1)NC(=O)[C@H](CCCCN)N
  pubchemCid: 11597698
  molecularFormula: C15H25N3O
  imageUrl: https://pubchem.ncbi.nlm.nih.gov/rest/pug/compound/cid/11597698/PNG
  wikipediaUrl: https://en.wikipedia.org/wiki/File:Lisdexamfetamine.svg
drugClass: stimulant
drugClassLabel:
  en: Stimulant
  zh: 兴奋剂
  ja: 中枢刺激薬
category: amphetamine
categoryLabel:
  en: Amphetamine
  zh: 苯丙胺类
  ja: アンフェタミン系
controlledSubstance: true
schedule:
  US: Schedule II
  CN: Not approved
  EU: Varies by country (typically Schedule II equivalent)
  JP: 第一種向精神薬
  UK: Class B, Schedule 2
activeIngredient:
  en: lisdexamfetamine dimesylate (prodrug of dextroamphetamine)
  zh: 甲磺酸赖右苯丙胺（右苯丙胺的前药）
  ja: リスデキサンフェタミンメシル酸塩（デキストロアンフェタミンのプロドラッグ）
mechanismOfAction:
  en: Prodrug that is converted to dextroamphetamine in the body. Increases release of dopamine and norepinephrine from nerve terminals and inhibits their reuptake. The prodrug design provides smoother onset and longer duration, with lower abuse potential than immediate-release amphetamines.
  zh: 在体内转化为右苯丙胺的前药。增加神经末梢多巴胺和去甲肾上腺素的释放并抑制其再摄取。前药设计提供更平稳的起效和更长的持续时间，滥用风险低于速释苯丙胺类药物。
  ja: 体内でデキストロアンフェタミンに変換されるプロドラッグ。神経末端からのドーパミンとノルエピネフリンの放出を増加させ、再取り込みを阻害します。プロドラッグ設計により、即放性アンフェタミンよりも滑らかな効果発現と長い持続時間を提供し、乱用の可能性が低くなります。
neurotransmittersAffected:
  - dopamine
  - norepinephrine
forms:
  - type: capsule
    typeLabel:
      en: Capsule
      zh: 胶囊
      ja: カプセル
    releaseType: extended
    releaseTypeLabel:
      en: Extended Release
      zh: 缓释
      ja: 徐放性
    brandName: Vyvanse
    strengths:
      - 10mg
      - 20mg
      - 30mg
      - 40mg
      - 50mg
      - 60mg
      - 70mg
    durationHours: 10-14
    notes:
      en: Can be opened and dissolved in water; prodrug provides smooth release
      zh: 可打开溶于水中；前药设计提供平稳释放
      ja: 開けて水に溶かすことができます；プロドラッグにより滑らかな放出を提供
  - type: chewable
    typeLabel:
      en: Chewable Tablet
      zh: 咀嚼片
      ja: チュアブル錠
    releaseType: extended
    releaseTypeLabel:
      en: Extended Release
      zh: 缓释
      ja: 徐放性
    brandName: Vyvanse
    strengths:
      - 10mg
      - 20mg
      - 30mg
      - 40mg
      - 50mg
      - 60mg
    durationHours: 10-14
    notes:
      en: Chewable tablet formulation
      zh: 咀嚼片剂型
      ja: チュアブル錠剤形
onsetMinutes: 60-90
peakEffectHours: 3.5
durationHours: 10-14
sideEffects:
  common:
    - name:
        en: decreased appetite
        zh: 食欲下降
        ja: 食欲減退
      frequency: 30-40%
    - name:
        en: insomnia
        zh: 失眠
        ja: 不眠
      frequency: 20-30%
    - name:
        en: dry mouth
        zh: 口干
        ja: 口渇
      frequency: 15-25%
    - name:
        en: headache
        zh: 头痛
        ja: 頭痛
      frequency: 10-20%
    - name:
        en: irritability
        zh: 易怒
        ja: 易刺激性
      frequency: 10-15%
    - name:
        en: weight loss
        zh: 体重减轻
        ja: 体重減少
      frequency: 10-15%
    - name:
        en: upper abdominal pain
        zh: 上腹痛
        ja: 上腹部痛
      frequency: 10-15%
  uncommon:
    - name:
        en: increased heart rate
        zh: 心率加快
        ja: 心拍数増加
      frequency: 5-10%
    - name:
        en: anxiety
        zh: 焦虑
        ja: 不安
      frequency: 5-10%
    - name:
        en: dizziness
        zh: 头晕
        ja: めまい
      frequency: 5%
    - name:
        en: nausea
        zh: 恶心
        ja: 悪心
      frequency: 5%
    - name:
        en: vomiting
        zh: 呕吐
        ja: 嘔吐
      frequency: 5%
  serious:
    - name:
        en: cardiovascular events
        zh: 心血管事件
        ja: 心血管イベント
      notes:
        en: Rare; monitor in patients with heart conditions
        zh: 罕见；有心脏病患者需监测
        ja: まれ；心臓疾患のある患者はモニタリングが必要
    - name:
        en: psychiatric symptoms
        zh: 精神症状
        ja: 精神症状
      notes:
        en: May cause or worsen psychosis, mania, aggression
        zh: 可能引起或加重精神病、躁狂、攻击性
        ja: 精神病、躁病、攻撃性を引き起こしたり悪化させたりする可能性
    - name:
        en: serotonin syndrome
        zh: 血清素综合征
        ja: セロトニン症候群
      notes:
        en: When combined with serotonergic drugs
        zh: 与血清素能药物联用时
        ja: セロトニン作動薬との併用時
    - name:
        en: peripheral vasculopathy
        zh: 外周血管病变
        ja: 末梢血管障害
      notes:
        en: Raynaud's phenomenon
        zh: 雷诺现象
        ja: レイノー現象
    - name:
        en: growth suppression
        zh: 生长抑制
        ja: 成長抑制
      notes:
        en: May affect height and weight in children
        zh: 可能影响儿童身高和体重
        ja: 小児の身長と体重に影響を与える可能性
contraindications:
  en:
    - Hypersensitivity to amphetamines
    - MAO inhibitor use within 14 days
    - Advanced arteriosclerosis
    - Symptomatic cardiovascular disease
    - Moderate to severe hypertension
    - Hyperthyroidism
    - Glaucoma
    - Agitated states
    - History of drug abuse
  zh:
    - 对苯丙胺类过敏
    - 14天内使用过MAO抑制剂
    - 晚期动脉硬化
    - 有症状的心血管疾病
    - 中度至重度高血压
    - 甲状腺功能亢进
    - 青光眼
    - 激动状态
    - 药物滥用史
  ja:
    - アンフェタミン類に対する過敏症
    - 14日以内のMAO阻害剤使用
    - 進行性動脈硬化
    - 症候性心血管疾患
    - 中等度から重度の高血圧
    - 甲状腺機能亢進症
    - 緑内障
    - 興奮状態
    - 薬物乱用歴
drugInteractions:
  - drug:
      en: MAO inhibitors
      zh: MAO抑制剂
      ja: MAO阻害剤
    severity: major
    effect:
      en: Hypertensive crisis risk
      zh: 高血压危象风险
      ja: 高血圧クリーゼのリスク
  - drug:
      en: Serotonergic drugs
      zh: 血清素能药物
      ja: セロトニン作動薬
    severity: major
    effect:
      en: Serotonin syndrome risk
      zh: 血清素综合征风险
      ja: セロトニン症候群のリスク
  - drug:
      en: Acidifying agents
      zh: 酸化剂
      ja: 酸性化剤
    severity: moderate
    effect:
      en: Decrease amphetamine absorption
      zh: 降低苯丙胺吸收
      ja: アンフェタミン吸収を低下
  - drug:
      en: Alkalinizing agents
      zh: 碱化剂
      ja: アルカリ化剤
    severity: moderate
    effect:
      en: Increase amphetamine absorption
      zh: 增加苯丙胺吸收
      ja: アンフェタミン吸収を増加
  - drug:
      en: Antihypertensives
      zh: 降压药
      ja: 降圧薬
    severity: moderate
    effect:
      en: May reduce effectiveness
      zh: 可能降低疗效
      ja: 効果を低下させる可能性
blackBoxWarnings:
  en:
    - High potential for abuse and dependence
    - CNS stimulants may cause sudden death and serious cardiovascular adverse events
  zh:
    - 高度滥用和依赖风险
    - 中枢神经兴奋剂可能导致猝死和严重心血管不良事件
  ja:
    - 乱用および依存の可能性が高い
    - CNS刺激薬は突然死および重篤な心血管有害事象を引き起こす可能性がある
pregnancyCategory: C
foodInteractions:
  en: Can be taken with or without food; avoid vitamin C and acidic foods/drinks close to dosing
  zh: 可随餐或空腹服用；服药前后避免维生素C和酸性食物/饮料
  ja: 食事の有無にかかわらず服用可能；服用前後はビタミンCや酸性の食品/飲料を避ける
typicalDosing:
  children:
    startingDose: 30mg once daily in the morning
    maxDose: 70mg/day
    notes:
      en: Titrate in 10-20mg increments weekly
      zh: 每周按10-20mg递增调整
      ja: 毎週10〜20mg刻みで漸増
  adults:
    startingDose: 30mg once daily in the morning
    maxDose: 70mg/day
    notes:
      en: Same dosing as children
      zh: 与儿童剂量相同
      ja: 小児と同じ用量
costEstimate:
  US:
    brand: $350-450/month
    generic: $30-100/month (available since 2023)
  CN:
    brand: Not available
    generic: Not available
storageRequirements:
  en: Room temperature (20-25°C), protect from light
  zh: 室温保存（20-25°C），避光
  ja: 室温（20-25°C）で保存、光を避ける
approvals:
  - region: US
    agency: FDA
    year: 2007
    approvedAges:
      en: 6 years and older
      zh: 6岁及以上
      ja: 6歳以上
    indications:
      en:
        - ADHD
        - Binge eating disorder
      zh:
        - 注意缺陷多动障碍
        - 暴食症
      ja:
        - ADHD
        - 過食性障害
    available: true
    notes:
      en: Generic available since August 2023
      zh: 2023年8月起有仿制药
      ja: 2023年8月以降ジェネリックが利用可能
  - region: CN
    agency: NMPA
    year:
    approvedAges:
      en: ""
      zh: ""
      ja: ""
    indications:
      en: []
      zh: []
      ja: []
    available: false
    notes:
      en: Not approved in China
      zh: 中国未批准
      ja: 中国では未承認
  - region: EU
    agency: EMA
    year: 2013
    approvedAges:
      en: 6 years and older (children); adults in some countries
      zh: 6岁及以上（儿童）；部分国家适用于成人
      ja: 6歳以上（小児）；一部の国では成人も
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: Adult approval varies by EU member state (UK, Denmark, Sweden approved for adults)
      zh: 成人适应症因欧盟成员国而异（英国、丹麦、瑞典已批准成人使用）
      ja: 成人への承認はEU加盟国によって異なる（英国、デンマーク、スウェーデンは成人に承認）
  - region: JP
    agency: PMDA
    year: 2019
    approvedAges:
      en: 6-17 years only
      zh: 仅限6-17岁
      ja: 6〜17歳のみ
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: Children only; requires registration in ADHD Proper Distribution Management System; sales started December 2019
      zh: 仅限儿童；需在ADHD适当流通管理系统注册；2019年12月开始销售
      ja: 小児のみ；ADHD適正流通管理システムへの登録が必要；2019年12月より販売開始
  - region: UK
    agency: MHRA
    year: 2013
    approvedAges:
      en: 6 years and older (children and adults)
      zh: 6岁及以上（儿童和成人）
      ja: 6歳以上（小児および成人）
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: Elvanse Adult approved for adult ADHD
      zh: Elvanse Adult已获批用于成人ADHD
      ja: Elvanse Adultが成人ADHDに承認
  - region: AU
    agency: TGA
    year: 2014
    approvedAges:
      en: 6 years and older
      zh: 6岁及以上
      ja: 6歳以上
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: ""
      zh: ""
      ja: ""
  - region: CA
    agency: Health Canada
    year: 2010
    approvedAges:
      en: 6 years and older
      zh: 6岁及以上
      ja: 6歳以上
    indications:
      en:
        - ADHD
      zh:
        - 注意缺陷多动障碍
      ja:
        - ADHD
    available: true
    notes:
      en: ""
      zh: ""
      ja: ""
specialConsiderations:
  cardiacRisk:
    en: Screen for cardiac disease before treatment; avoid in patients with structural cardiac abnormalities
    zh: 治疗前筛查心脏疾病；有心脏结构异常者禁用
    ja: 治療前に心臓疾患のスクリーニングを行う；心臓構造異常のある患者には避ける
  abuseRisk:
    en: Prodrug design reduces abuse potential compared to immediate-release amphetamines, but still Schedule II
    zh: 前药设计相比速释苯丙胺降低了滥用风险，但仍为二类管制药物
    ja: プロドラッグ設計により即放性アンフェタミンと比べて乱用の可能性は低いが、依然としてスケジュールII
  withdrawalNotes:
    en: Fatigue and depression may occur upon discontinuation; no severe physical withdrawal
    zh: 停药时可能出现疲劳和抑郁；无严重身体戒断症状
    ja: 中止時に疲労やうつが生じる可能性；重度の身体的離脱症状はない
  monitoringRequired:
    en: Height, weight, blood pressure, heart rate, psychiatric symptoms
    zh: 身高、体重、血压、心率、精神症状
    ja: 身長、体重、血圧、心拍数、精神症状
travelRules:
  generalAdvice:
    en: As an amphetamine-class stimulant, lisdexamfetamine faces strict international restrictions. Always check destination country requirements before traveling.
    zh: 作为苯丙胺类兴奋剂，赖右苯丙胺在国际旅行中面临严格限制。旅行前务必确认目的地国家的要求。
    ja: アンフェタミン系刺激薬として、リスデキサンフェタミンは国際的に厳しい制限があります。旅行前に目的地の国の要件を必ず確認してください。
  requiredDocumentation:
    - type: prescription
      typeLabel:
        en: Valid prescription
        zh: 有效处方
        ja: 有効な処方箋
      notes:
        en: Original prescription in original packaging
        zh: 原始处方和原包装
        ja: 元の処方箋と元のパッケージ
    - type: medical_letter
      typeLabel:
        en: Doctor's letter
        zh: 医生证明信
        ja: 医師の診断書
      notes:
        en: Stating medical necessity and dosage
        zh: 说明医疗必要性和剂量
        ja: 医学的必要性と用量を記載
  maxPersonalSupply:
    default: 90 days
    byRegion:
      JP: 30 days
      UK: 3 months
      AU: 3 months
  crossBorderRules:
    - fromRegion: US
      toRegion: JP
      status: requires_permit
      statusLabel:
        en: Requires Import Permit
        zh: 需要进口许可
        ja: 輸入許可が必要
      requirements:
        en:
          - Apply to Japanese Narcotics Control Department 2+ weeks before travel
          - Carry Yakkan Shoumei (import certificate)
          - Maximum 30-day supply
        zh:
          - 旅行前2周以上向日本麻药取缔部门申请
          - 携带药监证明（Yakkan Shoumei）
          - 最多30天用量
        ja:
          - 旅行の2週間以上前に麻薬取締部への申請が必要
          - 薬監証明の携帯
          - 最大30日分
      maxSupply: 30 days
      notes:
        en: Lisdexamfetamine requires a Yakkan Shoumei import permit for Japan. Apply through the Japanese embassy or directly to the Narcotics Control Department.
        zh: 赖右苯丙胺进入日本需要药监证明。通过日本大使馆或直接向麻药取缔部门申请。
        ja: リスデキサンフェタミンを日本に持ち込むには薬監証明が必要です。日本大使館または麻薬取締部に直接申請してください。
      sources:
        - https://www.ncd.mhlw.go.jp/en/application.html
    - fromRegion: US
      toRegion: CN
      status: prohibited
      statusLabel:
        en: Prohibited
        zh: 禁止
        ja: 禁止
      requirements:
        en: []
        zh: []
        ja: []
      notes:
        en: Amphetamines are strictly illegal in China. Do NOT attempt to bring this medication into China under any circumstances. Severe legal penalties apply.
        zh: 苯丙胺类药物在中国属于严格违禁物品。任何情况下都不要试图将此药物带入中国。将面临严厉的法律处罚。
        ja: アンフェタミン類は中国で厳格に違法です。いかなる状況下でもこの薬を中国に持ち込まないでください。厳しい法的処罰が科されます。
      sources:
        - https://www.china-embassy.org/eng/
    - fromRegion: US
      toRegion: UK
      status: allowed
      statusLabel:
        en: Allowed with Documentation
        zh: 凭文件允许
        ja: 書類があれば許可
      requirements:
        en:
          - Carry prescription in original packaging
          - Letter from prescribing doctor recommended
        zh:
          - 携带原包装处方药
          - 建议携带开药医生的证明信
        ja:
          - 処方箋を元のパッケージで携帯
          - 処方医の手紙を推奨
      maxSupply: 3 months
      notes:
        en: UK allows personal import of controlled medicines with valid prescription.
        zh: 英国允许携带个人使用的管制药物入境，需有效处方。
        ja: 英国は有効な処方箋があれば規制薬の個人輸入を許可しています。
      sources:
        - https://www.gov.uk/travelling-controlled-drugs
    - fromRegion: US
      toRegion: EU
      status: restricted
      statusLabel:
        en: Restricted - Varies by Country
        zh: 受限 - 因国家而异
        ja: 制限あり - 国によって異なる
      requirements:
        en:
          - "Schengen countries: Carry Schengen certificate for controlled medicines"
          - "Non-Schengen: Check individual country requirements"
        zh:
          - 申根国家：携带管制药品申根证明
          - 非申根国家：查询各国具体要求
        ja:
          - シェンゲン加盟国：規制薬のシェンゲン証明書を携帯
          - 非シェンゲン：各国の要件を確認
      maxSupply: 30 days
      notes:
        en: EU Schengen countries require a standardized certificate. Check with your destination country's embassy.
        zh: 欧盟申根国家需要标准化证明。请向目的地国家大使馆查询。
        ja: EUシェンゲン加盟国は標準化された証明書が必要です。目的地の大使館に確認してください。
      sources:
        - https://www.emcdda.europa.eu/
    - fromRegion: US
      toRegion: AU
      status: restricted
      statusLabel:
        en: Restricted - Declaration Required
        zh: 受限 - 需要申报
        ja: 制限あり - 申告が必要
      requirements:
        en:
          - Declare medication at customs
          - Carry prescription and doctor's letter
          - Maximum 3 months supply
        zh:
          - 在海关申报药物
          - 携带处方和医生证明信
          - 最多3个月用量
        ja:
          - 税関で薬物を申告
          - 処方箋と医師の手紙を携帯
          - 最大3ヶ月分
      maxSupply: 3 months
      notes:
        en: Australia requires declaration of Schedule 8 medications. Bring supporting documentation.
        zh: 澳大利亚要求申报Schedule 8药物。请携带证明文件。
        ja: オーストラリアはSchedule 8の薬物の申告が必要です。証明書類を携帯してください。
      sources:
        - https://www.tga.gov.au/entering-australia
    - fromRegion: US
      toRegion: CA
      status: allowed
      statusLabel:
        en: Allowed with Prescription
        zh: 凭处方允许
        ja: 処方箋があれば許可
      requirements:
        en:
          - Carry medication in original labeled container
          - Bring copy of prescription
        zh:
          - 携带原标签容器中的药物
          - 携带处方副本
        ja:
          - 元のラベル付き容器で薬を携帯
          - 処方箋のコピーを持参
      maxSupply: 90 days
      notes:
        en: Canada-US border crossing is generally straightforward with proper documentation.
        zh: 携带适当文件过加美边境通常较为简单。
        ja: 適切な書類があれば、カナダ-米国国境の通過は一般的に簡単です。
      sources:
        - https://www.cbsa-asfc.gc.ca/
rxnormData:
  ingredientRxcui: "700810"
  ingredientName: lisdexamfetamine
  rxcuiMappings:
    - rxcui: "700810"
      name: lisdexamfetamine
      tty: IN
      description: Base ingredient
    - rxcui: "2726049"
      name: Arynta
      tty: BN
      description: Brand name
    - rxcui: "711043"
      name: Vyvanse
      tty: BN
      description: Brand name
    - rxcui: "673579"
      name: lisdexamfetamine dimesylate
      tty: PIN
      description: Precise ingredient (includes salt form)
    - rxcui: "1593858"
      name: lisdexamfetamine dimesylate 10 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871459"
      name: lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871461"
      name: lisdexamfetamine dimesylate 30 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871463"
      name: lisdexamfetamine dimesylate 20 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871465"
      name: lisdexamfetamine dimesylate 10 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871467"
      name: lisdexamfetamine dimesylate 60 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871469"
      name: lisdexamfetamine dimesylate 50 MG Chewable Tablet [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "2726055"
      name: lisdexamfetamine dimesylate 10 MG/ML Oral Solution [Arynta]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854832"
      name: lisdexamfetamine dimesylate 20 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854836"
      name: lisdexamfetamine dimesylate 30 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854840"
      name: lisdexamfetamine dimesylate 40 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854844"
      name: lisdexamfetamine dimesylate 70 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854848"
      name: lisdexamfetamine dimesylate 60 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "854852"
      name: lisdexamfetamine dimesylate 50 MG Oral Capsule [Vyvanse]
      tty: SBD
      description: Branded drug (brand + strength + form)
    - rxcui: "1871457"
      name: lisdexamfetamine Chewable Tablet [Vyvanse]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "2726053"
      name: lisdexamfetamine Oral Solution [Arynta]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "705294"
      name: lisdexamfetamine Oral Capsule [Vyvanse]
      tty: SBDF
      description: Branded ingredient + dose form
    - rxcui: "1593856"
      name: lisdexamfetamine dimesylate 10 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871456"
      name: lisdexamfetamine dimesylate 40 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871460"
      name: lisdexamfetamine dimesylate 30 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871462"
      name: lisdexamfetamine dimesylate 20 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871464"
      name: lisdexamfetamine dimesylate 10 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871466"
      name: lisdexamfetamine dimesylate 60 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871468"
      name: lisdexamfetamine dimesylate 50 MG Chewable Tablet
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "2726048"
      name: lisdexamfetamine dimesylate 10 MG/ML Oral Solution
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854830"
      name: lisdexamfetamine dimesylate 20 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854834"
      name: lisdexamfetamine dimesylate 30 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854838"
      name: lisdexamfetamine dimesylate 40 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854842"
      name: lisdexamfetamine dimesylate 70 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854846"
      name: lisdexamfetamine dimesylate 60 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "854850"
      name: lisdexamfetamine dimesylate 50 MG Oral Capsule
      tty: SCD
      description: Clinical drug (ingredient + strength + form)
    - rxcui: "1871455"
      name: lisdexamfetamine Chewable Tablet
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "2726045"
      name: lisdexamfetamine Oral Solution
      tty: SCDF
      description: Ingredient + dose form
    - rxcui: "700812"
      name: lisdexamfetamine Oral Capsule
      tty: SCDF
      description: Ingredient + dose form
instructions:
  indicationsAndUsage:
    en: |
      Lisdexamfetamine dimesylate is a central nervous system (CNS) stimulant indicated for the treatment of:
      - Attention Deficit Hyperactivity Disorder (ADHD) in patients 6 years of age and older
      - Moderate to severe Binge Eating Disorder (BED) in adults

      Lisdexamfetamine is a prodrug of dextroamphetamine. It is converted to the active drug dextroamphetamine in the body. ADHD should be diagnosed according to DSM criteria based upon a complete history and evaluation of the patient.
  dosageAndAdministration:
    en: |
      ADHD:
      - Initial dose: 30 mg once daily in the morning
      - May increase in increments of 10 mg or 20 mg at weekly intervals
      - Maximum dose: 70 mg/day

      Dosing by Age:
      - Children (6-12 years): Start 30 mg, max 70 mg/day
      - Adolescents (13-17 years): Start 30 mg, max 70 mg/day
      - Adults: Start 30 mg, max 70 mg/day

      BINGE EATING DISORDER:
      - Initial dose: 30 mg once daily in the morning
      - Increase by 20 mg at weekly intervals
      - Target dose: 50-70 mg/day
      - Maximum dose: 70 mg/day

      General Instructions:
      - Take in the morning with or without food
      - Avoid afternoon doses to prevent insomnia
      - Capsules may be swallowed whole OR opened and contents dissolved in water, yogurt, or orange juice
      - If dissolved, consume entire contents immediately
      - Chewable tablets: chew thoroughly before swallowing
  dosageForms:
    en: |
      Capsules: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg
      Chewable Tablets: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg
      Oral Solution: Available in some markets
  contraindications:
    en: |
      Lisdexamfetamine is contraindicated in patients with:
      - Known hypersensitivity to amphetamine products or any components (angioedema and anaphylaxis reported)
      - Concurrent treatment with monoamine oxidase inhibitors (MAOIs), or within 14 days of discontinuing MAOI treatment
      - Not indicated or recommended for weight loss (serious cardiovascular events reported)
  warningsAndPrecautions:
    en: |
      SERIOUS CARDIOVASCULAR REACTIONS:
      - Sudden death in patients with pre-existing structural cardiac abnormalities or other serious heart problems has been reported
      - Sudden death, stroke, and myocardial infarction reported in adults
      - Avoid use in patients with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems

      BLOOD PRESSURE AND HEART RATE INCREASES:
      - Monitor blood pressure and pulse during treatment
      - Use with caution in patients for whom blood pressure increases may be problematic

      PSYCHIATRIC ADVERSE REACTIONS:
      - May exacerbate symptoms of behavior disturbance and thought disorder in patients with pre-existing psychotic disorder
      - May induce a mixed/manic episode in patients with bipolar disorder
      - May cause treatment-emergent psychotic or manic symptoms (hallucinations, delusional thinking, mania) in children and adolescents without prior history

      SUPPRESSION OF GROWTH:
      - Monitor height and weight in pediatric patients during treatment

      PERIPHERAL VASCULOPATHY (Raynaud's Phenomenon):
      - Monitor for digital changes during treatment

      SEROTONIN SYNDROME:
      - Risk when co-administered with serotonergic drugs; discontinue if occurs
  adverseReactions:
    en: |
      Most Common Adverse Reactions in ADHD (≥5%):
      - Decreased appetite
      - Insomnia
      - Dry mouth
      - Upper abdominal pain
      - Irritability
      - Nausea
      - Weight loss
      - Dizziness
      - Diarrhea
      - Affect lability

      Most Common Adverse Reactions in BED (≥5%):
      - Dry mouth
      - Insomnia
      - Decreased appetite
      - Increased heart rate
      - Constipation
      - Feeling jittery
      - Anxiety
  drugInteractions:
    en: |
      CONTRAINDICATED:
      - MAO Inhibitors: Do not use during or within 14 days of MAOI treatment. Risk of hypertensive crisis.

      USE WITH CAUTION:
      - Serotonergic drugs: Risk of serotonin syndrome
      - Antihypertensive drugs: May decrease effectiveness
      - Acidifying agents (urinary): May decrease amphetamine blood levels
      - Alkalinizing agents: May increase amphetamine blood levels
      - CYP2D6 inhibitors: May potentiate amphetamine effects
      - Tricyclic antidepressants: Enhanced activity of TCAs
  useInSpecificPopulations:
    en: |
      PREGNANCY:
      - Category C. May cause fetal harm. Use only if potential benefit justifies risk to fetus.
      - Amphetamines may cause premature delivery, low birth weight, and withdrawal symptoms in infants.

      LACTATION:
      - Amphetamines are excreted in human milk. Advise to avoid breastfeeding or use alternative treatment.

      PEDIATRIC USE:
      - ADHD: Safety and efficacy established in patients 6 years and older
      - Not recommended for children under 6
      - Long-term growth effects should be monitored

      GERIATRIC USE:
      - Clinical studies did not include sufficient patients 65 and older

      RENAL IMPAIRMENT:
      - Severe impairment (GFR <30): Maximum dose 50 mg/day
      - ESRD: Maximum dose 30 mg/day

      HEPATIC IMPAIRMENT:
      - No dose adjustment required for mild to moderate impairment
  overdosage:
    en: |
      SIGNS AND SYMPTOMS:
      - Restlessness, tremor, hyperreflexia
      - Rapid respiration, confusion
      - Assaultiveness, hallucinations, panic states
      - Hyperpyrexia, rhabdomyolysis
      - Cardiovascular: arrhythmias, hypertension or hypotension
      - Gastrointestinal: nausea, vomiting, diarrhea, abdominal cramps
      - Fatigue and depression following CNS stimulation
      - Convulsions, coma (may be fatal)

      TREATMENT:
      - Consult Poison Control Center (1-800-222-1222)
      - Provide symptomatic and supportive care
      - Administer activated charcoal if ingestion recent
      - Maintain adequate circulation and respiratory exchange
      - Treat hyperpyrexia with cooling measures
      - Monitor cardiac status
  clinicalPharmacology:
    en: |
      MECHANISM OF ACTION:
      Lisdexamfetamine is a prodrug of dextroamphetamine. After oral administration, lisdexamfetamine is converted to dextroamphetamine. Dextroamphetamine is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space. The prodrug design provides:
      - Smoother onset of action
      - Longer duration of effect
      - Reduced potential for abuse

      PHARMACOKINETICS:
      - Absorption: Rapidly absorbed; peak plasma concentration 3.5 hours (d-amphetamine)
      - Distribution: Does not bind to plasma proteins
      - Metabolism: Converted to dextroamphetamine and L-lysine primarily in blood
      - Half-life: Less than 1 hour (lisdexamfetamine); approximately 10 hours (d-amphetamine)
      - Excretion: 96% recovered in urine; 42% as amphetamine
  howSupplied:
    en: |
      STORAGE AND HANDLING:
      - Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F)
      - Protect from light
      - Keep container tightly closed
      - Dispense in tight, light-resistant container

      DEA SCHEDULE:
      - Schedule II Controlled Substance

      Keep out of reach of children. Store in a secure place.
  patientCounselingInfo:
    en: |
      IMPORTANT PATIENT INFORMATION:

      1. ABUSE AND DEPENDENCE: This medicine has potential for abuse. Keep in a safe place to prevent misuse and abuse. Selling or giving away this medication is against the law.

      2. CARDIOVASCULAR RISKS: Report immediately any chest pain, shortness of breath, fainting, or rapid heartbeat.

      3. PSYCHIATRIC EFFECTS: Report any new or worsening mental symptoms including hallucinations, aggressive behavior, paranoia, or mood changes.

      4. CIRCULATION PROBLEMS: Report any unexplained wounds on fingers or toes, or changes in skin color.

      5. SUPPRESSED GROWTH: Height and weight will be monitored during treatment in children.

      6. PREGNANCY: Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

      7. DOSING: Take in the morning. Capsules may be opened and dissolved in water. Avoid afternoon doses.

      8. MEDICATION GUIDE: Read the Medication Guide before starting and with each refill.

      9. DRIVING: May cause dizziness; use caution until effects are known.

      10. BINGE EATING: This medication is not for weight loss. Serious cardiovascular events have occurred in adults using CNS stimulants for weight loss.
  brandMappings:
    - brandName: Arynta
      rxcui: "2726049"
      region: US
    - brandName: Vyvanse
      rxcui: "711043"
      region: US
  synonyms:
    - name: lisdexamfetamine dimesylate
      type: chemical
      source: RxNorm
    - name: Arynta
      type: brand
      source: RxNorm
    - name: Vyvanse
      type: brand
      source: RxNorm
    - name: lisdexamfetamine
      type: generic
      source: RxNorm
  relatedDrugs:
    - rxcui: "1593856"
      name: lisdexamfetamine dimesylate 10 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871456"
      name: lisdexamfetamine dimesylate 40 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871460"
      name: lisdexamfetamine dimesylate 30 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871462"
      name: lisdexamfetamine dimesylate 20 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871464"
      name: lisdexamfetamine dimesylate 10 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871466"
      name: lisdexamfetamine dimesylate 60 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1871468"
      name: lisdexamfetamine dimesylate 50 MG Chewable Tablet
      tty: SCD
      relationship: clinical_drug
    - rxcui: "2726048"
      name: lisdexamfetamine dimesylate 10 MG/ML Oral Solution
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854830"
      name: lisdexamfetamine dimesylate 20 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854834"
      name: lisdexamfetamine dimesylate 30 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854838"
      name: lisdexamfetamine dimesylate 40 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854842"
      name: lisdexamfetamine dimesylate 70 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854846"
      name: lisdexamfetamine dimesylate 60 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "854850"
      name: lisdexamfetamine dimesylate 50 MG Oral Capsule
      tty: SCD
      relationship: clinical_drug
    - rxcui: "1593858"
      name: lisdexamfetamine dimesylate 10 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871459"
      name: lisdexamfetamine dimesylate 40 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871461"
      name: lisdexamfetamine dimesylate 30 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871463"
      name: lisdexamfetamine dimesylate 20 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871465"
      name: lisdexamfetamine dimesylate 10 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871467"
      name: lisdexamfetamine dimesylate 60 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871469"
      name: lisdexamfetamine dimesylate 50 MG Chewable Tablet [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "2726055"
      name: lisdexamfetamine dimesylate 10 MG/ML Oral Solution [Arynta]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854832"
      name: lisdexamfetamine dimesylate 20 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854836"
      name: lisdexamfetamine dimesylate 30 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854840"
      name: lisdexamfetamine dimesylate 40 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854844"
      name: lisdexamfetamine dimesylate 70 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854848"
      name: lisdexamfetamine dimesylate 60 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "854852"
      name: lisdexamfetamine dimesylate 50 MG Oral Capsule [Vyvanse]
      tty: SBD
      relationship: branded_drug
    - rxcui: "1871455"
      name: lisdexamfetamine Chewable Tablet
      tty: SCDF
      relationship: drug_form
    - rxcui: "2726045"
      name: lisdexamfetamine Oral Solution
      tty: SCDF
      relationship: drug_form
  lastUpdated: 2025-12-04
lastUpdated: 2025-12-04
sources:
  - https://pharmacyportal.eu/elvanse-europe/
  - https://en.wikipedia.org/wiki/Lisdexamfetamine
  - https://h-navi.jp/column/article/35027521
  - https://www.additudemag.com/adhd-medications-list-chart-stimulants-nonstimulants/
notes:
  en: Prodrug design provides smoother, longer-lasting effect with lower abuse potential than traditional amphetamines. Not available in China. Japan only approves for children (6-17). Generic became available in US in 2023.
  zh: 前药设计比传统苯丙胺类药物提供更平稳、更持久的效果，滥用风险更低。中国不可用。日本仅批准用于儿童（6-17岁）。2023年美国开始有仿制药。
  ja: プロドラッグ設計により、従来のアンフェタミンよりも滑らかで長時間持続する効果を提供し、乱用の可能性が低い。中国では利用不可。日本では小児（6〜17歳）のみ承認。2023年に米国でジェネリックが利用可能に。