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Tips for tapering off Vyvanse (lisdexamfetamine dimesylate)

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Altostrata

Like all other psychiatric drugs, it is advisable to taper Vyvanse, a stimulating amphetamine analog that is truly addictive. According to FDA information at http://www.drugs.com/cdi/vyvanse.html
 

When used for long periods of time or at high doses, Vyvanse may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Vyvanse stops working well. Do not take more than prescribed.
 
Some people who use Vyvanse for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction. If you stop taking Vyvanse suddenly, you may have WITHDRAWAL symptoms. These may include severe or unusual sadness, agitation, or fatigue.

 
Also see Taking multiple psych drugs? Which drug to taper first?
 
From http://www.drugs.com/pro/vyvanse.html, Vyvanse comes in a range of dosages that may enable tapering, depending on how much you're taking:
 

Capsules 10 mg: pink body/pink cap (imprinted with S489 and 10 mg)
Capsules 20 mg: ivory body/ivory cap (imprinted with S489 and 20 mg)
Capsules 30 mg: white body/orange cap (imprinted with S489 and 30 mg)
Capsules 40 mg: white body/blue green cap (imprinted with S489 and 40 mg)
Capsules 50 mg: white body/blue cap (imprinted with S489 and 50 mg)
Capsules 60 mg: aqua blue body/aqua blue cap (imprinted with S489 and 60 mg)
Capsules 70 mg: blue body/orange cap (imprinted with S489 and 70 mg)

 
Reduce by 10% per month to start
To forestall withdrawal symptoms, we advise a very conservative tapering schedule: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Use a combination of capsules to taper
If your doctor will write prescriptions to enable you to taper, you might be able to get your prescription filled with a combination of capsule dosages. (Most likely, your doctor will have to specify divided doses to be taken at different times throughout the day to get insurance coverage for a combination of capsules.)
 
For example, if you are taking 50mg Vyvanse per day and want to decrease by 10% to 45mg, you could get your prescription filled with 20mg capsules and 10mg capsules. You would take 2 capsules of 20mg and a half of a 10mg capsule per day to total 45mg.
 
As your daily dosage decreases, you will want to become fairly precise in how you measure half a 10mg capsule. You can do this by making a liquid from it and taking half the liquid. See instructions below.
 
Make your own liquid
To taper, you can make their own liquid with water. See How to make a liquid from tablets or capsules.
 
FDA information at http://www.drugs.com/pro/vyvanse.htmlspecifies that one may open the capsule and dissolve the contents in liquids:
 

....The contents should be mixed until completely dispersed. Consume the entire mixture immediately. It should not be stored. The active ingredient dissolves completely once dispersed; however, a film containing the inactive ingredients may remain in the glass or container once the mixture is consumed.....


(Taking partial capsules is discouraged, probably to avoid unauthorized distribution of this drug.)

 

Use oral syringes to taper with the liquid, see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/
 
Have a compounding pharmacy make up capsules of smaller dosages or a liquid
With a prescription, a compounding pharmacy will accurately weigh small doses and put them into capsules for you. This is usually somewhat expensive.

 

A compounding pharmacy may also be able to make a liquid for tapering.

See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001
 

Using a combination of tablets or capsules and liquid

Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another.

 

If your doctor prescribes compounded liquid and tablets or capsules at the same time, most likely he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance.

 

Precisely weighing capsule contents with an electronic digital scale
You may wish to precisely measure your dosage with an electronic scale that measures milligrams. These are available for under $30 US. See Using a digital scale to measure doses

Edited by Altostrata
updated

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