Using Water Titration Strategies to Effectively Dose Vyvanse:
This post from 2007 spells out Vyvanse dosage details that work, and have recently been approved by the FDA. At CorePsych we use water titration [dosage adjustment] in every patient who has never tried AMP [amphetamine] stimulants. The result: better compliance, patient appreciation, improved dialogue, better outcomes, less mystery. Starting slowly makes a big difference for the duration of treatment.
How To Take Vyvanse Dosage Down Below 20 mg
For example: less than 20 mg – dosing down to 5 mg/dose:
The bottom line with any stimulant dosage, is precision and accuracy. More specifics are spelled out carefully in my book New ADHD Medication Rules – Brain Science & Common Sense - also now available at this same link in Audio, as well.
Many have asked offline about clarification of my *water titration* recipe with Vyvanse, and this post is a brief clarification on that process – and, by the way, it’s easy. Vyvanse water titration works to increase medication predictability.
Why Small Vyvanse Dosage
- Please don’t misunderstand, these directions are not for everyone, less than 5% of individuals – adults [off label at this writing -'07] rarely need to use this option. See previous posts here on The Therapeutic Window.
- You know you absolutely have to use this strategy if you previously have experienced problems with stimulant medication reactions.
- These suggestions apply for those who have a history of unusual sensitivity to medications, especially those young children who the treatment team feels will not tolerate new meds well – Asperger’s, those with food sensitivities, picky eaters, adults with brain injury.
- Refer back to this previous Tips Post introducing Vyvanse that describes more recent Vyvanse clinical experience
- Vyvanse – Shire did recently introduce new sizes [20 mg, 40 mg, 60 mg] so perhaps we won’t have to use these off-label suggestions – offered in the spirit of pharmaceutical precision [off-label = not in the package insert].
- If you do like the possibility of Vyvanse for it’s range of effectiveness and efficacy as well as the promise of better compliance with our ADHD folk who seem to often forget meds, then consider this option for those special individuals with a very narrow Therapeutic Window, or an unusually high degree of medication sensitivity, even to small doses of stimulant meds.
How To Use Water To Decrease The Vyvanse Dose
- Take the Vyvanse capsule at the lowest dose, 20 mg, break it 1/2 and pour the powdered contents into 2 oz of water in a measuring cup. Throw away the gelatin capsule.
- Stir, and don’t worry about the small amount of material at the bottom.
- Give 1 oz in the AM, then put the other into the refrigerator, warn others not to drink it
- Corrected below by FDA approval: Give the other 1 oz the next AM. Saving it was, in ’07, *not recommended by Shire,* but works effectively with many patients who have used this strategy. Safety is an issue: I do suggest you throw the other half away if you can’t keep it from accidental use by others.
- Dosage equivalence from Adderall to Vyvanse is approximately: Adderall 10 mg = Vyvanse 30 mg, Adderall 20 mg = Vyvanse 50 mg, Adderall 30 mg = Vyvanse 70 mg. I always start lower than expected with a change to Vyvanse, as for about 10-15% that anticipated dose of Vyvanse proves too much. I don’t want folks on my watch to experience 10% problems.
How To Take The Vyvanse Dose Even Smaller
- For very sensitive kids I take this one step further, and pour the 20 mg capsule [powder] into 4 oz of water, then spread the dosage over the next four days, giving essentially 5 mg/day. Titrate slowly as in this Start Slow ADHD Meds video.
- No, you don’t have to use water, OJ or apple juice will do. Stomach acidity is not an issue with Vyvanse, based upon the prodrug release.
- No, there is no Vyvanse taste problem with touchy, taste sensitive folk, though I’m sure an exception exists out there.
- And in spite of the Vyvanse prodrug action I always give all psych meds with a protein breakfast, and I make that pitch on almost every med check if we don’t have protein breakfast compliance. Protein is an essential precursor for neurotransmitters.
And if these details aren’t sufficient: do click over [for ADHD videos and other commentary] to another site I built at Squidoo, – Squidoo is an excellent platform for pulling together more ADHD information.
Don’t Forget: My 8 part easy to watch ADHD Medication Tutorial is available at this link – or up here on the CorePsych Navigation Bar ↑ Check it out!
ADHD Meds Playlists To Forward
Take a look at all these ADHD Medication Videos – and use the short URLs to forward specific playlists:
ADHD Meds Tutorial – Overview: http://bit.ly/medstutorial
ADHD Meds Dosage: http://bit.ly/dosevids
ADHD Meds Problems – Mind and Gut: http://bit.ly/mindgut
ADHD Meds & Allergies – Milk and Wheat: http://bit.ly/mawimmun
ADHD Meds & Allergies – Street Immunity: http://bit.ly/IorWJs
Addendum – August 2013: The FDA Agrees - General Instructions at Drugs.com, or here under General Instructions at Med Library
Intuniv Addendum: For Additional Notes Dosing Titration: Intuniv Notes
Hope this helps,- please drop a comment so that we can discuss the details if you have a question or remark. Theses useful New Rules will save you hours of confusion!