Using Water Titration Strategies to Effectively Dose Vyvanse: Less than 30mg.
Vyvanse titrations
Some have asked offline about clarification of the *water titration* recipe with Vyvanse,
and this post is a brief clarification on that process:
- Please don’t misunderstand, these directions are not for everyone, less than 5% of individuals – adults [off label at this writing] rarely need to use this option.
- 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.
- Refer back to this previous Tips Post introducing Vyvanse to you and this immediately preceding post describing more recent Vyvanse clinical experience
- Vyvanse/Shire will very likely be coming out in this next quarter with half sizes [20mg, 40mg, 60mg] so we won’t have to use these off-label suggestions – offered in the spirit of pharmaceutical precision, 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 ADD 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 -
- Take the Vyvanse capsule at the lowest dose, 30mg, 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 frig, warn others not to drink it, and -
- Give the other 1 oz the next AM. Saving it is *not recommended by the company,* but is reported to work effectively with a few 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.
- I was in Roanoke VA last week for a day of presentations to the local docs, and one of the docs [pediatrician] said that she thinks of Vyvanse 30mg as equivalent to 15mg of Adderall XR. That observation does help clarify for some the anticipated superior efficacy of Vyvanse.
- For very sensitive kids I take this one step further, and pour the capsule powder into 4 oz of water, then spread the dosage of the next four days, giving essentially 7.5mg/day – most often those do go up at least to 1/2 cap.
- 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 ADD videos and other commentary] to another site I built at Squidoo, – Squidoo is an excellent platform for pulling together more ADD information.
Hope this helps,- please drop a comment so that we can discuss the details if you have a question or remark.
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