Vyvanse (lisdexamfetamine) is a long-acting stimulant medication approved for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents, and adults, as well as for moderate to severe binge eating disorder in adults. It is a prodrug that is converted in the body to dextroamphetamine, providing a smoother onset and longer duration of action compared with immediate-release stimulants. Dosing is always individualized, but body weight serves as an important starting point—especially in pediatric patients—to guide initial selection and titration.
Official prescribing information provides weight-based ranges for children and adolescents aged 6–17 years, while adult dosing relies more on symptom response and tolerability than strict weight calculations. Clinicians start low and titrate slowly (usually in 10–20 mg increments weekly) to find the lowest effective dose with acceptable side effects. Maximum daily doses are capped to balance efficacy against risks such as cardiovascular effects, appetite suppression, and growth impact in growing children.
This article summarizes the most commonly referenced weight-based dosing patterns for Vyvanse that appear in product labeling, clinical guidelines, and real-world pediatric and adult practice.
The information is for educational purposes only and is not medical advice. Vyvanse is a Schedule II controlled substance that requires a prescription and regular medical supervision. Dosing decisions must be made exclusively by a qualified healthcare provider who evaluates the patient’s full medical history, current symptoms, coexisting conditions, and ongoing response.
Vyvanse Dosing Principles in Children and Adolescents
Vyvanse is approved for ADHD in patients 6 years and older. There is no weight minimum listed in labeling, but children below approximately 20–25 kg (44–55 lb) are rarely started on the medication due to limited safety data and the availability of lower-strength alternatives. Initial dosing is conservative—most clinicians begin at 20 mg or 30 mg once daily in the morning regardless of exact weight—to assess tolerability.
Titration proceeds in increments of 10 mg or 20 mg at weekly intervals. The target dose is the lowest strength that provides meaningful symptom improvement with tolerable side effects. Maximum recommended daily doses are weight-dependent in younger children and capped at 70 mg for adolescents and adults.
Because Vyvanse is a prodrug activated by red-blood-cell metabolism, dose adjustments are not routinely made for mild kidney or liver impairment. However, weight remains a key guide in the pediatric population to avoid excessive exposure in smaller children.
Pediatric Starting and Titration Approach
- Most children begin at 20 mg or 30 mg once daily in the morning.
- Increase by 10–20 mg weekly based on response and tolerability.
- Target range is usually 30–70 mg/day depending on age and weight.
- Do not exceed 70 mg/day in any pediatric patient.
These are general patterns—actual prescribing varies by clinician judgment.
Vyvanse Dosage Ranges by Weight (Pediatric Patients)
Weight-based dosing guidance is clearest for children and younger adolescents (6–17 years). The table below reflects ranges commonly referenced in product labeling, clinical practice guidelines, and real-world prescribing patterns.
Doses are expressed in milligrams per day (single morning dose). Starting doses are intentionally low; final doses are determined by symptom control and tolerability rather than weight alone.
Typical Vyvanse Dosing Ranges by Body Weight (Ages 6–17)
| Approximate Weight Range | Starting Dose | Common Target Dose Range | Maximum Recommended Dose |
|---|---|---|---|
| 20–30 kg (44–66 lb) | 20 mg | 20–40 mg | 50–60 mg |
| 30–40 kg (66–88 lb) | 20–30 mg | 30–50 mg | 60–70 mg |
| 40–50 kg (88–110 lb) | 30 mg | 40–60 mg | 70 mg |
| >50 kg (>110 lb) | 30 mg | 50–70 mg | 70 mg |
Doses above 50 mg in children under 30 kg or above 70 mg overall are used cautiously and require careful risk-benefit assessment. Titration should never exceed one increment (10–20 mg) per week unless clinically justified.
Adolescent and Adult Dosing – Less Weight-Dependent
Adolescents (13–17 years) and adults may begin at 30 mg once daily. Many clinicians start at 20 mg in patients who are stimulant-naïve or sensitive to side effects, then titrate upward in 10–20 mg increments weekly. Target doses most commonly fall between 50 mg and 70 mg daily.
Weight is less rigidly applied in older patients. A 55 kg teenager and a 100 kg adult might both stabilize on 60 mg or 70 mg if that dose provides optimal symptom control with acceptable tolerability. Maximum recommended daily dose for both adolescents and adults is 70 mg.
Higher doses (60–70 mg) are used more frequently in adolescents and adults than in younger children because older patients generally tolerate increased exposure better and may require more robust symptom control for school or occupational demands.
Adult Dosing Highlights
- Starting dose: 30 mg once daily (20 mg if stimulant-naïve or sensitive)
- Titration: Increase by 10–20 mg weekly
- Common target: 50–70 mg/day
- Maximum recommended: 70 mg/day
Dosing is guided primarily by symptom improvement and side-effect profile.
How Clinicians Decide the Right Vyvanse Dose
Initial dose selection considers age, weight, previous stimulant exposure, symptom severity, coexisting conditions (anxiety, tics, sleep issues), and family history of cardiovascular disease. A child with no prior stimulant experience usually starts at 20–30 mg regardless of exact weight.
Titration follows a “start low, go slow” principle. The clinician increases the dose every 7 days (or longer) until there is meaningful symptom improvement or until side effects become limiting. Ongoing monitoring includes regular assessment of height, weight, blood pressure, heart rate, sleep, appetite, mood, and school/occupational functioning.
Dose adjustments may occur months or years after initiation if response changes due to growth, puberty, or new stressors. Periodic “drug holidays” are sometimes used (e.g., weekends or school vacations) to assess ongoing need and monitor growth velocity.
Signs a Dose May Need Adjustment
- Persistent significant inattention, hyperactivity, or impulsivity
- Excessive appetite suppression or weight loss
- New or worsening mood changes (irritability, sadness, anxiety)
- Sleep disturbance that interferes with functioning
- Rebound symptoms in the evening as medication wears off
Dose changes should always be guided by a prescribing clinician.
Common Side Effects at Different Dose Levels
Lower doses (20–40 mg) usually produce milder side effects. Higher doses (50–70 mg) increase the likelihood and intensity of appetite suppression, insomnia, mood changes, and cardiovascular effects.
Appetite suppression and weight loss are dose-dependent and among the most frequently reported concerns, particularly in growing children. Sleep difficulties and irritability also tend to become more noticeable at higher strengths.
Most side effects diminish over the first few weeks as the body adjusts. Persistent or severe effects may require dose reduction or a different medication.
Frequently Reported Side Effects by Dose Range
20–40 mg
- Mild appetite decrease
- Mild sleep delay
- Occasional headache or stomach discomfort
50–70 mg
- More pronounced appetite suppression
- Greater risk of insomnia
- Increased chance of irritability or emotional lability
- Potential for mild tachycardia or elevated blood pressure
Side effects should be reported promptly to the prescribing clinician.
Monitoring Growth and Vital Signs in Children
Regular measurement of height, weight, blood pressure, and heart rate is standard practice during Vyvanse treatment, especially in children and adolescents. Stimulants can cause temporary slowing of growth velocity in some patients.
Growth suppression, when it occurs, is usually modest and often partially catches up after medication is discontinued or dose is lowered. Clinicians weigh the benefits of symptom control against any observed growth effects when deciding whether to continue, adjust, or stop treatment.
Blood pressure and pulse are checked at baseline and periodically thereafter. Significant or sustained elevations may prompt dose reduction or medication change.
Switching or Stopping Vyvanse
When switching from Vyvanse to another stimulant or discontinuing treatment, the dose is usually tapered rather than stopped abruptly to minimize withdrawal symptoms (rebound hyperactivity, mood changes, fatigue). The taper schedule is individualized.
Dose conversion charts exist when switching between different methylphenidate or amphetamine formulations, but these are only rough guides. The prescribing clinician determines the equivalent dose based on clinical response.
Periodic “drug holidays” (planned breaks from medication) are sometimes used, especially during school vacations, to assess ongoing need and allow catch-up growth if growth velocity has slowed.
Conclusion
Vyvanse dosing follows weight-based patterns most clearly in children and younger adolescents, with starting doses of 20–30 mg daily and maximum recommended doses of 50–70 mg depending on age and weight.
Final therapeutic doses are always determined by symptom improvement and tolerability rather than weight alone, with careful titration and ongoing monitoring of growth, vital signs, and side effects. Individual response varies widely, so no single chart can predict the perfect dose for any patient. This article is for informational purposes only and not medical advice. Vyvanse is a controlled medication that requires a prescription and regular medical supervision. Dosing decisions must be made exclusively by a qualified healthcare provider who can assess the patient’s full medical history, current symptoms, and response to treatment.
FAQ
Does Vyvanse dosing strictly follow body weight?
No. Weight is one factor used to guide initial dose selection and maximum limits, especially in children. Final doses are determined by symptom response and tolerability, not a rigid weight-based formula.
What is the usual starting dose for children?
Most children 6 years and older begin with 20–30 mg once daily in the morning. The dose is increased by 10–20 mg increments at weekly intervals if needed and tolerated.
What is the maximum recommended Vyvanse dose?
The maximum approved daily dose is 70 mg for children, adolescents, and adults. Doses above 70 mg are not recommended in official labeling and are rarely used in routine practice.
How long does it take to find the right Vyvanse dose?
Titration usually occurs every 7 days or longer. Most patients reach a stable effective dose within 2–6 weeks. Ongoing adjustments may be needed months or years later.
Does higher body weight always mean a higher Vyvanse dose?
Not necessarily. Adolescents and adults with higher body weight may end up on the same dose (e.g., 60–70 mg) as smaller patients if that dose controls symptoms well with acceptable side effects.
Can Vyvanse dose be increased above 70 mg?
Doses above 70 mg are not recommended in official labeling. Some clinicians use higher amounts in rare cases, but this increases side-effect risk and requires very careful monitoring.
How often should Vyvanse dose be reviewed?
Doses are usually reviewed at follow-up visits every 1–3 months initially, then every 3–6 months once stable. Growth, blood pressure, heart rate, and symptom control are monitored regularly.
What should I do if the current Vyvanse dose is not working well?
Contact the prescribing clinician. Do not increase the dose on your own. The provider may adjust the dose, change timing, add a short-acting booster, or consider switching medications.
Are there weight-based maximums for adults?
Official labeling does not set a strict weight-based maximum for adults. The recommended maximum remains 70 mg daily for most adults, although individual factors may influence the clinician’s decision.
Can Vyvanse be stopped suddenly?
Sudden discontinuation can cause rebound symptoms (worsening ADHD, fatigue, mood changes). When stopping or switching, the dose is usually tapered gradually under medical supervision.
Dr. Usman is a medical content reviewer with 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic health topics. His work is based on trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Usman is for educational purposes and does not replace professional medical advice.