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Vyvanse (lisdexamfetamine dimesylate)

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  #1  
Old 05-15-08, 01:51 PM
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Is vyvanse really effected by acids and antacids?

I've read and heard a lot of conflicting information about the interactions of vyvanse and acids and/or antacids. This medicine works for me, although it is not consistent and does not last as long as it's suppose to. I stopped taking vitamins or drinking/eating anything with vitamin c, citric acid or etc. in the morning. I was under the impression from my doc that foods did not effect the absorption of the med. I think an IR medication would offer more consistency and give the patient more control over symptoms. I've only been treated for 4 months, therefore am not comfortable enough yet with my doc to ask for IR meds. Sometimes I need 12 hour control, sometimes less, some days more. Weekends I give myself a break and just my regular disorganized, scatter-brained self. I believe their are positives to being afflicted with this disorder. High energy, spontaneity, social, fun-loving, and creative are wonderful qualities to possess. Getting of topic!! I would love to heard about anyone's experience with or information about vyvanse. Also, how to manage ADHD aside from or along with meds.
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Old 05-15-08, 02:54 PM
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Re: Is vyvanse really effected by acids and antacids?

According to Canadian psychiatrist claptrap, IR medications should be used prior to initiation of XR based preparations (which would be used as a second resort should the IRs not last long enough or produce unacceptable side effects)... I don't understand all the Americans coming online the other way around.
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Old 05-15-08, 03:10 PM
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Re: Is vyvanse really effected by acids and antacids?

I've seen a lot of Vyvanse being supplemented with IR boosters such as Dexedrine or Adderall. If it is wearing off to early or not taking effect soon enough the IR booster is something to bring up with your doctor.
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Old 05-15-08, 03:45 PM
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Re: Is vyvanse really effected by acids and antacids?

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Originally Posted by airhead05 View Post
I've read and heard a lot of conflicting information about the interactions of vyvanse and acids and/or antacids. This medicine works for me, although it is not consistent and does not last as long as it's suppose to. I stopped taking vitamins or drinking/eating anything with vitamin c, citric acid or etc. in the morning. I was under the impression from my doc that foods did not effect the absorption of the med. I think an IR medication would offer more consistency and give the patient more control over symptoms. I've only been treated for 4 months, therefore am not comfortable enough yet with my doc to ask for IR meds. Sometimes I need 12 hour control, sometimes less, some days more. Weekends I give myself a break and just my regular disorganized, scatter-brained self. I believe their are positives to being afflicted with this disorder. High energy, spontaneity, social, fun-loving, and creative are wonderful qualities to possess. Getting of topic!! I would love to heard about anyone's experience with or information about vyvanse. Also, how to manage ADHD aside from or along with meds.
Vyvanse seems to give me heartburn more. I take prolisec Sp? the generic, over the counter, one. I have to take it about every three days and have not noticed any differance on those days.
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Old 05-15-08, 03:47 PM
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Re: Is vyvanse really effected by acids and antacids?

Thanks. That's really interesting point. There is so much stigma surrounding IR adhd meds. I've only been in treatment for four months. First, doc prescribed Concerta, which did nothing for the ADHD and had terrible side effects. She swiched me to Vyvanse 30mg and upped the dose the following month. Last visit, I throughly explained the inconsistency and how the meds wore off early most days. Doc said it could be a bi-polar issue and it sometimes goes along with ADHD. I then preceeded to explain that I had never had ups and downs until this medication. Doc wants to keep me at 50mg, then increase dose strength next month. I was hoping for an IR like Adderall since I had a bad experience with ritalin type meds. I'm a little shy about asking for an IR. I just don't feel I've established that relationship with my doc. I have an buddy with adult ADHD and she raves about Adderall. She gave me a day's dose and it worked wonders. I had no rebound, I could eat normally, no side effects, and slept great. Vyvanse is similar, but not as effective for my symptoms and has a few pesky side effects. With all the controversy about Adderall, I'm not comfortable going there with my doc. Not to mention, I don't think there would be any approval about trying someone else's meds. I'm not sure what to do. Vyvanse helps, but it not doing the total job.
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Old 05-15-08, 04:28 PM
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Re: Is vyvanse really effected by acids and antacids?

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Originally Posted by airhead05 View Post
I've read and heard a lot of conflicting information about the interactions of vyvanse and acids and/or antacids.
To answer this part of your question; yes, I have seen a huge difference in my son (who's on Vyvanse) when he has consumed citric or ascorbic acid. The meds seem like they don't even exist if he consumes it within the first hour of taking them. After that he can consume it and there is no problem. This is just my family's experience though, could be different for others.
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Old 05-15-08, 06:44 PM
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Re: Is vyvanse really effected by acids and antacids?

Thanks for the info. I've read that nothing is suppose to interfere with the absorption of Vyvanse. But, I've read that antacids potentate amphetamines and acids, such as asorbic acid (vitamin c) and citric acids, cause the body to flush out these types of medicine. I noticed when I first started Vyvanse that it wore of in 4 to 6 hrs tops. I was drinking diet sunkist (loaded with citric acid) and taking multi-vitamins in the morning. I think it was making the medicine wear off quickly or, sometimes, not work at all. Now I only consume acidic drinks, fruits, and vitamins in the evening. I found that exercise and healthy eating seems to prolong and even help this medication.
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Old 05-15-08, 09:06 PM
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Re: Is vyvanse really effected by acids and antacids?

Nope. Vyvanse isn't harmed by acids because the body doesn't cleave the lysine portion from the amphetamine in the stomach. Digestion occurs after contents leave the stomach and enter the small intestine at which time the body will readjust low pH levels back to a more neutral, higher pH level (mostly because the small intestine and later the large intestine are not lined with protective coating to buffer against low pH (like the stomach is). A peptic ulcer results when the body can't adjust the pH from the stomach.

So what does this all mean?
Well vyvanse is just plain old vyvanse until the pill contents pass into the small intestine in which the body does the normal thing of digestion and cleaves the lysine molecule leaving the amphetamine portion to absorb into the blood stream. This is why Vyvanse has a longer 'lag time' to kick in because Adderall and Dexedrine start absorbing while in the stomach (but are effected by acidity). Vyvanse needs to pass from the stomach into the small intestine which adds an hour or two before it takes effect. Taking Vyvanse with food will slow down the process a little but won't reduce absorbtion.

J
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Old 05-15-08, 09:26 PM
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Re: Is vyvanse really effected by acids and antacids?

Thanks, even though it's all confusing. I'm starting to think that maybe the true problem that I'm experiencing with the Vyvanse is that it not the right dose or even treatment for me. It so unreliable due to the lack of consistent symptom control. Some days it works some, some days not at all. I'm also curious about just stopping this med. I read on the pharmacy printout that stopping the medicine without doctor consent could be harmful due to withdrawal. I've been on it for over two months, although I give myself a break from it on Saturday or Sunday once in a while with no apparent issues. Maybe 50mg is not enough. I've read on other posts and forums that some folks are on upwards of 100mg. I'm already tired of feeling like a guinea pig and I understand it can take a while to find the proper meds and dose! I know what works, but not ballsy enough to ask doc for it out right. Especially considering the short duration of my treatment. Just so frustrating.
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Old 05-16-08, 11:40 AM
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Re: Is vyvanse really effected by acids and antacids?

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Originally Posted by JR1973 View Post
Nope. Vyvanse isn't harmed by acids because...
OK, now I'm confused. Why does the prescribing information and the manufacturer specifically say not to take with citric acid?
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Old 05-16-08, 12:55 PM
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Re: Is vyvanse really effected by acids and antacids?

I couldn't find that info in the prescribing sheet. It does mention about Urinary acidifying/alkalizing agents which makes perfect sense however such agents that raise or lower urinary pH levels are not antiacids. Which holds to the topic that Vyvanse isn't as prone to stomach acidifying agents like regular amphetamines are.

Adderall XR clearly states about this but also gastrointestinal agents (antiacids) since Adderall is absorbed in the stomach.

I'm not sure about what medications or supplements screw with urine pH but as a dog owner I have learned that it is a dangerous topic due to formation of certain types of kidney stones.

J
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Old 05-17-08, 04:07 AM
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Re: Is vyvanse really effected by acids and antacids?

concerta and adderall were effected big time by acids and antacids for me, so I'm not taking my chances with Vyvanse.

I pretty much phased fruit juice out of my diet a few years ago so I'm used to it. I almost only ever drink fruit juice at night now after my medicine has worn off. Believe it or not, you do get used to it.
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Old 05-21-08, 12:54 AM
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Re: Is vyvanse really effected by acids and antacids?

Oh man... this just happened today:

My stomach was being very terrible and cramping. So I drank some Mylanta for that before breakfast. the ingredients read:
Aluminum hydroxide 200 mg
Magnesium hydroxide 200 mg
Simethicone 20 mg

So I thought "Oh this can't hurt... it DOES have Magnesium in it" (Magnesium helps my vyvanse work)

So I drank it... ate some egg sandwiches (egg and cheese on toast) and then took my 140 of vyvanse.

It had been an hour and it hadn't kicked in... this is normally when I start feeling the medicine. Next 2 hours... I feel it a little... like a reduced dose. So I know what the problem was... that damn Mylanta. Then about 5 hours later (7 after I took it) it kicked in! I have no idea why this happened and haven't read anything about this interaction.

Anyone have an idea?
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Old 05-22-08, 03:49 PM
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Re: Is vyvanse really effected by acids and antacids?

okay so would taking prevacid reduce the medications effectiveness as well? I've been taking prevacid daily for a few years and have been having trouble with my meds strangely for 2 years-
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Old 05-25-08, 02:45 AM
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Re: Is vyvanse really effected by acids and antacids?

Prevacid is unlikely to affect Vyvanse absorption or excretion.

Maybe I will be able to help clear things up here a bit. There are a few issues being discussed in relation to a drug's concentration in the blood over time. Let's assume for now that the concentration of drug in the blood at a given time is porportional to the biological effect of the drug. (In reality it's a bit more complicated than this, but not too important for this discussion).

Now, a drug's concentration over a given time is dependent on the body's absorption and elimination of the drug. For our purposes, a drug is absorbed in the stomach or intestines, and eliminated in the urine after being filtered by the kidney. For example, Vyvanse is absorbed in the intestines, and eliminated by renal excretion (that is, filtration by the kidney).

Absorption: Vyvanse is absorbed in the intestine, and adderall in both stomach and intestine. Increasing pH of the stomach will have little effect on the Vyvamse absorption, but may slow abosption of adderall.

The important piece is elimination. Blood is filtered by the kidney, and the material and liquid that passes through the filter will either be excreted as urine, or reabsorbed by the kidney and put back into the blood. Vyvanse and adderall pass through the filter. If the filtrate develops an acidic pH, vyvanse and adderall will become ionized and less likely to be reabsorbed into the blood. A basic pH will favor the non-ionized form and more drug will be reabsorbed. This is the basics of what is meant by "urinary pH".

What changes urine pH? Acids in citrus fruits are ingested and excrteded into the urine, making the pH of urine more acidic. Bases such as the hydroxides wil make urine more alkaline. Drug acting on stomach pH that are not bases in themselves, like prevacid, will have little effect on urine pH.

Hopefully that provides a simple but not too dumbed down explanation of oral bioavailability and renal excretion.
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