Amphetamine prodrug stimulant
Lisdexamfetamine mesilate
Brand names: Elvanse
Adult dose
Dose: 30mg PO OD initially, increase weekly by 20mg to max 70mg OD
Route: PO
Frequency: OD
Clinical pearls
- ADHD ≥6y; specialist initiation
- CD2 controlled drug; baseline CV history, BP, HR; growth monitoring in children
Contraindications
- Symptomatic cardiovascular disease
- Moderate-severe hypertension
- Hyperthyroidism
- Concurrent MAOI / within 14 days
- Glaucoma
- Phaeochromocytoma
Side effects
- Reduced appetite/weight loss
- Insomnia
- Tachycardia
- Hypertension
- Mood changes
- Tics
- Dependence
- Cardiomyopathy (rare)
Interactions
- MAOIs (avoid)
- Sympathomimetics
- TCAs
- Antihypertensives
Monitoring
- BP
- HR
- Weight
- Height (children)
- Mental state
Reference: BNF; NICE NG87; https://bnf.nice.org.uk/drugs/lisdexamfetamine-mesilate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF