Lisdexamfetamine Restarting After Prolonged Discontinuation
Restarting lisdexamfetamine after a prolonged drug-free interval should follow the initial titration dosing schedule rather than resuming the prior maintenance dose. [1]
Medication Selection Algorithm
Lisdexamfetamine dosing should be individualized to therapeutic response and administered at the lowest effective dosage. [1]
Key Evidence Supporting This Recommendation
The FDA prescribing information defines dosing for patients “starting treatment for the first time” as 30 mg once daily in the morning with titration thereafter. [1]
Monotherapy Versus Combination Therapy
No adjustment to restart dosing is indicated based on concomitant ADHD medication use in the prescribing information. [1]
Important Clarifications or Nuances
The prescribing information provides a dose-titration framework for initiation and dose adjustments, but it does not provide a specific protocol for restarting after months off therapy. [1]
Initiation Thresholds and Dosing Algorithm
For ADHD, the recommended starting dose is 30 mg once daily in the morning. [1] Dosage may be increased in increments of 10 mg or 20 mg at approximately weekly intervals. [1] The maximum recommended dose is 70 mg/day. [1]
Common Pitfalls to Avoid
Resuming a prior higher maintenance dose without re-titration is not aligned with the labeled starting-dose-and-weekly-increment titration framework. [1]
Target Blood Pressure and Heart Rate Goals During Restart
Blood pressure and pulse should be monitored during treatment, with benefit-risk consideration in patients for whom increases may be problematic. [1]