Vyvanse (Lisdexamfetamine) is a psychostimulant medication manufactured by Shire Pharmaceuticals for the treatment of ADHD (attention-deficit/hyperactivity disorder). Many consider Vyvanse to be a “new and improved” successor of the drug Adderall. Vyvanse contains the ingredient Lisdexamfetamine which is pharmacologically inactive until metabolized; hence being classified as a “prodrug.”
The fact that Vyvanse is a prodrug is considered medically advantageous in that it facilitates improved absorption, a smoother onset/offset of action, and minimizes likelihood of abuse (via insufflation or injection). Metabolism of the ingredient Lisdexamfetamine yields: dextroamphetamine and L-Lysine. The dextroamphetamine functions as a TAAR1 agonist and VMAT2 inhibitor, increasing concentrations of the neurotransmitters dopamine and norepinephrine.
Elevation of dopamine and norepinephrine concentrations increases neurophysiological arousal and provides therapeutic benefit for conditions such as: ADHD, binge eating disorder, and some cases of depression. That said, some people decide to stop taking Vyvanse for a variety of reasons including: adverse reactions, deleterious long-term effects, and/or to simply function “drug free.” If you stopped taking Vyvanse recently, you may be wondering how long it stays in your system before you’re fully detoxified.
How long does Vyvanse stay in your system after stopping?
After discontinuing this drug, you may feel as if you’ve been hit with a brick wall of lethargy, brain fog, and an array of other debilitating Vyvanse withdrawal symptoms. These discontinuation effects may lead you to wonder whether any of the drug is still lingering within your body. To determine how long Vyvanse is likely to stay in your system, it is necessary to examine its elimination half-life.
The elimination half-life of Vyvanse is estimated to be under 1 hour, some sources suggest ~47 minutes. This indicates that following administration of Vyvanse, nearly 50% of an ingested dose will be eliminated from your system in just one hour. For complete systemic clearance of Lisdexamfetamine (the chief ingredient), it will take (on average) between 4.3 and 5.5 hours; an extremely short duration.
However, just because the lisdexamfetamine is fully out of your system in under 6 hours doesn’t mean that its metabolites will also have been excreted. Lisdexamfetamine metabolizes to form dextroamphetamine (and L-Lysine). The dextroamphetamine component has a much longer half-life than Lisdexamfetamine spanning between 9 to 11 hours; some studies suggest 10.39 hours.
This means that dextroamphetamine will remain in your body for between 2.06 days to 2.52 days post-ingestion. Though various other secondary metabolites such as benzoic acid have a longer elimination half-life than lisdexamfetamine, they are excreted quicker than their parent metabolite dextroamphetamine. Based on the average clearance time of 10.39 hours for dextroamphetamine, most people can expect to fully eliminate Vyvanse and its metabolites in under 3 days (2.38 days).
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/Lisdexamfetamine
- Source: http://www.ncbi.nlm.nih.gov/pubmed/18991468
Variables that influence how long Vyvanse stays in your system
There are a variety of variables that are necessary to consider when contemplating how long Vyvanse is likely to remain in your system upon cessation. These variables include things such as: individual factors, the dosage taken, frequency of administration, tolerance, and co-ingestion of other drugs. It is the cumulative influence of these variables that may facilitate expedited clearance of Vyvanse in one person, yet prolong the clearance time in another.
Two people may take the same dosage of Vyvanse, for the same duration, and discontinue at the exact same moment. Though the “average” half-life would imply that both users are likely to clear the drug in under 3 days, not everyone fits the “average.” Some people will naturally clear the drug quicker (by hours) compared to the other user. Factors that influence clearance rates of Vyvanse include: a person’s age, body mass, renal function, and gastrointestinal pH.
Age: It is known that elderly individuals (age 65+) often excrete drugs slower than adolescents and younger adults. Some speculate that this may be due to the fact that elderly often exhibit poorer renal function compared to younger counterparts. Poorer renal function may result in reduced clearance of Vyvanse (specifically the dextroamphetamine metabolite), and could even facilitate reabsorption prior to excretion.
Some research suggests that poorer renal function is not responsible for decreased clearance of dextroamphetamine among elderly individuals, however, a more specific cause was not elucidated. It could be due to an array of complex physiologic changes that occur with old age. Understand that if you’re still young (under 65), you should clear Vyvanse quicker than if you were classified as “elderly.”
- Source: http://www.ncbi.nlm.nih.gov/pubmed/23431065
Body height/weight/fat: Though not scientifically confirmed, it is suspected that a person’s body mass may affect clearance rate of Vyvanse. In most cases, the greater the amount of a drug that is ingested relative to a person’s body mass, the slower it is excreted. On the other hand, when only a small amount of a drug is ingested relative to a person’s body mass, it is more efficiently metabolized and excreted.
If you are a larger individual (based on your body mass) and are only taking the minimal dose of Vyvanse (30 mg), you’ll likely clear the drug quicker from your system than a petite person taking the same dose. This is because there is less of an exogenous chemical within your body relative to the size of it. Though Vyvanse is not stored in body fat, it could also be hypothesized that body fat percentage may have a subtle effect on clearance time.
Food intake / hydration: Although Vyvanse can be taken with food or on an empty stomach, some believe that taking it with food decreases its absorption. As a result of the subtle effect of food on absorption efficiency and timing, it could be thought to affect the clearance time of Vyvanse from a person’s system. Though the effect on clearance time wouldn’t be anything major, it still should be mentioned.
Furthermore, since a large percentage of Vyvanse is excreted through your urine, staying hydrated could either enhance excretion if you were dehydrated. This is due to the fact that your urinary flow rate can impact the speed at which drugs are cleared from your system. When you are hydrated, your urinary flow rate is faster and Vyvanse (and dextroamphetamine) are excreted quicker.
Kidney function: It is understood that the kidneys are responsible for excreting a significant amount of Vyvanse from your system. Individuals with renal impairment (e.g. end stage renal disease) tend to excrete the drug at a much slower rate compared to those with normative renal function. As a result, an ingested dose of Vyvanse could result in an accumulation of dextroamphetamine, thereby extending its half-life (and possibly yielding toxic effects).
Among individuals with renal impairment, it is often recommended to reduce the dosage of Vyvanse, thereby placing less of a burden on their kidneys. The increase in half-life as a result of functional kidney abnormalities is largely subject to individual variation based on severity of the impairment. In fact, among those with renal impairment, the maximum daily dose is only 50 mg to account for the decreased clearance.
- Source: https://books.google.com/books?id=AlFxWXBz9oIC
- Source: http://www.accessdata.fda.gov/drugsatfda_docs/nda/2015/021977Orig1s037.pdf
Metabolic rate: This drug is known to speed up a person’s metabolic rate, which is why many people associated Vyvanse with weight loss. That said, it is important to realize that a person’s pre-medication basal metabolic rate (BMR) can have subtle effects on drug clearance. In general, those with higher pre-treatment BMRs are thought to excrete the medication faster than those with lower pre-treatment BMRs. Baseline BMR is unlikely to make a huge difference in clearance speed, but even a tiny (seemingly negligible) difference should be considered.
Gastrointestinal / urinary pH: The pH of your gastrointestinal (GI) tract affects the bioavailability of dextroamphetamine (Vyvanse’s active metabolite), as well as its absorption. When your GI tract is highly basic, an increased amount of dextroamphetamine is absorbed through lipid-rich cell membranes. When your GI tract is highly acidic, the drug stays in its water-soluble format, resulting in decreased absorption.
In addition to your GI tract affecting clearance of Vyvanse, a person’s urinary pH is capable of expediting or prolonging its clearance. Specifically, the more acidic your urine (low pH), the faster you’ll excrete Vyvanse. The half-life of Vyvanse in acidic urine can drop to just 8 hours, whereas its half-life in alkaline (high pH) urine can increase between 16 and 31 hours.
Other drugs: Though Vyvanse is extensively metabolized by enzymes in red blood cells, its metabolite dextroamphetamine undergoes additional metabolism by a variety of enzymes. As a result of certain enzymes contributing to the metabolism of dextroamphetamine, complete systemic clearance may be expedited or prolonged as a result of simultaneous ingestion of other drugs (or supplements). Should a drug affect CYP2D6, dopamine beta-hydroxylase, flavin-containing monooxygenase 3, butyrate-CoA ligase, and/or glycine N-acyltransferase – it may alter clearance times.
Drugs known as “inducers” of the aforementioned enzymes should expedite metabolism and reduce half-life of dextroamphetamine. However, drugs considered “inhibitors” may prolong clearance of dextroamphetamine from your system. Be cognizant of other substances that you’re taking along with Vyvanse and realize that they may affect timing of systemic clearance.
Dosage (30 mg to 70 mg)
Generally the higher the dosage of Vyvanse you’re taking, the greater the burden you’ve placed on your kidneys for excretion. At high doses (e.g. 70 mg per day), you’re ingesting more of an exogenous chemical that needs to be absorbed, metabolized, and eventually excreted. This means that there will be a greater amount of Lisdexamfetamine metabolite “dextroamphetamine” circulating throughout your system.
As a result of the increased level of dextroamphetamine, it is more taxing on your kidneys because they can only efficiently excrete a set amount of the drug at a time. In addition, since there’s more total dextroamphetamine circulating throughout your body at higher doses, there’s an increased chance that some of it will get reabsorbed prior to excretion; resulting in a prolonged half-life.
Those taking lower doses (especially relative to their body size) should metabolize and excrete the drug more efficiently. There is less of the drug to metabolize which yields fewer metabolites and there’s less of the drug to accumulate within the kidneys prior to excretion. If you are taking a lower dose, it’s generally easier for your body to efficiently clear.
Frequency of use (Tolerance)
In general, the greater the frequency by which a person ingests Vyvanse, the longer the drug will take to get excreted from the body. Though most individuals take Vyvanse just once per day, some individuals may take it twice per day. Yet other individuals may take Vyvanse on an “as needed” basis to avoid significant tolerance. If you use Vyvanse twice per day, you’d be considered a “high frequency” user, whereas if you use it “as needed” (less than once per day), you’d be considered a “low frequency” user.
High frequency users tend to accumulate more of the drug within the kidneys prior to excretion because they are dosing more often. Additionally, it is necessary to understand that when administered frequently, the likelihood of tolerance to Vyvanse increases. As a result, frequent users often become tolerant to high doses, accumulating more of the drug (and its metabolites) within their system. Elimination half-life increases (sometimes substantially) among frequent users.
Low frequency users are less likely to accumulate Vyvanse throughout their system because they are infrequently dosing. Someone who takes Vyvanse just once or twice a week probably won’t build up significant tolerance to the drug’s effects and will be more likely to derive benefit from lower doses. As a result of these lower doses and no substantial accumulation of the drug (associated with frequent dosing), infrequent users are likely to have a shorter half-life and a faster clearance time.
- Source: http://www.ncbi.nlm.nih.gov/books/NBK64323/
Vyvanse: Absorption, Metabolism, Excretion (Details)
Following oral ingestion of Vyvanse, the “Lisdexamfetamine” prodrug is efficiently absorbed by the gastrointestinal tract. It undergoes first-pass metabolism within the bloodstream, facilitated by enzymes in red blood cells. These enzymes within red blood cells convert Lisdexamfetamine (via hydrolysis) to form the pharmacologically active metabolite “dextroamphetamine” as well as the amino acid “l-lysine.”
Plasma concentrations of unchanged lisdexamfetamine are considered low following red blood cell hydrolysis. Lisdexamfetamine generally is undetectable within 8 hours post-ingestion. Approximately 50% of lisdexamfetamine is cleared from the body in under 1 hour post-ingestion. This implies that complete systemic clearance of lisdexamfetamine should take less than 11 hours (on average).
Unlike many other drugs, lisdexamfetamine is not subject to metabolism within liver enzymes (e.g. CYP450). As a result, renal impairment isn’t thought to significantly affect systemic clearance of the drug. After conversion of lisdexamfetamine to “dextroamphetamine” and l-lysine, the dextroamphetamine is distributed throughout the body (and brain) where it elicits a psychostimulatory effect; ramping up activation of the CNS.
The dextroamphetamine has a longer half-life of 10.39 hours (on average); usually ranging between 9 and 11 hours. A variety of enzymes aid in the metabolism of dextroamphetamine including: CYP2D6, dopamine β-hydroxylase, flavin-containing monooxygenase 3, butyrate-CoA ligase, and glycine N-acyltransferase. As a result, various other secondary metabolites are formed including: hippuric acid, norephedrine, benzoic acid, and phenylacetone.
Within 120 hours after ingestion, approximately 96% of orally-administered lisdexamfetamine (and its metabolites) are excreted through urine and only 0.3% will be excreted via feces. The contents of urinary excretion consist specifically of: 42% dextroamphetamine, 25% hippuric acid, and 2% unchanged lisdexamfetamine – relative to the dose administered. Most people should have cleared Vyvanse (Lisdexamfetamine) and its chief metabolite Dextroamphetamine within 3 days post-administration.
- Source: http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021977s036s037lbledt.pdf
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/Lisdexamfetamine
- Source: https://pubchem.ncbi.nlm.nih.gov/compound/dextroamphetamine
Types of Vyvanse Drug Tests
There are various types of drug tests that are capable of detecting the dextroamphetamine metabolite formed upon metabolism of lisdexamfetamine (via red blood cell-induced hydrolysis). Types of drug tests capable of detecting dextroamphetamine include: urine tests, blood tests, hair tests, and even saliva (oral-fluid) tests. While the most common type of drug test is a urine test, a hair test may be utilized in some cases because it offers a longer window of detection.
Urine tests: Dextroamphetamine or “d-amphetamine” is considered the dextrorotatory enantiomer of the drug amphetamine. Amphetamines are commonly tested for on urine tests and should remain detectable within your urine for up to 3 days post-Vyvanse ingestion. Some individuals may eliminate dextroamphetamine quicker than others based on their urinary pH.
A urine test involves collecting a fresh urine sample, followed by a urinalysis (laboratory analysis of the urine) to determine whether it contains amphetamines. Some individuals may test positive for dextroamphetamine longer than 3 days after ingestion (due to alkaline urine and/or frequent Vyvanse ingestion). Other individuals may test negative for dextroamphetamine in less than 3 days time (due to highly acidic urine and/or infrequent Vyvanse usage).
The threshold level of dextroamphetamine required to test positive on a standard urine test is 1000 ng/ml. However, if the urine is analyzed with gas chromatography/mass spectrometry (GC/MS), the cutoff is reduced to just 500 ng/ml.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/9788523
Hair tests: Collecting a sample of your hair could be used to determine whether you ingested amphetamines within the past month. Though dextroamphetamine from Vyvanse wouldn’t be detectable on a hair test immediately after ingestion, it may show up within a week or two in proximal outgrowths. It may remain in distal outgrowths of the hair for 1 month or longer after a person’s final ingestion.
Though hair testing is uncommon, it may be preferred to accurately predict long-term ingestion of amphetamines. Hair follicles (at least 3 cm) are typically removed from a person’s head and analyzed with gas chromatography/mass spectrometry (GC/MS) to determine amphetamine usage. Research has shown that detectability of dextroamphetamine (primary metabolite of Vyvanse) in hair is prolonged among those with reduced melanin.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/26329917
Saliva tests: Though not as common as a urine tests, saliva tests are sometimes utilized to determine whether an individual had ingested amphetamines. A saliva test involves collecting a sample of oral fluid (saliva) and sending it to a laboratory for analysis with high-performance liquid chromatography (HPLC). The HPLC technique is capable of detecting dextroamphetamine within 16 minutes of collecting the sample; a relatively quick turnaround.
That said, it is understood that concentrations of dextroamphetamine do not remain in saliva for as long as in the urine. Generally a person may test positive for the presence of dextroamphetamine within an hour of ingestion, and for up to 48 hours thereafter. The greater the amount and/or frequency of Vyvanse a person takes, the longer the duration over which they’ll remain detectable in oral fluid.
As technology capable of quickly detecting amphetamines in saliva continues to improve, we can expect that saliva testing will increase in popularity. It will allow law enforcement agents, medical professionals, and researchers to collect oral fluid – analyzing it to determine degree of amphetamine intoxication.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/26349081
Blood tests: It is not likely that you’d be tested for Vyvanse or dextroamphetamine within your bloodstream following ingestion. A blood test is not only invasive, but it offers the shortest window of detection. The short detection window is due to the fact that Lisdexamfetamine levels are nearly undetectable after 8 hours in the blood, and dextroamphetamine would be unlikely to remain detectable in the bloodstream for over 24 hours.
As a result of this short detection window and substantial effort required for a blood draw, other forms of testing are typically preferred. In some cases a blood draw may be taken to detect dextroamphetamine if an individual is hospitalized and/or fails to cooperate with a law enforcement agent.
Who is commonly tested for Vyvanse?
Most individuals aren’t tested specifically for “Vyvanse,” rather they are tested for the presence of amphetamines. Since Vyvanse yields dextroamphetamine (the right-handed enantiomer of amphetamine), many individuals may face penalization if detected within their body. Examples of people that are commonly tested for dextroamphetamine include: athletes, criminals, drug addicts, employees, and students.
- Athletes: A high-performance athlete such as a professional football player will be frequently tested for amphetamines. Athletes can attain a psychological, and physiological advantage over their opponents if they ingest a drug like Vyvanse prior to a competition. For this reason, if any athlete is caught having taken Vyvanse, he/she may be banned from competition and penalized (with a hefty fine).
- Criminals: Many criminals use drugs that they aren’t authorized to attain. If a law enforcement agent suspects that a criminal may have taken Vyvanse (or any other amphetamine), that individual will likely be subject to a drug test. Should the criminal get caught with dextroamphetamine in his/her body, additional penalization (e.g. more jail time) may be appropriate.
- Drug addicts: Individuals addicted to drugs often struggle to stay sober and end up in rehabilitation facilities. During rehab, these individuals may seek out any drugs that can be used to attain a psychological “high” – including amphetamines. For this reason, rehab facilities frequently test their patients with drug tests capable of detecting dextroamphetamine. If a person is caught with dextroamphetamine in their urine, they may need to spend more time at the facility.
- Employees: Most employers issue random, mandatory drug tests to current and prospective (future) employees. If the employees pass the drug test, they either keep (or get) a job. If they test positive for a substance like dextroamphetamine, they could lose their job. Obviously there are exceptions such as if an employee has a medical prescription for Vyvanse. However, should an individual get caught with dextroamphetamine in his/her system without a prescription, they may lose their job.
- Students: Many students use psychostimulants in attempt to get better grades, cram for tests, and/or outperform the competition. However, many of these individuals do not have legitimate medical conditions that warrant Vyvanse (or amphetamine) ingestion. Should they end up failing a drug test as a result of amphetamines, they may be penalized for “academic doping.” Though penalization for academic doping is uncommon, it may become more popular in the future.
Tips to clear Vyvanse from your system
If you have Vyvanse in your body and want to ensure that it gets eliminated as quickly as possible, there are some tricks you may want to consider. Understand that you should always talk to a medical professional and verify safety of these techniques before implementing them. Also keep in mind that certain suggestions may be more beneficial for some people than others.
- Stop taking it: To ensure that Vyvanse is eliminated from your system, you’ll want to completely stop taking it. Never stop taking it “cold turkey” without guidance from a professional. The sooner you cease usage of Vyvanse, the quicker you’ll attain a state of sobriety.
- Acidify urinary pH: It is known that acidification of your urine could decrease the elimination half-life of Vyvanse’s primary metabolite “dextroamphetamine” by up to 3 hours. This means that it could drop the half-life from 11 to 8 hours, resulting in complete systemic clearance in less than 3 days (as opposed to 3+ days). Foods that increase the acidity of your urinary pH should expedite clearance, whereas those that alkalinize it will extend clearance.
- Increase urinary flow: The flow rate of your urine is known to influence amphetamine clearance. If you want to clear dextroamphetamine as rapidly as possible, you’ll want to drink plenty of water (as to stay optimally hydrated). Optimal hydration will maximize your urinary flow rate (output), clearing more metabolites in a shorter period of time.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/9788523
Are you trying to clear Vyvanse from your system?
If you’ve discontinued Vyvanse and are hoping to clear it, along with its dextroamphetamine metabolite from your system, share a comment below. Mention when you stopped taking the drug and how long it’s been since your final dose. Discuss any steps you’ve taken to ensure that Vyvanse is cleared from your system in the fastest possible time, or any things you may be doing that could be prolonging clearance.
Understand that the Lisdexamfetamine prodrug should be excreted from your body in less than 12 hours. However, the dextroamphetamine that is formed via blood-enzyme-induced hydrolysis has a longer half-life exceeding 10 hours. Most individuals should expect complete systemic clearance of Vyvanse (and its metabolites) within several days of their final dose.