Medically reviewed by Alex Yampolsky, PharmD
Suppose you or your child has been prescribed - or are considering - taking stimulant medication for attention-deficit hyperactivity disorder (ADHD).
If so, you may want to know more about two popularly prescribed ADHD medications, Vyvanse and Adderall.
Vyvanse (lisdexamfetamine) is Food and Drug Administration (FDA)-approved to treat ADHD in adults and children six and older and severe binge eating disorder (BED) in adults.
Adderall (amphetamine/dextroamphetamine) is FDA-approved to treat ADHD in adults and children three years and older, while Adderall XR can treat ADHD in adults and children six and older.
Adderall also treats narcolepsy (a sleep disorder that causes daytime drowsiness) in adults and children six and older.
This article will compare both medications, highlighting their uses, side effects, warnings, and other important information.
How Is ADHD Treated?
Drugs for ADHD are categorized as stimulant or non-stimulant medications.
Stimulants (central nervous system [CNS] stimulants), the most common type of ADHD medication, work by increasing levels of chemicals (dopamine and norepinephrine) in the brain to help with ADHD symptoms.
People with ADHD may experience various symptoms, including:
Inattention: Having a hard time focusing and staying organized
Hyperactivity: Moving around constantly and fidgeting, tapping, or talking excessively
Impulsivity: Acting without thinking
Binge Eating Disorder (BED): When you regularly devour a large quantity of food and feel you cannot control your eating
Vyvanse and Adderall are classified by the Drug Enforcement Administration (DEA) as Schedule II Controlled Substances because they have a high potential for abuse and dependence.
Vyvanse vs. Adderall: Main Differences
The following information outlines more information about Vyvanse versus Adderall. Both drugs do share some similarities, however.
For example, both are classified as stimulant ADHD medications and work the same way by increasing levels of chemicals called dopamine and norepinephrine in the brain.
Active Ingredient(s)
Vyvanse contains the ingredient lisdexamfetamine, a prodrug (a drug that does not work until it is metabolized in the body).
In the body, lisdexamfetamine converts into dextroamphetamine. This mechanism is thought to lower the abuse potential of Vyvanse.
In comparison, Adderall contains amphetamine and dextroamphetamine (sometimes called mixed amphetamine salts).
Adderall is available in two formulations, an immediate-release (IR) form and an extended-release (ER) form (Adderall XR).
Adderall XR also contains amphetamine and dextroamphetamine but in an ER form.
Uses
Vyvanse is FDA-approved to treat:
ADHD in adults and children 6 and older
Moderate to severe BED in adults 18 and older
Adderall is FDA-approved to treat:
ADHD in adults and children 3 and older
Narcolepsy in adults and children 6 and older
Adderall XR is FDA-approved to treat:
ADHD in adults and children 6 and older
Dosage: Vyvanse vs. Adderall
Vyvanse and Adderall are both available as brand-name medications. Adderall, but not Vyvanse, is also available in generic form.
In dosing these medications, the healthcare provider will generally start on the lower end of the dosing and slowly increase the dose if needed.
Vyvanse
Vyvanse is available as:
An oral capsule (in 10-milligram [mg], 20-milligram, 30-milligram, 40-milligram, 50-milligram, 60-milligram, and 70-milligram doses)
A chewable tablet (in 10-milligram, 20-milligram, 30-milligram, 40-milligram, 50-milligram, and 60-milligram doses)
Vyvanse is taken once daily in the morning, often with the following dosages:
The dosage for ADHD in adults and children is 30 to 70 milligrams once daily in the morning.
The dose for moderate to severe BED in adults is 50 to 70 milligrams once daily in the morning.
The maximum daily dose for either indication is 70 milligrams per day.
Other Vyvanse instructions for use:
Vyvanse capsules should be swallowed whole. Do not chew or crush. Alternatively, you can empty the capsule's contents, mix it with orange juice, water, or yogurt, and consume the mixture immediately.
You can take Vyvanse with or without food.
Vyvanse chewable tablets should be thoroughly chewed before swallowing.
Adderall
Adderall is available as:
An IR oral tablet in 5-milligram, 7.5-milligram, 10-milligram, 12.5-milligram, 15-mg, 20-milligram, and 30-milligram doses.
The dose for ADHD is:
Adults and children 6 and older: 5 milligrams to 40 milligrams daily divided into one, two, or three doses
Children 3 to 5 years old: 2.5 milligrams to 40 milligrams daily divided into one, two, or three doses
The dose for narcolepsy in adults is 5 milligrams to 60 milligrams daily, divided into one, two, or three doses.
Adderall XR
Adderall XR is available as:
An ER oral capsule in 5-milligram, 10-milligram, 15-milligram, 20-milligram, 25-milligram, and 30-milligram doses.
The dose for ADHD is:
Adults: 20 milligrams once daily in the morning (maximum 60 milligrams per day)
Children 6 to 12 years old: 10 milligrams once daily in the morning (maximum 30 milligrams per day)
Adolescents/teenagers 13 to 17 years old: 10 milligrams to 20 milligrams once daily in the morning (maximum 40 milligrams per day)
Other Adderall XR instructions for use:
Swallow the capsule whole with water or another liquid. If the capsule cannot be swallowed, you can open it and sprinkle it over one spoonful of applesauce. Swallow the mixture immediately, without chewing, then drink water or another liquid.
You can take Adderall XR with or without food.
Do not chew or crush the capsule or the medicine inside the capsule.
When to Use Vyvanse vs. Adderall
A review of studies compared Vyvanse against several other drugs, including Adderall, and concluded that Vyvanse was more effective than the other medications.
Another study found that most people who took Vyvanse were more likely to take their medication daily as directed than those who took other ADHD medications. Taking medication daily as prescribed is expected to lead to better control of symptoms.
Another review of studies found that amphetamines were the most effective compounds in children, adolescents, and adults. Still, side effects could be an issue in certain people. This study did not recommend Vyvanse over other amphetamine medications.
It's important to remember that Vyvanse converts to dextroamphetamine, a component of Adderall, in the body, so effects would be expected to be similar.
Which Drug Lasts Longer?
Vyvanse and Adderall XR are taken once daily because they last longer in the body.
Vyvanse capsules take about three and a half hours to reach the full effect, while chewable tablets take about four hours to reach the full effect. A dose of Vyvanse lasts for up to 14 hours.
Adderall XR capsules take about seven hours to reach the full effect, and a dose lasts up to 12 hours.
Adderall (IR) is a shorter-acting drug, so it needs to be dosed more frequently. Adderall dosage varies, but some individuals take it up to three times daily to achieve the desired effect. Adderall reaches its full effect in about three hours, and a dose lasts about four to six hours.
Who Should Avoid Vyvanse or Adderall?
You should not take either drug if you are allergic to lisdexamfetamine, amphetamine, dextroamphetamine, or any inactive ingredients in Adderall or Vyvanse.
Other people who should not take Adderall or Vyvanse include:
People who have taken a monoamine oxidase inhibitor (MAOI) within the past 14 days
Individuals who are pregnant or breastfeeding
People with severe heart disease or other heart or heart rhythm problems
Adderall or Vyvanse may be prescribed with caution in some people only if the healthcare provider determines it is safe, including:
People with kidney problems (including a history of kidney failure)
People with heart disease or a history of heart disease
People with hypertension (high blood pressure)
People with hyperthyroidism
People with glaucoma
People with certain mental health conditions, such as bipolar disorder or Tourette syndrome
People with a history of seizures or who are at risk of seizures
People with a history of substance abuse
Black Box Warning
Like all ADHD stimulants, Vyvanse and Adderall have a black box warning. This is the strongest warning the FDA requires.
The warning states that these medications have a high potential for abuse and dependence. The healthcare provider will assess the risk of abuse before prescribing a stimulant and closely monitor the person while taking a stimulant.
Also, misuse of a stimulant like Vyvanse or Adderall can cause sudden death, stroke, or heart attack. People with certain medical conditions will not be prescribed a stimulant due to the possible cardiovascular risk.
Side Effects
Common Side Effects of Vyvanse
Common side effects of Vyvanse include:
Appetite and weight loss
Dry mouth
Stomach pain
Irritability
Nausea, vomiting, diarrhea, or constipation
Tachycardia (fast heartbeat)
Anxiety
Dizziness
Excess sweating
Mood swings
Increased blood pressure
Worsening of tics
Shortness of breath
Tremor
Common Side Effects of Adderall and Adderall XR
Common side effects of Adderall and Adderall XR include:
Appetite and weight loss
Dry mouth
Headache
Stomach pain
Mood swings
Anxiety
Nausea, vomiting, diarrhea, or constipation
Dizziness
Nervousness
Tachycardia
Heart palpitations
Heartburn
Changes in sex drive/impotence
Worsening of tics
Shortness of breath
Excess sweating
Increased blood pressure
Serious Side Effects of Vyvanse vs. Adderall
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency.
Serious side effects of Vyvanse and Adderall are similar and may include, but are not limited to:
Severe, life-threatening allergic reactions (anaphylaxis; symptoms of hives, difficulty breathing, or swelling of the face, lips, tongue, or throat require emergency medical attention)
Severe, life-threatening skin reactions (symptoms of fever, burning eyes, sore throat, red or purple rash, or blistering or peeling skin require emergency medical attention)
Abuse and dependence
Psychosis (disconnection from reality)
Mania (extremely elevated, excited mood)
Aggressive behavior
Sudden death
Heart attack
Stroke
High blood pressure
Seizures
Priapism (painful erection)
Raynaud's syndrome (bodily numbness in response to cold temperatures)
Additionally, long-term use in children may affect growth, so children who take stimulants will be closely monitored.
Drug Interactions
Although stimulants are safe with many other drugs, various drug interactions still exist. Tell your healthcare provider about all your medications, including prescription, over-the-counter (OTC), and vitamins or supplements.
While taking Vyvanse or Adderall, do not start any new medications without approval from your healthcare provider. Some drug interactions include but are not limited to
MAOIs should not be used within 14 days of Vyvanse or Adderall, such as phenelzine or tranylcypromine.
Tricyclic antidepressants, such as Pamelor (nortriptyline)
Other antidepressants, such as Paxil (paroxetine), Lexapro (escitalopram), and Effexor XR (venlafaxine)
Mysoline (primidone)
Dilantin (phenytoin)
Blood thinners, such as Jantoven (warfarin)
Decongestants or cold or allergy medicine that contains a decongestant, such as Claritin-D (loratadine) or Biophren (phenylephrine)
Opioid pain relievers, such as Trezix (acetaminophen/codeine)
This is not a complete list of drug interactions. Consult your healthcare provider for more information about drug interactions and how they may affect you.
Cost Comparison: Vyvanse vs. Adderall
Because Vyvanse is only available as a brand-name drug, an individual would pay much more for an out-of-pocket price of Vyvanse than for a generic equivalent of Adderall or Adderall XR.
On the other hand, choosing a generic version of Adderall or Adderall XR could save a significant amount of money.
However, because insurance plans vary, the best way to know how much Vyvanse or Adderall would cost on your goal is to contact your health insurance provider for the most up-to-date coverage information.
Many insurance plans cover Vyvanse or Adderall to some degree, so cost may or may not factor into which medication is most appropriate for you.
Summary
Vyvanse and Adderall are prescription stimulant medications for treating ADHD in adults and children.
Vyvanse can also treat moderate to severe binge eating disorders in adults. Adderall can also be used to treat narcolepsy in adults and children.
Ask your healthcare provider if you want to know more about these medications and if one may be appropriate for you.