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SO, once again, the conversion rate of Vyvanse to dexedrine/dextroamphetamine/d-amphetamine (they are all the same chemical) is 35%. So 300 mg of Vyvanse (you will never get a script for this much Vyvanse) produces 105 mg dexedrine/dextroamphetamine/d-amphetamine.

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On 5/3/2018 at 4:20 PM, mmaryland said:

zenzedi also comes in 30mg tablets.

@notloki had already mentioned this so I left it out. But yes, they also make the only 30 mg IR tablets.

 

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The conversion between lisdexamfetamine and dextroamphetamine dosages with IV use is approximately 33–36% going by dose-adjusted AUC0–24 ratios in IV PK research comparing LDX and dextroamphetamine sulphate ((319.5/25)/(355.8/10) => 35.92%, (562.7/50)/(681.4/20) => 33.03%, ref).

However, 40 mg of dextroamphetamine is supposedly an equimolar dose to 100 mg of lisdexamfetamine, suggesting a 40% conversion (apparently 40.3 mg of dextroamphetamine sulfate salts is equal to 100 mg of lisdexamfetamine dimesylate salts, with both being equal to 29.6 mg of dextroamphetamine base). The same study suggests a conversion of approximately 42% going by the dose-adjusted AUC ratios with oral doses of LDX and dextroamphetamine sulfate ((1817/100)/(1727/40) => 42.08%, ref).

Now it's clear that IV and oral use are quite utterly incomparable, especially so given the major differences between how d-amp and LDX operate and are absorbed, so the calculated 33–36% figures from the IV study isn't anywhere near an accurate estimate for oral use comparisons. The main reason for this is likely due to LDX having a consistently very high oral bioavailability with essentially all of the conversion from LDX to d-amp happening after absorption, while d-amp in comparison has a significantly lower oral bioavailability that is dependent on a number of factors. Therefore 40–42% seems to be the most accurate rough lower estimate for conversion between LDX and d-amp, and is in line with the literature I have previously reviewed on estimated equipotent doses of LDX and MAS/d-amp (generally in the range of 40–50%). However it is still useful to know where the incorrect lower estimates came from (the prior IV research). Note that the second cited ref (comparing oral dosing) has a much larger sample size than the first ref (23/24 vs 3/3 + 9/9).

On 5/3/2018 at 8:13 PM, Iceberg said:

@notloki What's that converted to adderall? It seems like it be a lot 

You cannot really truly directly convert d-amp and MAS because MAS is a mixture of multiple different salts and MAS is approximately 25% l-amp, which is not exactly pharmacologically equivalent to d-amp (although the exact magnitude and effects of the difference between l-amp and d-amp are still under debate). However it's fair enough to say that MAS is roughly equivalent to the same dose (by weight) of d-amp. Thus 90 mg d-amp ≈ 90 mg MAS.

In theory if you go by amphetamine base content (ignoring the differential effects of l-amp base and d-amp base entirely), a given dose of MAS is supposedly equal to roughly ~85.5% of that dose in d-amp (e.g. 30 mg MAS ≈ 25.65 mg d-amp), or a given dose of d-amp is equal to roughly ~117% of that dose in MAS (e.g. 30 mg d-amp ≈ 35.1 mg MAS), but I honestly don't put that much stock in this conversion methodology given how it's seen very limited use in peer-reviewed literature and how it has obvious flaws. If you use this method, 90 mg d-amp ≈ 105.3 mg MAS.

On 5/3/2018 at 9:06 PM, mmaryland said:

90mg Dexedrine Spansules is A LOT converted to adderall. So I've seen some stim conversion/equal dosage table that 15mg Dexedrine Spansules are equal to Adderall 20mg XR, so using this conversion we would come up with Adderall XR 120mg as the equivalent dose, which to me sounds like a dose of Adderall no psychiatrist would prescribe to their patients daily (I mean it is four 30mg XR capsules at once..). 

Using another source (https://simpleandpractical.com/converting-stimulants-equivalent-doses/), it states that 15mg Dexedrine Spansules is equal to 50mg Vyvanse. So take that and multiply by 6 (since to take 90mg of Dexedrine Spansules you have to take 6 capsules) and you will come up with 300mg of Vyvanse!! Now I think that's crazy high dosage of Vyvanse that no psychiatrist would prescribe ever, I mean it is practically more than 4x the FDA maximum dose. For Dexedrine Spansules, the FDA says in rare cases should the dosage for ADHD be above 40mg daily, and 60mg daily for narcolepsy. 

Any way you put it, 90mg Dexedrine Spansules is a hefty dose, but I feel like if you took the equivalent in Adderall XR and especially Vyvanse it would be way to much, overwhelming, causing your heart rate to go crazy and have lots of nasty side effects plus a terrible comedown. On one occasion I took 210mg Vyvanse and I was so agitated, irritated, hostile, aggressive, snappy, and the focus/concentration wasn't even there. My adhd symptoms were being controlled maybe 40% on 210mg Vyvanse, plus the comedown was dreadful so dreadful and I couldn't fall asleep for almost 2 days. I don't know why Dexedrine, at an equivalent dose, doesn't have the same negative effects, but I'm sure as hell happy about it because it allows me to take stimulants without suffering from anxiety, irritability, insomnia, and enables me to rise above my ADHD symptoms and really feel in control of what I need to do, when I am going to do things, keeping items/papers organized, and focusing on the right things for longer periods of time.

So 24.5*4 = roughly 100mg. Multiplying 70mg*4 gives us 280mg of Vyvanse, but since we used a multiple of 4 because it made calculations simpler, the equivalent of 90mg Dexedrine Spansules would probably be between 255mg-265mg, based on your conversion information of 70mg-->24.5mg (btw where did you find this, just curious)

90 mg of d-amp is equivalent to ~90–105.3 mg MAS. 90 mg of d-amp is also equivalent to ~180–225 mg (214.29 mg @ 42% LDX/d-amp conv) LDX (oral). Your numbers are wildly off.

On 5/4/2018 at 9:45 AM, notloki said:

SO, once again, the conversion rate of Vyvanse to dexedrine/dextroamphetamine/d-amphetamine (they are all the same chemical) is 35%. So 300 mg of Vyvanse (you will never get a script for this much Vyvanse) produces 105 mg dexedrine/dextroamphetamine/d-amphetamine.

300 mg LDX (oral) = ~120–150 mg d-amp (126 mg @ 42% LDX/d-amp conv). You'll never see 35% conversion outside of IV use.

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@BipolarSpinster my experience with Adderall was the same. It made me feel too amped and my experience has been that Vyvanse is "smoother". You're also more likely to get approved for Vyvanse than Zenzedi or Evekeo or other branded amphetamines in light of the fact that Adderall and Dexedrine are now available as generics. I'm bipolar as well and don't feel that Vyvanse triggers mania at all for me anymore now that I take Depakote and Rexulti.

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Posted (edited)
9 minutes ago, browri said:

@BipolarSpinster my experience with Adderall was the same. It made me feel too amped and my experience has been that Vyvanse is "smoother". You're also more likely to get approved for Vyvanse than Zenzedi or Evekeo or other branded amphetamines in light of the fact that Adderall and Dexedrine are now available as generics. I'm bipolar as well and don't feel that Vyvanse triggers mania at all for me anymore now that I take Depakote and Rexulti.

After seeing doc’s response to giving me Topamax, I can almost bet she either doesn’t know what it is or won’t prescribe it for some outlandish reason. 

Edited by BipolarSpinster

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12 minutes ago, BipolarSpinster said:

After seeing doc’s response to giving me Topamax, I can almost bet she either doesn’t know what it is or won’t prescribe it for some outlandish reason. 

That's odd to me because of the brand name stimulants (e.g. Vyvanse, Zenzedi, Evekeo, Mydayis, etc.), Vyvanse is most likely to be the preferred brand and have the lower brand copay. This is because of the fact that they've bonded the dextroamphetamine to lysine which acts as an abuse deterrent. You can't snort it or anything like that. It has to go through your digestive system to work. So the fact that it can't be abused encourages insurance companies to pay for it because they have the comfort of knowing that patients aren't "blowing" through it (no pun intended) faster than their prescription permits.

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6 minutes ago, browri said:

That's odd to me because of the brand name stimulants (e.g. Vyvanse, Zenzedi, Evekeo, Mydayis, etc.), Vyvanse is most likely to be the preferred brand and have the lower brand copay. This is because of the fact that they've bonded the dextroamphetamine to lysine which acts as an abuse deterrent. You can't snort it or anything like that. It has to go through your digestive system to work. So the fact that it can't be abused encourages insurance companies to pay for it because they have the comfort of knowing that patients aren't "blowing" through it (no pun intended) faster than their prescription permits.

Ah, gotcha. I wonder if it would be contraindicated for me having had gastric bypass 10 years ago. Having smaller stomach, less intestine, not to mention constant stomach upset   

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13 minutes ago, browri said:

That's odd to me because of the brand name stimulants (e.g. Vyvanse, Zenzedi, Evekeo, Mydayis, etc.), Vyvanse is most likely to be the preferred brand and have the lower brand copay. This is because of the fact that they've bonded the dextroamphetamine to lysine which acts as an abuse deterrent. You can't snort it or anything like that. It has to go through your digestive system to work. So the fact that it can't be abused encourages insurance companies to pay for it because they have the comfort of knowing that patients aren't "blowing" through it (no pun intended) faster than their prescription permits.

It’s a good idea though, so I definitely plan on asking. 

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56 minutes ago, BipolarSpinster said:

Ah, gotcha. I wonder if it would be contraindicated for me having had gastric bypass 10 years ago. Having smaller stomach, less intestine, not to mention constant stomach upset   

I get why you would say that. Because that genuinely is a problem for medications that normally clear the body really quickly so they come out with an XR form which in the end is usually just a specially manufactured pill to extend the life of the pill throughout the intestinal tract or ensures the pill doesn't dissolve before reaching a portion of the small intestine that has the pH required to dissolve the pill. In those situations, this would be an issue. Ask your doctor, but in the case of Vyvanse, we're talking about a metabolic reaction that occurs in the bloodstream after it's been absorbed in your stomach and early on in your small intestine. Even if your intestine is shorter, this pill and it's content are long gone and dissolved fairly early on I would think, unlike a horse pill tablet that you know isn't gonna be dissolved by the time it gets to the end of the line if you know what I mean. Lol.

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1 minute ago, browri said:

I get why you would say that. Because that genuinely is a problem for medications that normally clear the body really quickly so they come out with an XR form which in the end is usually just a specially manufactured pill to extend the life of the pill throughout the intestinal tract or ensures the pill doesn't dissolve before reaching a portion of the small intestine that has the pH required to dissolve the pill. In those situations, this would be an issue. Ask your doctor, but in the case of Vyvanse, we're talking about a metabolic reaction that occurs in the bloodstream after it's been absorbed in your stomach and early on in your small intestine. Even if your intestine is shorter, this pill and it's content are long gone and dissolved fairly early on I would think, unlike a horse pill tablet that you know isn't gonna be dissolved by the time it gets to the end of the line if you know what I mean. Lol.

I will definitely bring it up after a few weeks after she's done adding an AD. lol First things first. Must first stop crying. ha!

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9 minutes ago, BipolarSpinster said:

I will definitely bring it up after a few weeks after she's done adding an AD. lol First things first. Must first stop crying. ha!

Best of luck to you!

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