Sunday, April 14, 2019

Lisdexamfetamine for ADHD

Attention deficit hyperactivity disorder (ADHD) is a fairly common condition that mainly affects a child's behaviour. Children with ADHD show persistent restlessness, impulsiveness and/or inattention. You will be given help to understand your child's emotions and behaviours but where this is insufficient, medicines can be prescribed.

Lisdexamfetamine works on the parts of the brain responsible for self-control and attention. It improves activity in these areas, helping them to work better. This helps to focus your child's attention, improve concentration, and reduce impulsive behaviour. It will initially be prescribed by a specialist doctor.

ADHD is usually diagnosed in children, but it can continue through the teenage years and into adulthood. Other medicines for ADHD are usually tried first, but where these are unsuccessful, lisdexamfetamine can be helpful. This information leaflet is written for parents or carers of children who have been prescribed lisdexamfetamine, and also for young people and adults who are taking it themselves.

Before taking lisdexamfetamine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you or your child (or a child in your care) start taking lisdexamfetamine it is important that your doctor knows:

If it is for a young person who could be pregnant.
If you are pregnant, trying for a baby, or breastfeeding.
If you (or your child) have ever had a problem with drug or alcohol misuse.
If you (or your child) have a heart condition, or any problems with blood vessels.
If you (or your child) have ever had any uncontrollable movements such as a nervous tic, or a condition called Tourette's syndrome.
If you (or your child) have any liver or kidney problems.
If you (or your child) have an overactive thyroid gland.
If you (or your child) have epilepsy.
If you (or your child) have high blood pressure.
If you (or your child) have an eye problem called glaucoma.
If you (or your child) have a mental health problem - for example, psychosis or bipolar disorder.
If you (or your child) have a rare inherited blood condition called porphyria.
If you (or your child) are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
If you (or your child) have ever had an allergic reaction to a medicine.
How to take lisdexamfetamine
Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about lisdexamfetamine and a full list of side-effects which may be experienced from taking it.
Make sure you (or your child) take the capsules exactly as your doctor tells you. The starting dose is usually 20-30 mg daily, taken in the morning. This dose may then be increased over the following few weeks, which will mean taking a different strength of capsule. As there are several strengths of lisdexamfetamine capsule available, each time you collect a fresh supply, check to make sure it is the strength you are expecting.
It is not important whether lisdexamfetamine is taken before or after food, but try to remember to take each dose at the same time every morning. If a dose is forgotten, do not take it later in the day, as this can cause sleeping problems. Skip the dose for that day, but remember to take a dose the next day as normal. Do not take two doses together to make up for a missed dose.
The capsules can be swallowed whole, or you can open them up and stir the contents into a glass of water or orange juice or into soft food such as yoghurt. If you do this, the mixture must be stirred well until the medicine is dissolved and then swallowed straightaway.
Getting the most from your treatment
Keep the regular appointments with your doctor. Your doctor will want to check to ensure that the treatment is helping. Your doctor will also monitor things like weight and height, and do some blood tests.
There are treatment programmes that will be recommended for you and your child. These will provide you with strategies to improve behaviour and reduce any long-term impact.
From time to time your doctor will assess the treatment to make sure it is still required. This may involve stopping lisdexamfetamine for a short while.
There is a small amount of evidence to show that a change in diet may help some children with ADHD. If you think that diet may be a factor for you or your child, discuss this with your doctor to see if speaking with a dietician might be of benefit.
Before buying any medicines, check with your pharmacist which medicines are safe to take alongside lisdexamfetamine.
You (or your child) should not drink alcohol while on lisdexamfetamine.
If you (or your child) are due to have an operation, it is important that you tell the person carrying out the treatment that you are taking lisdexamfetamine.
You should not stop taking this treatment without first talking to a doctor. This is because stopping suddenly may cause problems, and also the symptoms of ADHD may come back.
Can lisdexamfetamine cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with lisdexamfetamine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common lisdexamfetamine side-effects What can I do if I experience this?
Headache Ask your pharmacist to recommend a suitable painkiller
Feeling dizzy If this happens, do not drive and do not use tools or machines
Diarrhoea Have plenty of water to drink to replace lost fluids
Feeling sick (nausea) or being sick (vomiting), tummy (abdominal) pain Stick to simple meals - avoid rich or spicy foods
Lack of appetite, loss of weight, sleeping problems, dry mouth, feeling irritable If any of these become troublesome, speak with your doctor
If you or your child experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store lisdexamfetamine
Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never give more than the prescribed dose. If you suspect that someone may have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you or your child. Never give it to other people even if their condition appears to be the same.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

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Manufacturer's PIL, Elvanse® 20 mg, 30 mg, 40 mg, 50 mg, 60 mg and 70 mg Capsules, hard; Shire Pharmaceuticals Limited, The electronic Medicines Compendium. Dated September 2016.

Manufacturer's PIL, Elvanse® Adult 30 mg, 50 mg and 70 mg Capsules, hard; Shire Pharmaceuticals Limited, The electronic Medicines Compendium. Dated July 2015.

British National Formulary; 72nd Edition (Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

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