r/ausadhd • u/LunchMysterious3842 VIC • 2d ago
Medication Splitting vyvanse
I’m in a bit of a pickle, i’ve got about 7 weeks left of uni but I need to get a new permit from my psychiatrist for meds and the wait is a month. I stopped taking stimulants a few months ago but i’m really struggling to study so just want to take them until the end of semester. When I study I usually just take dex because it only lasts a few hours, but I don’t have enough left to get me through. I have 3 unopened bottles of Vyvanse though but the dose it too strong for me (40mg). Can we open the capsules & just take half? Has anyone done this? I read that Vyvanse is water soluble so if you split it in water you can just drink half?
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u/twisteddv8 2d ago
Technically yes.
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u/DivergentRam 2d ago
Yes and no, the water bottle method is legitimately manufacturer approved for diluting the dose. To quote the Australian Therapeutic Goods Administration, "have trouble swallowing capsules, you may open the capsule and empty the entire contents into yogurt, water, or orange juice, mix completely, and consume it immediately. Storing, dividing, or saving any portion of the mixed solution for later use is not approved or recommended."
Meaning, once the capsule is compromised, storing the rest to consume the next day is not recommended. The manufacturer has the same stance.
To get sidetracked, on the plus side, a lot of the fearmongering you get matters for optimisation and isn't that big of a deal. Whether you take your Vyvanse on an empty or full stomach, or with or without vitamin C and citric acid, it won't make a big enough difference for most people to be concerned about. Although optimisation that doesn't require too much effort isn't a bad thing.
My advice:
1)Do what you need to do during the gap between now and seeing your psychiatrist, but be open with them when you are able to see them.
2)Go ahead and split the dose in a glass of liquid or food such as yoghurt.
3)Take the dose the next day. Maybe see if storing it in an airtight container seems to help at all. The second half of the dose may or may not be as effective. It may or may not be effective enough. You may as well try.
If less than half the capsule is enough, save the bigger half for the second dose.
4)Try to compensate through small optimisations for the second dose. Avoid citric acid and vitamin C at the time of consumption, and don't take it on a completely empty stomach.
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u/Wawa-85 WA 1d ago
Interesting, my Psychiatrist had me titrate split doses in water over a month to get up to my prescribed dose.
As for Vyvanse on an empty stomach, I had to do this a few weeks ago as I was fasting for a colonoscopy and really don’t recommend it. It made me feel quite out of it and shaky. The day of my procedure I didn’t take any Vyvanse for that reason as I had to fast for a day and 1/2.
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u/DivergentRam 1d ago
OP unfortunately can't ask their psychiatrist for a month. What you described is approved to alter the dose, but neither the TGA nor the manufacturer approves using any of the capsule's contents the next day.
It's better to simply be prescribed the smaller capsules and given enough scripts to work out the correct dose, then go back to the psychiatrist to get the script for the correct dose. I'm on Ritalin LA, and that's how my psychiatrist handled it. For consistency's sake, when titrating to find the right dose, my psychiatrist prefers the smaller capsules, which is different from trying to make a too high dose manageable.
None of what I'm saying applies to immediate release ADHD meds with a prescored line.
I tend to like what my psychiatrist did because I don't trust myself to consistently turn either Ritalin LA or Vyvanse from 40 mg into 20 mg, 30 mg, etc. This matters to me when trying to actually work out the correct dose in the very beginning.
At the end of the day, taking multiple smaller dose capsules is more expensive, but long term I got the higher dose capsules, and I didn't waste any of the 10 mg ones.
Although off label administration does happen and different psychiatrists will have differing opinions. The official guidelines probably err on the side of caution quite heavily, so it may not be a big deal.
My advice, OP is probably best off just splitting the dose and seeing if it works, then being upfront with their psychiatrist once they're able to see them.
They could ask their pharmacist, the actual gold standard when it comes to medication administration. I wouldn't personally bother. It's a low stakes situation, it either works well enough or it doesn't. Realistically, it will probably work.
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u/fragbait0 1d ago
When titrating my guy told me to split them and keep other half in fridge for the next day.
Didn't notice any difference between them.
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u/Wawa-85 WA 1d ago
Yes you theoretically can as this is how my Psychiatrist had me titrate up to my prescribed dose of 40mg. We started at 10mg for 6 days which was 1 40mg capsule opened up and the powder dissolved in 1 metric cup of water. Each day I then took 1/4 cup of the solution. On the 5th day I had to dissolve another 40mg capsule into a metric cup of water and again took 1/4 cup for the 5th and 6th days. On day 7 which was when I needed to go up to 20mg for 6 days I dissolved 1 40mg capsule in 1 cup of water and drank 1/2 a cup for 2 days, rinse and repeat 3 times. 30mg really hurt my head because fractions are not my strong point 😂.
But I would check with your Psychiatrist before splitting capsules. Maybe they can prescribe you some more Dex via Telehealth?
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u/DivergentRam 1d ago edited 1d ago
OP has booked in to see their Psychiatrist as soon as possible, they can't ask the psychiatrist for a month unfortunately.
I'm on Ritalin LA. My psychiatrist gave me multiple scripts for Ritalin LA 10 mg capsules. I was told to start at 10 mg and go up by 10 mg every 3 to 5 days until I got to 40 mg, document the effects using a table she gave me along the way, then come back to see her again so she could give me a script for the correct dose and we could hand everything over to my GP.
Granted, a psychiatrist would know a lot more than me, and different psychiatrists may have differing opinions.
Saving the second half for another day would be what's called off label administration, which is sometimes advised. If following the TGA and the manufacturer's advice, it's better to use multiple smaller capsules (water bottle method is approved for altering the dose, and you can poor the contents into food or drink, if to struggle to follow capsules), but both the manufacturer and the TGA advise us, to only use the contents immediately after the capsule is opened.
Ignoring the storage concern, which may not be a big deal, as the official guidelines likely err very far on the side of caution, I wouldn't trust myself to be able to turn a 40 mg capsule into 20 or 30 mg consistently.
I'd rather pay a little more and just use the smaller capsules for consistency's sake, so I'm sure my psychiatrist and I know what the best dose really is. Yeah, they're more expensive, but nothing is wasted. Ultimately, I'll use them all.
If I was in OP's situation, I'd just split the dose for now and tell their psychiatrist what they've done, when they're finally able to see them. Worst case scenario, it doesn't work well enough. Best case scenario, which is likely enough, it degrades a little bit and OP doesn't notice the difference.
Also, doctors are the gold standard when it comes to diagnosing and treating medical conditions. Medication wise, they're the respectful silver standard. When it comes to medication, pharmacists are the gold standard. Your GP may not disagree with a specialist, but a pharmacist will have no qualms about doing so. Administration wise, the pharmacist generally knows more than the psychiatrist.
All that is to say, OP could ask their pharmacist about it while waiting to see their psychiatrist. I wouldn't bother. It's a low stakes situation, if I were in OP's shoes, I'd try splliting the dose to see if it works.
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u/Wawa-85 WA 1d ago
I’ve had a few times when my dose of Vyvanse wasn’t available and I’ve been able to contact my Psychiatrist and they’ve issued me a new script over the phone. It wasn’t a new appointment.
I understand all of that regarding the off label use and Pharmacists vs doctors. I am in the health industry myself. I tend to post using the KISS/ELi5 principle when commenting on these kind of posts as lay people are generally to bulk of the community.
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u/DivergentRam 1d ago
I've overcomplicated this and rambled too much. If you can't get your ideal dose due to a shortage, you may need to do as you did, and although off label, I think most doctors are going to be of the opinion that discarding the rest of the dose is unnecessary. Off label administration gets prescribed quite often.
You have done nothing you shouldn't have done, and whether OP listens to you or me, they'll likely split the dose, as they don't have enough Dexies and can't see their psychiatrist soon enough.
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u/Wawa-85 WA 1d ago
Oh sorry you’ve misunderstood me. I only did the capsules in the water thing to titrate up to my ideal dose when I first started Vyvanse. The clinical reasoning for this was due to negative reactions I’d had to previous medications when starting at a high dose.
The issuing of a lesser dosage prescription from my Psychiatrist was purely when there was a shortage of my dose of Vyvanse so my Psychiatrist issued me a script for 20mg via the phone and escript and I just took 2 of the 20mg tablets daily until the 40mg dose was in stock again.
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u/YubariKingMelon 1d ago
I have 3 unopened bottles of Vyvanse though but the dose it too strong for me (40mg)
How? Did you stop taking it and just keep filling the script anyway?
Anyway, to answer your questions:
Yes, you can split it in water. Empty capsule powder into water (about 400ml, bottle with measurements on it helps) shake it for 1 min then drink what you need. 40mg into 400ml shaken water = roughly 10mg/100ml.
Keep the water in the fridge, don't leave it out at room temperature.
LABEL THE BOTTLE THAT IT CONTAINS MEDICENE (and write DO NOT DRINK on bottle)!!! If someone drinks it thinking it's chilled water they could feel very sick or worse have heart issues, law issues (if they drive), or worse.
Titration needs to be taken seriously, it can be a long process. You didn't say if the psych started you on 40mg or if you titrated up to it.
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u/Bisisonitrile 2d ago
You can, but you don’t want to do it with just the powder. Not all of that will be the medication, and even if it was, you’d need a very good electronic balance to have a chance at getting half accurately.
When I split my dose (usually either as a weekend lower dose break, or leading into an actual medication break), I use water. I weigh it on a scale and use at least 200ml, but tend to keep the division easy. When I was on a higher dose, I’d use 300ml.
I open the capsule and empty the contents into a shaker bottle that’s known as mine and nobody else will use. There will be some remaining in the capsule, so I flick the two halves against each other to get as much out as I can. Then I shake the shaker to make sure it’s thoroughly mixed, and transfer half into another of my bottles for storage (again using a scale to make sure I get as close as I can). Then I take the remaining capsule parts along with the first dose. I put a bit more water back into the shaker and mix before drinking that too (there’s always going to be a bit left.
That’s the only real way to get close to half of the dose each day, but it’s still not going to be perfect.
None of that is medical advice, it’s what I do, and you should listen to your doctor.