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For many people with attention-deficit hyperactivity disorder (ADHD), finding the right medication can be key to managing symptoms. Adderall XR and Vyvanse are central nervous system (CNS) stimulants that increase the levels of certain neurotransmitters in the brain, which may help improve concentration and focus.
These two medications are available by prescription and are commonly used to treat ADHD in both adults and children. Although they can be used for a similar purpose, they may differ in how long they work for, dosage, potential side effects, and cost, among other factors.
Read on to learn more about the similarities and differences between Adderall XR and Vyvanse.
RELATED: What is Adderall XR? | What is Vyvanse?
What are the main differences between Adderall XR and Vyvanse?
Both Adderall XR and Vyvanse are U.S. Food and Drug Administration (FDA) approved ADHD medications that work as CNS stimulants. They increase the availability of the neurotransmitters dopamine and norepinephrine in the brain, which may help regulate attention and behavior. However, they contain different active ingredients.
Adderall XR contains a mixture of amphetamine salts, including dextroamphetamine saccharate, amphetamine sulfate, and dextroamphetamine sulfate. In contrast, Vyvanse consists of lisdexamfetamine dimesylate, a prodrug that is converted into the active ingredient dexamphetamine after ingestion. This means that Vyvanse is inactive until it’s metabolized by the body, which may help improve the medication’s effectiveness and reduce serious side effects.
Adderall XR is available as an extended-release capsule designed to provide a sustained release of medication throughout the day. The goal with extended-release Adderall is to manage ADHD symptoms for an extended period, which is usually around 10 to 12 hours. Vyvanse, on the other hand, is available as an oral capsule and chewable tablet, both providing effects lasting up to 14 hours.
Main differences between Adderall XR and Vyvanse |
||
|---|---|---|
| Adderall XR | Vyvanse | |
| Drug class | CNS stimulant | CNS stimulant |
| Brand/generic status | Both brand and generic versions are available | Both brand and generic versions are available |
| What is the generic name? | Dextroamphetamine/amphetamine salts, extended-release | Lisdexamfetamine dimesylate |
| What form(s) does the drug come in? | Oral capsule | Oral capsule
Chewable tablet |
| What is the standard dosage? | 5 to 30 mg once daily in the morning | 30 to 70 mg once daily in the morning |
| How long is the typical treatment? | Long-term | Long-term |
| Who typically uses the medication? | Adults and children 6 years of age and older | Adults and children 6 years of age and older |
Conditions treated by Adderall XR and Vyvanse
Adderall XR and Vyvanse are FDA-approved to manage ADHD in adults and children aged six years and older. They may be prescribed to help increase attention and decrease hyperactivity and impulsiveness in people with ADHD.
In addition to ADHD, Vyvanse is also approved for the treatment of moderate to severe binge eating disorder in adults. Binge eating disorder is a condition that involves recurrent episodes of eating large amounts of food, a feeling of a loss of control during the binge-eating episodes, and experiencing shame, distress, or guilt afterward.
Adderall XR and Vyvanse may also both be used off-label to treat narcolepsy. Narcolepsy is a condition characterized by excessive daytime sleepiness and sudden sleep attacks. Note that the regular immediate-release version of Adderall is currently FDA-approved for narcolepsy, not the extended-release version.
| Condition | Adderall XR | Vyvanse |
| ADHD | Yes | Yes |
| Binge eating disorder | No | Yes |
| Narcolepsy | Off-label | Off-label |
Is Adderall XR or Vyvanse more effective?
Clinical trials have shown that Adderall XR and Vyvanse are more effective than placebo. However, limited studies compare Adderall XR and Vyvanse head-to-head. The better option comes down to personal preference and individual responses to the medications, as one medication may not work the same for everyone.
Adderall XR starts working within 30 minutes to an hour and lasts for up to 12 hours, while Vyvanse starts working within one to two hours but lasts for up to 14 hours. Some people report a smoother onset of action with Vyvanse than with Adderall XR. The wearing-off period for Vyvanse is also less abrupt, which may result in fewer noticeable changes in mood or behavior as the medication is cleared from the body.
In one study comparing the effects of Adderall XR and Vyvanse on children with ADHD, it was found that a higher percentage of children showed significant improvement when treated with Vyvanse compared to Adderall XR or a placebo. Specifically, 32% of children on Vyvanse were reported to be “very much improved” compared to 16% on Adderall XR. The study concluded that Vyvanse resulted in more participants experiencing a significant improvement in symptoms compared to Adderall XR or placebo.
Always consult a healthcare provider to determine the most appropriate option for your condition.
Coverage and cost comparison of Adderall XR versus Vyvanse
Most insurance plans and Medicare often include coverage for Adderall XR, particularly for the generic version. Vyvanse, being a newer medication, may be more expensive, with insurance coverage not being as widespread as for Adderall XR. However, Vyvanse is also available as a generic version, which may be cheaper than brand-name options.
Patients without insurance or those looking to lower their copay may benefit from pharmacy discount programs. SingleCare, for example, offers coupons that can help reduce the retail cost of these medications.
The average costs of these medications without insurance vary greatly depending on the pharmacy, quantity, and location. Adderall XR and Vyvanse can cost several hundred dollars for a month’s supply of brand-name capsules.
| Adderall XR | Vyvanse | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare Part D? | Yes | No |
| Quantity | 30, 30 mg capsules | 30, 30 mg capsules |
| Typical Medicare copay | Varies | Varies |
| SingleCare cost | $23 | $86 |
Common side effects of Adderall XR vs. Vyvanse
Adderall XR and Vyvanse come with similar side effects as stimulant medications. Common side effects of Vyvanse and Adderall XR include dry mouth, difficulty sleeping, and loss of appetite. As stimulants, they can also increase heart rate and blood pressure, which may be important to monitor.
Both medications can also lead to serious side effects, although they are less common. For example, they carry a risk of abuse and addiction, as well as mental problems, including worsened bipolar disorder or new psychotic symptoms. Discuss potential side effects with a healthcare professional who can provide a complete list and medical advice on managing side effects.
| Adderall XR | Vyvanse | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Insomnia | Yes | 27% | Yes | 27% |
| Dry mouth | Yes | 35% | Yes | 26% |
| Loss of appetite | Yes | 33% | Yes | 27% |
| Nausea | Yes | 8% | Yes | 7% |
| Abdominal pain | Yes | 14% | Yes | 12% |
| Fever | Yes | 5% | Yes | 2% |
| Indigestion | Yes | 2% | No | – |
| Diarrhea | Yes | 6% | Yes | 7% |
| Headache | Yes | 26% | Yes | 1% |
| Drowsiness | No | – | Yes | 2% |
| Dizziness | Yes | 7% | Yes | 5% |
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more. Source: DailyMed (Adderall XR), DailyMed (Vyvanse)
Drug interactions of Adderall XR vs. Vyvanse
Adderall XR and Vyvanse can interact with many of the same drugs, potentially leading to decreased effectiveness or increased side effects of these stimulants. For example, both medications can interact with monoamine oxidase inhibitors (MAOIs). Patients should not use these ADHD medications with MAOIs or if they’ve taken an MAOI in the last 14 days due to the risk of hypertensive crisis—a severe increase in blood pressure.
Because Adderall XR and Vyvanse can increase heart rate and blood pressure, they may lower the effectiveness of blood pressure medications or antihypertensives. Individuals with high blood pressure may need to monitor their blood pressure closely while taking stimulants.
Taking Adderall XR or Vyvanse with serotonergic drugs like SSRIs or SNRIs can cause serotonin syndrome, leading to symptoms such as confusion, hallucinations, rapid heartbeat, fever, and muscle stiffness.
When Adderall XR or Vyvanse is taken with alkalinizing agents, its absorption in the body increases. Conversely, when taken with acidifying agents, its absorption decreases. This interaction can affect the effectiveness of the medication and may require dosage adjustments by a healthcare provider.
Adderall XR may have interactions with proton pump inhibitors (PPIs) like omeprazole and esomeprazole, which can affect how the drug is released in the body. A recent study looked at how Vyvanse and Adderall XR behave when taken with omeprazole. The study found that Adderall XR showed changes in the time it took to reach peak concentration when combined with omeprazole, possibly due to how stomach acid levels affect the drug’s release pattern. On the other hand, Vyvanse did not show a consistent interaction with omeprazole.
| Drug | Drug Class | Adderall XR | Vyvanse |
| Nardil (phenelzine)
Parnate (tranylcypromine) Marplan (isocarboxazid) Emsam (selegiline) |
Monoamine oxidase inhibitor (MAOI) | Yes | Yes |
| Prozac (fluoxetine)
Zoloft (sertraline) Lexapro (escitalopram) Paxil (paroxetine) |
Selective serotonin reuptake inhibitor (SSRI) | Yes | Yes |
| Cymbalta (duloxetine)
Effexor (venlafaxine) Pristiq (desvenlafaxine) |
Serotonin-norepinephrine reuptake inhibitor (SNRI) | Yes | Yes |
| Elavil (amitriptyline)
Tofranil (imipramine) Pamelor (nortriptyline) Norpramin (desipramine) |
Tricyclic antidepressant (TCA) | Yes | Yes |
| Prilosec (omeprazole)
Nexium (esomeprazole) Prevacid (lansoprazole) Protonix (pantoprazole) |
Proton pump inhibitor (PPI) | Yes | No |
| Sodium bicarbonate
Potassium citrate Citric acid Magnesium hydroxide |
Alkalinizing agent | Yes | Yes |
| Ammonium chloride
Methenamine |
Acidifying agent | Yes | Yes |
| Zestril (lisinopril)
Norvasc (amlodipine) Cozaar (losartan) |
Antihypertensive | Yes | Yes |
This is not a complete list of drug interactions. Please consult your doctor before taking these medications.
Warnings of Adderall XR and Vyvanse
Adderall XR and Vyvanse are Schedule II controlled substances that carry a high risk of abuse and addiction. This means that using these drugs in ways not prescribed by a doctor could lead to serious health problems, including addiction or even life-threatening overdose. When prescribed these medications, it’s important to understand how to use them safely. This includes properly storing them to prevent misuse and disposing of unused medicines.
For those with serious heart conditions, Adderall XR and Vyvanse might not be safe options. These medications can increase your blood pressure and heart rate, which can be dangerous if you have heart problems. In addition, if you experience new or worsening symptoms like mood swings, hallucinations, unusual behaviors, or other mental health problems, it’s important to contact your healthcare provider.
Monitoring is also important for children, as Adderall XR and Vyvanse can affect growth. If a child using Adderall XR or Vyvanse isn’t growing or gaining weight as expected, a healthcare provider might need to adjust the treatment plan.
Other precautions include looking out for signs of poor circulation in fingers and toes, known as peripheral vasculopathy or Raynaud’s phenomenon, and being aware of an increased risk of serotonin syndrome, especially when mixed with other medications that affect serotonin levels. It’s also important to check for any family history of motor tics or Tourette’s syndrome before starting the medication and to monitor for any new or worsening symptoms that might require stopping the medication.
Frequently asked questions about Adderall XR vs. Vyvanse
What is Adderall XR?
Adderall XR is a long-acting central nervous system stimulant that contains dextroamphetamine and amphetamine salts. It is typically prescribed for the treatment of ADHD in adults and children over six years old. It comes as an oral capsule taken once daily.
What is Vyvanse?
Vyvanse is a prescription medication containing lisdexamfetamine. It is known as a prodrug, meaning it becomes active only after metabolizing it. It is effective in treating ADHD and has also been approved to manage moderate to severe binge eating disorders in adults.
Are Adderall XR and Vyvanse the same?
While both medications belong to the same class of stimulants, they are not the same. Adderall XR contains a combination of amphetamine salts, whereas Vyvanse contains lisdexamfetamine. Although both medications are FDA-approved for ADHD in adults and children over six years old, Vyvanse is also approved to treat binge eating disorder.
Is Adderall XR or Vyvanse better?
Determining whether Adderall XR or Vyvanse is better depends on a person’s specific needs, how their body processes the medication, and their response to treatment. Both are effective in treating symptoms of ADHD. Vyvanse may have a more gradual onset and last longer than Adderall XR, which some people may prefer. Consult a healthcare provider to find the most appropriate option.
Can I use Adderall XR or Vyvanse while pregnant?
Using Adderall XR or Vyvanse during pregnancy may cause harm to an unborn baby. It is important to discuss potential benefits and risks with a healthcare professional. They can provide guidance on safe treatment options during pregnancy.
Can I use Adderall XR or Vyvanse with alcohol?
Combining these prescription drugs with alcohol is not recommended. Alcohol can amplify certain side effects of these medications and may lead to an increased risk of developing substance-related problems. Always consult with a healthcare professional regarding substance use while on these medications.
Sources
- Adderall XR highlights of prescribing information, The U.S. Food and Drug Administration (2023)
- Vyvanse highlights of prescribing information, The U.S. Food and Drug Administration (2023)
- Dextroamphetamine-amphetamine, StatPearls (2023)
- Physician perception of clinical improvement in children with attention-deficit/hyperactivity disorder: A post hoc comparison of lisdexamfetamine dimesylate and mixed amphetamine salts extended release in a crossover analog classroom study, Neuropsychiatric Disease and Treatment (2011)
- Effects of omeprazole on the pharmacokinetic profiles of lisdexamfetamine dimesylate and extended-release mixed amphetamine salts in adults, Postgraduate Medicine (2009)