How is vyvanse metabolized?

Vyvanse (lisdexamfetamine dimesylate) is a prodrug of dextroamphetamine. Its metabolism works this way:

- Activation: After oral intake, lisdexamfetamine is cleaved in the body to release the active drug, dextroamphetamine, plus the amino acid lysine.
- Where it happens: The conversion is done mainly by enzymes in red blood cells (a hydrolysis/amide bond cleavage). This makes the onset gradual and prolongs the effect.
- Hepatic metabolism: Vyvanse is not significantly metabolized by the liver’s cytochrome P450 system. There is minimal hepatic metabolism; most of the activity comes from the red blood cell–mediated conversion.
- Excretion: The active dextroamphetamine and the lysine moiety are excreted in the urine. The drug's effects last longer than immediate-acting amphetamines because of the slow prodrug conversion.
- Practical notes: Vyvanse can be taken with or without food; absorption is not highly dependent on meals.

In short: Vyvanse is a prodrug that is slowly converted to dextroamphetamine in the blood, not by liver metabolism, with elimination via the kidneys.