Adverse effects & allergy testing to lisdexamfetamine (Vyvanse)

I am not aware of any testing for lisdexamfetamine and would expect side effects to be nonimmunologic adverse reactions. Lisdexamfetamine is formed by adding a lysine, an amino acid, to dextroamphetamine. Hypersensitivity reactions have been reported with lisdexamfetamine. I would expect this to be due to incipients or dextroamphetamine. Eosinophilic reactions have been reported to dextroamphetamine but the immune mechanism is not known, presumably a cellular reaction so testing would require some form of patch testing. Stevens Johnson and urticaria have also been reported but most of the reported adverse events are pharmacologic effects due to the large number of drug-drug interactions. No IgE skin testing has been reported. The only formulations are capsules and chewable tablets and testing with such formulations is often associated with irritant skin responses. The capsules contain gelatin to which some subjects are allergic.

In summary, I am not aware of any testing for lisdexamfetamine. Depending on the type of reaction you may want to test for specific-IgE to gelatin if your patient reacted to capsules or switch to the tablet formulation.

I hope this information is of help to you and your practice.

All my best.
Dennis K. Ledford, MD, FAAAAI