Adderall XR vs. Vyvanse: Use, side effects, and costs

In this article:

• Main differences
• Conditions treated
• Efficiacy
• Cost and insurance coverage
• Side effects
• Interactions
• Warnings

In this article

• Main differences
• Conditions treated
• Efficiacy
• Cost and insurance coverage
• Side effects
• Interactions
• Warnings

For many people with attention-deficit hyperactivity disorder (ADHD), finding the right medication can be the 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 are used for a similar purpose, they differ in duration of effectiveness, 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 are 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 in the body. This means that Vyvanse is inactive until it’s metabolized. This may help improve the medication’s effectiveness and reduce serious side effects. 

Adderall XR is an extended-release capsule intended to provide a sustained release of medication for 10 to 12 hours. Vyvanse, on the other hand, is also an extended-release medication, available as either an oral capsule or a chewable tablet, and both provide treatment lasting up to 14 hours.

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 FDA-approved to treat 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 loss of control during the binge-eating episodes, and experiencing shame, distress, or guilt afterward.

Adderall XR and Vyvanse are also used off-label(meaning not FDA-approved) to treat narcolepsy. Narcolepsy is a condition of excessive daytime sleepiness and sudden sleep attacks. The immediate-release version of Adderall is currently FDA-approved for narcolepsy, not the extended-release version. 

Is Adderall XR or Vyvanse more effective?

Clinical trials show that Adderall XR and Vyvanse are more effective than a placebo. However, limited studies compare Adderall XR to Vyvanse. The choice is related to personal preference and individual responses to the medications.

Adderall XR works within 30 minutes to an hour and lasts for up to 12 hours. Vyvanse works within one to two hours and 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 Adderall XR and Vyvanse in children with ADHD, it showed more improvement with Vyvanse compared to Adderall XR or a placebo. Specifically, 32% of children on Vyvanse reported “very much improved” compared to 16% on Adderall XR. 

Always consult a healthcare provider to determine the most appropriate treatment for your condition. 

Coverage and cost comparison of Adderall XR versus Vyvanse

Most insurance plans, including Medicare, often include coverage for Adderall XR, particularly for the generic version. Vyvanse is a newer medication, may be more expensive, and insurance coverage may not be as widespread as for Adderall XR. Consider that Vyvanse is available in 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 offers coupons that help reduce the retail cost of these medications.

The average cost of these medications without insurance varies greatly depending on the pharmacy, pharmacy location, medication strength, and quantity. Adderall XR and Vyvanse can cost several hundred dollars for a month’s supply of brand-name capsules. 

Common side effects of Adderall XR vs. Vyvanse

Adderall XR and Vyvanse come with similar side effects as other stimulant medications: dry mouth, difficulty sleeping, and loss of appetite. Increased heart rate and blood pressure can occur and are important to monitor. 

Other serious side effects of stimulant medications are the risk of abuse and addiction, worsened bipolar disorder, or new psychotic symptoms. Discuss potential side effects with a healthcare professional to help manage them.

Side effects for Adderall XR and Vyvanse can include:

• Insomnia
• Dry mouth
• Loss of appetite
• Nausea
• Abdominal pain
• Fever
• Indigestion
  Diarrhea
• Headache
• Dizziness 

Ozempic and Jardiance drug interactions

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 examined 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.

Adderall XR and Vyvanse share many potential drug interactions, particularly with rarely prescribed monoamine oxidase inhibitors (MAOIs), which can lead to a dangerous hypertensive crisis if used concurrently or within 14 days of each other. Both stimulants may also interfere with blood pressure medications due to their tendency to raise heart rate and blood pressure, necessitating careful monitoring in individuals with hypertension. Additionally, combining these medications with serotonergic drugs such as SSRIs or SNRIs poses a risk of serotonin syndrome, a serious condition marked by confusion, rapid heart rate, hallucinations, fever, and muscle rigidity.

The effectiveness of Adderall XR and Vyvanse can also be influenced by substances that alter stomach pH. Alkalinizing agents may increase absorption, while acidifying agents can decrease it, potentially requiring dose adjustments. Adderall XR, in particular, has shown interactions with proton pump inhibitors (PPIs) like omeprazole, which can alter its release and delay its peak concentration in the bloodstream. In contrast, Vyvanse appears to have a more stable profile when taken with omeprazole, showing no consistent changes in absorption or effectiveness. Breastfeeding mothers are advised not to take stimulants as the stimulant is excreted in breast milk, and the long-term neurodevelopmental effects on the infants are not known. 

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 have a high risk of abuse and addiction. Misuse or escalation of use can lead to serious health problems, including addiction or even life-threatening overdose. Use them as prescribed. Store them safely.

For those with serious heart conditions, Adderall XR and Vyvanse might not be safe options because these can increase your blood pressure and heart rate. Be aware of mood swings, hallucinations, unusual behaviors, or other mental health problems. If these occur, stop your medication and contact your healthcare provider. 

Monitoring weight and height is also important for children, as Adderall XR and Vyvanse can negatively affect growth, and treatment plans may need to be changed. 

Watch out for signs of poor circulation in fingers and toes, known as peripheral vasculopathy or Raynaud’s phenomenon, and of an increased risk of serotonin syndrome, especially when mixed with other medications that affect serotonin levels. Ask relatives for the family history of motor tics or Tourette’s syndrome before starting the medication, and monitor for any new or worsening symptoms that might require stopping the medication.