ADHD meds in milk?

Specialties School

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So I got this 5 year old Kindergarten student, was diagnosed with ADHD- unspecified type. They prescribed him 10 mg of Vyvanse and the mother instructed me to give it in milk? The APs and I were a bit baffled because I never heard of this method. So I called the doctor and they did indeed say to try in milk, but if the effects didn't happen to switch to pills.

Two questions:

You ever done this method and so how did you make sure it was actually working?

And also if it doesn't work, how do you teach a 5 year old how to swallow pills? Any tricks?

Thanks!

Specializes in Pediatrics Retired.
Vyvanse is perfectly safe to open caps and pour on food/drink. It is the only XR stimulant with FDA approval for that.

I had a parent come in one morning stating she had forgotten to give her son his ADD medicine. I just happened to glance at what she was holding and she had cut a Concerta lengthwise - in half. I asked why she had done that and she said she didn't want for him to have the full dose. I told her he may be getting half the dose but, by cutting it, he would receive the entire extended relief dose immediately and that would wear off in about 4 hours.:nailbiting:

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I had a parent come in one morning stating she had forgotten to give her son his ADD medicine. I just happened to glance at what she was holding and she had cut a Concerta lengthwise - in half. I asked why she had done that and she said she didn't want for him to have the full dose. I told her he may be getting half the dose but, by cutting it, he would receive the entire extended relief dose immediately and that would wear off in about 4 hours.:nailbiting:

This would be way contraindicated. The concerta capsule is designed to pass through the body whole. That's a lot methylphenidate to receive at once.

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Specializes in Adult Internal Medicine.

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021977s044lbl.pdf#page=37

Should have included this as a reference.

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Specializes in Cardiology, School Nursing, General.

The one thing I didn't know is there's chewable forms of Vyvanse.

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One year we taught a student how to swallow caps by using the empty capsule after pouring the contents into his applesauce. It took a week or two but he got it.

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Specializes in kids.
Vyvanse is perfectly safe to open caps and pour on food/drink. It is the only XR stimulant with FDA approval for that.

This seems like a more reasonable way to get the whole dose is. When mixed with a liquid, it is likely to stick to the side of the cup or onthe botton. One mouthful of applesauce or maybe yogurt and Boom! all done!

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Vyvanse is perfectly safe to open caps and pour on food/drink. It is the only XR stimulant with FDA approval for that.

No, sorry, you are mistaken. Focalin XR can be opened up and its contents sprinkled on food or in a cup of water too. When I first got that order from the doc I was nervous about it due to the extended release, but I looked it up, and it can be opened up because it is not the capsule that makes it extended release, it is the actual sprinkles inside that are extended release.

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You might want to read the medication insert previously linked as it states:

• Capsules:

o VYVANSE capsules may be swallowed whole.

o If you have trouble swallowing capsules, open your VYVANSE capsule and pour all the powder into yogurt,

water, or orange juice.

• Use all of the VYVANSE powder from the capsule so you get all of the medicine.

• Using a spoon, break apart any powder that is stuck together. Stir the VYVANSE powder and yogurt,

water or orange juice until they are completely mixed together.

• Eat all the yogurt or drink all the water or orange juice right away after it has been mixed with

VYVANSE. Do not store the yogurt, water, or orange juice after it has been mixed with VYVANSE. It

is normal to see a filmy coating on the inside of your glass or container after you eat or drink all the

VYVANSE.

The manufacturer doesn't recommend milk and I'm assuming there is a reason for that? I would go with water or yogurt (which we always have available free for breakfast at our school( to ensure I was following the manufacturer's guidelines.

Another sidenote, when I worked in a children's hospital - our child life specialists were great at teaching kids to swallow pills. We would put in a consult and they were always succesful. I worked nights and never saw them and wish I knew their techniques.

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