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> Vyvanse is metabolized to d-amphetamine in your blood cells

Do you have any more information about this? Can't find it on google - would be very interesting if its true but I'm a bit skeptical - I've never heard about blood cells being a primary site of drug metabolism.

A search turned up:

> "Lisdexamfetamine dimesylate is converted to dextoamphetamine and L- lysine, which is believed to occur by first-pass intestinal and/or hepatic metabolism."

(https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/02...)

According to this, sounds like its mostly intestines and liver, which is much more typical for drug metabolisms.




Old FDA data.

Here's the latest: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/02...

> 12.3 Pharmacokinetics

> Metabolism Lisdexamfetamine is converted to dextroamphetamine and l-lysine primarily in blood due to the hydrolytic activity of red blood cells after oral administration of lisdexamfetamine dimesylate. In vitro data demonstrated that red blood cells have a high capacity for metabolism of lisdexamfetamine; substantial hydrolysis occurred even at low hematocrit levels (33% of normal). Lisdexamfetamine is not metabolized by cytochrome P450 enzymes.

EDIT: A better one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257105/


~30 year old article on how red blood cells metabolize many classes of drugs: https://onlinelibrary.wiley.com/doi/pdf/10.1002/bod.25100904...

Basically, RBCs have lots of enzyme systems that serve (in part) to protect the important parts (e.g. haemoglobin) from oxidation. Put a bunch of lisdexamfetamine in the blood, and the RBCs will gradually hydrolyze it to cleave off the l-lysine and leave d-amph.


Very interesting, thanks!




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