Lisdexamfetamine Dimesylate Capsules side effects: what 4,852 FDA adverse event reports show
Drug class
Not stated in label
Who reports
4,852 reports · 74% serious · 65 with death outcome · 63% female
Used for
Lisdexamfetamine Dimesylate Capsules are indicated for the treatment of: Attention Deficit Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older . Moderate to severe binge eating disorder (BED) in adults .
What it is
Lisdexamfetamine dimesylate capsules, a CNS stimulant, are for once-a-day oral administration. The chemical designation for lisdexamfetamine dimesylate is (2S)-2,6-diamino- N -[(1 S )-1-methyl-2-phenylethyl] hexanamide dimethanesulfonate.
Boxed warning
ABUSE, MISUSE, AND ADDICTION Lisdexamfetamine dimesylate capsules have a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CN.
Causality screen of the 40 strongest signals
What the badges mean
- Labeled — boxed warning The term (or its clinical synonym) appears in the FDA boxed warning: causality is regulator-recognised and considered serious.
- Labeled adverse reaction The exact term appears in the label's warnings or adverse-reactions sections: a known, expected effect. The FAERS signal confirms the label rather than discovering anything.
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 174 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Intentional self-injury | 1,008 | 226.7 214.2–240.0ROR 285.7 · χ² 215,072 / p <1e-300 | 214.4 EB05 203.6 · IC025 +7.5 3/3 methods agree | Reporting / coding artifact | serious PRR 169.1 · 94% clinician | no trial data cached |
| Inability to afford medication | 386 | 176.2 159.7–194.3ROR 191.3 · χ² 64,414 / p <1e-300 | 167.8 EB05 154.2 · IC025 +7.0 3/3 methods agree | Not in label — unassessed | serious n=59 · 87% consumer | no trial data cached |
| Product availability issue | 486 | 95.5 87.7–104.0ROR 106.0 · χ² 44,408 / p <1e-300 | 93.1 EB05 86.4 · IC025 +6.3 3/3 methods agree | Reporting / coding artifact | serious PRR 39.7 · 78% consumer | no trial data cached |
| Insurance issue | 255 | 75.3 66.7–84.9ROR 79.4 · χ² 18,303 / p <1e-300 | 73.6 EB05 66.3 · IC025 +5.8 3/3 methods agree | Not in label — unassessed | serious PRR 11.7 · 77% consumer | no trial data cached |
| Intentional overdose | 1,043 | 71.7 67.9–75.7ROR 91.0 · χ² 71,642 / p <1e-300 | 70.4 EB05 66.9 · IC025 +6.0 3/3 methods agree | Reporting / coding artifact | serious PRR 57.0 · 96% clinician | no trial data cached |
| Impaired quality of life | 99 | 29.9 24.5–36.3ROR 30.5 · χ² 2,715 / p <1e-300 | 29.5 EB05 24.9 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious PRR 32.5 · ♀ 12% (drug 63%) | no trial data cached |
| Product substitution issue | 333 | 25.1 22.6–27.8ROR 26.8 · χ² 7,651 / p <1e-300 | 24.9 EB05 22.7 · IC025 +4.4 3/3 methods agree | Reporting / coding artifact | serious PRR 9.9 · 80% consumer | no trial data cached |
| Tubulointerstitial nephritis | 104 | 24.1 19.9–29.1ROR 24.6 · χ² 2,265 / p <1e-300 | 23.8 EB05 20.2 · IC025 +4.1 3/3 methods agree | Not in label — unassessed | serious PRR 18.7 · ♀ 6% (drug 63%) · 92% clinician | no trial data cached |
| Impaired work ability | 118 | 23.8 19.9–28.5ROR 24.4 · χ² 2,548 / p <1e-300 | 23.6 EB05 20.3 · IC025 +4.1 3/3 methods agree | Not in label — unassessed | serious PRR 20.6 · ♀ 13% (drug 63%) | no trial data cached |
| Drug effect less than expected | 69 | 21.2 16.8–26.8ROR 21.5 · χ² 1,302 / p 2e-285 | 21.0 EB05 17.1 · IC025 +3.8 3/3 methods agree | Reporting / coding artifact | serious n=32 · 74% consumer | no trial data cached |
| Product physical issue | 97 | 21.1 17.3–25.7ROR 21.5 · χ² 1,827 / p <1e-300 | 20.9 EB05 17.6 · IC025 +3.9 3/3 methods agree | Reporting / coding artifact | serious n=30 · 77% consumer | no trial data cached |
| Brain fog | 64 | 19.0 14.9–24.2ROR 19.2 · χ² 1,069 / p 1e-234 | 18.8 EB05 15.2 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious PRR 9.3 · 81% consumer | no trial data cached |
| Loss of personal independence in daily activities | 185 | 16.8 14.6–19.4ROR 17.5 · χ² 2,734 / p <1e-300 | 16.7 EB05 14.8 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 13.3 · ♀ 25% (drug 63%) | no trial data cached |
| Frequent bowel movements | 104 | 16.7 13.8–20.2ROR 17.1 · χ² 1,518 / p <1e-300 | 16.6 EB05 14.1 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious PRR 19.6 · ♀ 1% (drug 63%) · 90% clinician | no trial data cached |
| Swollen tongue | 110 | 15.2 12.6–18.3ROR 15.5 · χ² 1,444 / p <1e-300 | 15.1 EB05 12.9 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious PRR 16.4 · ♀ 14% (drug 63%) | no trial data cached |
| Disturbance in attention | 188 | 15.0 13.1–17.3ROR 15.6 · χ² 2,446 / p <1e-300 | 14.9 EB05 13.2 · IC025 +3.6 3/3 methods agree | Labeled (related wording) related wording | serious PRR 10.7 · 78% consumer | no trial data cached |
| Apathy | 46 | 13.7 10.3–18.3ROR 13.8 · χ² 527 / p 6e-117 | 13.4 EB05 10.3 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious PRR 10.3 · 72% consumer | no trial data cached |
| Poisoning deliberate | 29 | 13.5 9.4–19.4ROR 13.5 · χ² 322 / p 3e-72 | 13.0 EB05 9.2 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 10.4 · ♀ 93% (drug 63%) · 100% clinician | no trial data cached |
| Nightmare | 105 | 13.1 10.8–15.8ROR 13.3 · χ² 1,155 / p 2e-253 | 12.9 EB05 10.9 · IC025 +3.3 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 16.7 · ♀ 4% (drug 63%) | no trial data cached |
| Systemic lupus erythematosus | 101 | 12.3 10.2–15.0ROR 12.6 · χ² 1,040 / p 2e-228 | 12.2 EB05 10.3 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious PRR 9.8 · ♀ 3% (drug 63%) · 91% clinician | no trial data cached |
| Accidental overdose | 103 | 12.2 10.1–14.7ROR 12.4 · χ² 1,044 / p 2e-229 | 12.0 EB05 10.2 · IC025 +3.2 3/3 methods agree | Reporting / coding artifact | serious PRR 15.5 · ♀ 0% (drug 63%) · 91% clinician | no trial data cached |
| Bipolar disorder | 29 | 11.4 8.0–16.5ROR 11.5 · χ² 265 / p 6e-60 | 10.8 EB05 7.6 · IC025 +2.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 10.2 | no trial data cached |
| Irritability | 155 | 11.1 9.5–13.0ROR 11.5 · χ² 1,418 / p <1e-300 | 11.0 EB05 9.6 · IC025 +3.2 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 10.4 | no trial data cached |
| Tinnitus (ringing in the ears) | 113 | 10.6 8.8–12.7ROR 10.8 · χ² 973 / p 5e-214 | 10.4 EB05 8.9 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 12.5 · ♀ 12% (drug 63%) | no trial data cached |
| Medication error | 136 | 10.6 9.0–12.5ROR 10.9 · χ² 1,171 / p 6e-257 | 10.4 EB05 9.0 · IC025 +3.1 3/3 methods agree | Reporting / coding artifact | serious PRR 13.2 · ♀ 19% (drug 63%) | no trial data cached |
| Euphoric mood | 25 | 10.5 7.1–15.5ROR 10.5 · χ² 205 / p 1e-46 | 9.7 EB05 6.6 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious n=23 · 72% consumer | no trial data cached |
| Rectal haemorrhage | 102 | 10.2 8.4–12.4ROR 10.4 · χ² 839 / p 1e-184 | 10.0 EB05 8.4 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 8.5 · ♀ 0% (drug 63%) · 92% clinician | no trial data cached |
| Eczema | 116 | 10.0 8.3–11.9ROR 10.2 · χ² 926 / p 1e-203 | 9.8 EB05 8.3 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 21.5 · ♀ 13% (drug 63%) | no trial data cached |
| Colitis ulcerative | 102 | 9.9 8.1–12.0ROR 10.1 · χ² 805 / p 2e-177 | 9.7 EB05 8.1 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 8.2 · ♀ 0% (drug 63%) · 92% clinician | no trial data cached |
| Suicidal ideation (thoughts of suicide) | 195 | 9.2 8.0–10.5ROR 9.5 · χ² 1,418 / p <1e-300 | 9.1 EB05 8.0 · IC025 +2.9 3/3 methods agree | Labeled (related wording) related wording | serious PRR 7.4 | no trial data cached |
| Serotonin syndrome | 40 | 9.0 6.6–12.3ROR 9.1 · χ² 277 / p 1e-62 | 8.5 EB05 6.4 · IC025 +2.5 3/3 methods agree | Labeled — boxed warning exact term | serious PRR 7.1 | no trial data cached |
| Affect lability | 20 | 8.9 5.8–13.8ROR 9.0 · χ² 133 / p 5e-31 | 7.9 EB05 5.2 · IC025 +2.2 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.7 | no trial data cached |
| Personality change | 19 | 8.8 5.6–13.7ROR 8.8 · χ² 123 / p 7e-29 | 7.7 EB05 5.0 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 8.2 | no trial data cached |
| Haematochezia (blood in stool) | 111 | 8.7 7.2–10.5ROR 8.9 · χ² 749 / p 3e-165 | 8.5 EB05 7.2 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 7.4 · ♀ 4% (drug 63%) | no trial data cached |
| Psychomotor hyperactivity | 33 | 8.5 6.1–12.0ROR 8.6 · χ² 212 / p 2e-48 | 7.9 EB05 5.8 · IC025 +2.4 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 9.0 · ♀ 41% (drug 63%) | no trial data cached |
| Stress | 141 | 8.5 7.2–10.0ROR 8.7 · χ² 922 / p 8e-203 | 8.3 EB05 7.2 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious PRR 10.4 · ♀ 21% (drug 63%) | no trial data cached |
| Depressed mood | 103 | 8.4 7.0–10.2ROR 8.6 · χ² 669 / p 7e-148 | 8.2 EB05 7.0 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious PRR 8.4 | no trial data cached |
| Anger | 64 | 8.1 6.4–10.4ROR 8.2 · χ² 393 / p 8e-88 | 7.8 EB05 6.3 · IC025 +2.5 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.5 · 76% consumer | no trial data cached |
| Akathisia (inner restlessness) | 25 | 7.9 5.3–11.7ROR 7.9 · χ² 144 / p 2e-33 | 7.1 EB05 5.0 · IC025 +2.1 3/3 methods agree | Not in label — unassessed | serious PRR 8.0 · ♀ 38% (drug 63%) | no trial data cached |
| Palpitations (pounding heartbeat) | 213 | 7.9 6.9–9.0ROR 8.2 · χ² 1,273 / p 4e-279 | 7.7 EB05 6.9 · IC025 +2.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.1 · ♀ 35% (drug 63%) | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Intentional overdose | 1,043 | 71.7 67.9–75.7ROR 91.0 · χ² 71,642 / p <1e-300 | 70.4 EB05 66.9 · IC025 +6.0 3/3 methods agree | Reporting / coding artifact | serious PRR 57.0 · 96% clinician | no trial data cached |
| Intentional self-injury | 1,008 | 226.7 214.2–240.0ROR 285.7 · χ² 215,072 / p <1e-300 | 214.4 EB05 203.6 · IC025 +7.5 3/3 methods agree | Reporting / coding artifact | serious PRR 169.1 · 94% clinician | no trial data cached |
| Drug ineffective (drug did not work) | 799 | 2.6 2.5–2.8ROR 2.9 · χ² 849 / p 5e-187 | 2.6 EB05 2.5 · IC025 +1.3 3/3 methods agree | Reporting / coding artifact | serious PRR 3.0 | no trial data cached |
| Product availability issue | 486 | 95.5 87.7–104.0ROR 106.0 · χ² 44,408 / p <1e-300 | 93.1 EB05 86.4 · IC025 +6.3 3/3 methods agree | Reporting / coding artifact | serious PRR 39.7 · 78% consumer | no trial data cached |
| Inability to afford medication | 386 | 176.2 159.7–194.3ROR 191.3 · χ² 64,414 / p <1e-300 | 167.8 EB05 154.2 · IC025 +7.0 3/3 methods agree | Not in label — unassessed | serious n=59 · 87% consumer | no trial data cached |
| Fatigue (tiredness) | 375 | 2.1 1.9–2.3ROR 2.2 · χ² 218 / p 2e-49 | 2.1 EB05 1.9 · IC025 +0.9 | Not in label — unassessed | serious PRR 2.3 | no trial data cached |
| Headache | 363 | 2.5 2.3–2.8ROR 2.6 · χ² 335 / p 4e-75 | 2.5 EB05 2.3 · IC025 +1.1 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 2.9 | no trial data cached |
| Product substitution issue | 333 | 25.1 22.6–27.8ROR 26.8 · χ² 7,651 / p <1e-300 | 24.9 EB05 22.7 · IC025 +4.4 3/3 methods agree | Reporting / coding artifact | serious PRR 9.9 · 80% consumer | no trial data cached |
| Anxiety | 299 | 4.5 4.1–5.0ROR 4.8 · χ² 827 / p 4e-182 | 4.5 EB05 4.1 · IC025 +2.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 3.9 | no trial data cached |
| Depression | 284 | 5.4 4.8–6.0ROR 5.6 · χ² 1,013 / p 1e-222 | 5.3 EB05 4.8 · IC025 +2.2 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 4.8 | no trial data cached |
| Insurance issue | 255 | 75.3 66.7–84.9ROR 79.4 · χ² 18,303 / p <1e-300 | 73.6 EB05 66.3 · IC025 +5.8 3/3 methods agree | Not in label — unassessed | serious PRR 11.7 · 77% consumer | no trial data cached |
| Condition aggravated | 248 | 3.5 3.1–4.0ROR 3.7 · χ² 456 / p 2e-101 | 3.5 EB05 3.2 · IC025 +1.6 3/3 methods agree | Reporting / coding artifact | serious PRR 3.8 · ♀ 38% (drug 63%) | no trial data cached |
| Product use issue | 232 | 5.4 4.7–6.1ROR 5.6 · χ² 823 / p 2e-181 | 5.3 EB05 4.7 · IC025 +2.2 3/3 methods agree | Reporting / coding artifact | serious PRR 4.5 · 72% consumer | no trial data cached |
| Somnolence (drowsiness) | 219 | 4.7 4.1–5.3ROR 4.9 · χ² 639 / p 2e-141 | 4.7 EB05 4.2 · IC025 +2.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 5.3 · ♀ 32% (drug 63%) | no trial data cached |
| Palpitations (pounding heartbeat) | 213 | 7.9 6.9–9.0ROR 8.2 · χ² 1,273 / p 4e-279 | 7.7 EB05 6.9 · IC025 +2.7 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 8.1 · ♀ 35% (drug 63%) | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Inability to afford medication — n=386, PRR 176.2
- Insurance issue — n=255, PRR 75.3
- Impaired quality of life — n=99, PRR 29.9
- Tubulointerstitial nephritis — n=104, PRR 24.1
- Impaired work ability — n=118, PRR 23.8
- Brain fog — n=64, PRR 19.0
- Loss of personal independence in daily activities — n=185, PRR 16.8
- Frequent bowel movements — n=104, PRR 16.7
- Swollen tongue — n=110, PRR 15.2
- Apathy — n=46, PRR 13.7
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Lisdexamfetamine Dimesylate?
In FDA FAERS, the most frequently co-reported reaction terms for Lisdexamfetamine Dimesylate are inability to afford medication, fatigue, headache, anxiety, depression, insurance issue. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Lisdexamfetamine Dimesylate have an FDA boxed warning?
Yes. The current FDA label carries a boxed warning: ABUSE, MISUSE, AND ADDICTION Lisdexamfetamine dimesylate capsules have a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CN.
Do FAERS signals prove that Lisdexamfetamine Dimesylate causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 18a97c88-0f72-4b02-be0d-4d093886cca5, effective 20260316; matched on
openfda.generic_name.exact:"LISDEXAMFETAMINE DIMESYLATE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 214 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.