Atomoxetine

💊 What is Atomoxetine used for?

• •The label says atomoxetine is used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children, adolescents, and adults. It is meant to be part of a total treatment program for ADHD that may include counseling or other therapies. The label says it is not approved for major depressive disorder, and the Medication Guide says it has not been studied in children younger than 6.

How it works

The label describes atomoxetine as a selective norepinephrine reuptake inhibitor. The Medication Guide says it may help increase attention and decrease impulsiveness and hyperactivity in people with ADHD.

How it is usually taken

• •The label says the dose depends on body weight and age, and that treatment usually starts at a low total daily dose and is increased after at least 3 days. The label describes taking it either once daily in the morning or split into doses in the morning and late afternoon or early evening. The label says the dose may be adjusted over time. Follow the instructions from your prescriber or pharmacist for your own dose and schedule.

Comes as

• •Capsules containing atomoxetine: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, and 100 mg

⚠️ Atomoxetine side effects

🛑 Who should not take Atomoxetine, and who should be careful

The label says not to take it if

• 🚨You are taking, or have taken within the past 14 days, a monoamine oxidase inhibitor (MAOI) antidepressant. The label gives examples: Nardil (phenelzine sulfate), Parnate (tranylcypromine sulfate), and Emsam (selegiline transdermal system).
• 🚨You have narrow angle glaucoma.
• 🚨You have or have had a pheochromocytoma (a rare tumor).
• 🚨You are allergic to atomoxetine or any other ingredient in the product.
• 🚨You have a severe cardiovascular disorder that could get worse with clinically important increases in heart rate and blood pressure.

Tell your doctor before taking it if

• •Tell your doctor about any history of suicidal thoughts or actions, including a family history.
• •Tell your doctor about any heart problems, heart defects, irregular heartbeat, high blood pressure, low blood pressure, or a family history of these. The label says the doctor should check the heart carefully before starting and check blood pressure and heart rate during treatment.
• •Tell your doctor about any mental health conditions, including psychosis, mania, bipolar illness, or depression. The label says the prescriber should screen for bipolar disorder.
• •Tell your doctor about liver problems.
• •Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed.
• •Tell your doctor about any eye problems, especially narrow angle glaucoma.
• •The label says height and weight should be monitored in children and adolescents, and that the medicine may cause urinary hesitancy or retention.

🔀 Atomoxetine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •MAOIs: The label warns of serious, sometimes fatal reactions when atomoxetine is combined with an MAOI or other drugs that affect brain monoamine levels. Atomoxetine should not be taken with an MAOI or within 2 weeks after stopping one.
• •CYP2D6 inhibitors, such as paroxetine, fluoxetine, and quinidine: These can raise atomoxetine levels in the body to levels similar to those seen in people who process the drug slowly. The label says dose adjustment may be needed.
• •Antihypertensive drugs and pressor agents (such as dopamine and dobutamine): These may affect blood pressure, so the label says atomoxetine should be used cautiously with them.
• •Albuterol and other beta 2 agonists: Atomoxetine may increase the effect of these drugs on heart rate and blood pressure, so the label says to use it with caution.

Alcohol and food

The label does not say.

🤰 Atomoxetine in pregnancy and breastfeeding

Pregnancy

The label says it is not known if atomoxetine will harm an unborn baby. Available published studies in pregnant women are not enough to establish whether there is a risk of major birth defects, miscarriage, or other problems. Some animal studies showed adverse developmental effects. The label says there is a pregnancy registry for females exposed to ADHD medicines, including atomoxetine. Talk to your doctor if you are pregnant or plan to become pregnant. Registration information: National Pregnancy Registry for ADHD Medications, 1-866-961-2388.

Breastfeeding

The label says it is not known if atomoxetine passes into breast milk. Talk to your doctor about the best way to feed your baby.

🗓️ Storage, missed doses and taking too much

Storage

Store at 20 to 25 degrees C (68 to 77 degrees F). The label says short excursions between 15 and 30 degrees C (59 and 86 degrees F) are permitted.

If a dose is missed

The label does not say.

If too much is taken

The label says there is limited clinical trial experience with atomoxetine overdose. There have been no reported deaths from atomoxetine alone, including intentional overdoses. Deaths have been reported in mixed overdoses with at least one other drug. Seizures have been reported in some overdose cases. The most common symptoms were stomach problems, sleepiness, dizziness, tremor, and abnormal behavior. Hyperactivity and agitation have also been reported. If you think someone has taken too much, get emergency medical help right away.

🗒️ Questions to ask about Atomoxetine

• Is atomoxetine the right choice for my ADHD, and how does it compare with other options?
• Should my heart and blood pressure be checked before I start, and how often will they be checked during treatment?
• What signs of suicidal thoughts or mood changes should I watch for, and who should I call if they appear?
• What signs of liver problems should I report right away?
• Are any of my current medicines, including antidepressants, albuterol, or blood pressure medicines, a concern with atomoxetine?
• How long will I need this medicine, and how often will my need for it be reviewed?

❓ Atomoxetine: frequently asked questions