at/ə/moks’ ə/tēn

Brand Name: Strattera®

• Generic Available

Common Dosage Forms:

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

FDA Indications/Dosages:

  • For the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) with or without comorbid anxiety disorder: Children up to 70 kg: Start with a total daily dose of 0.5 mg/kg given once in the morning or evenly divided between the morning and late afternoon/early evening. After a minimum of 3 days, increase the total daily dose to 1.2 mg/kg. Maximum daily dose is 100 mg. Children over 70 kg: Start with a total daily dose of 40 mg. Increase after a minimum of 3 days to a target total daily dose of 80 mg given either once in the morning or evenly divided between the morning and late afternoon/early evening. Maximum daily dose is 100 mg.

Pharmacology/Pharmacokinetics:

The exact mechanism of action of atomoxetine in the treatment of ADHD is unknown. It may be related to a selective inhibition of the pre-synaptic norepinephrine transporter. After oral absorption, atomoxetine undergoes oxidative metabolism through the CYP2D6 pathway. Its half-life is approximately 5 hours. A small fraction of the population are poor metabolizers of CYP2D6 metabolized drugs and therefore experience a much longer half-life (24 hours). Peak plasma levels are reached in 1 to 2 hours after dosing. 98% of therapeutic concentrations are bound to plasma proteins, primarily albumin.

Drug Interactions:

Coadministration with MONOAMINE OXIDASE INHIBITORS may produce serious reactions resembling neuroleptic malignant syndrome. Use with oral or intravenous albuterol may compromise the cardiovascular system. Drugs that inhibit the CYP2D6 enzymatic system may increase atomoxetine levels. These drugs include paroxetine, fluoxetine, and quinidine.

Contraindications/Precautions:

Use is contraindicated within 14 days of taking a monoamine oxidase inhibitor, in patients with narrow angle glaucoma, and in patients hypersensitive to any component of Strattera. ATOMOXETINE MAY INCREASE SUICIDAL THOUGHTS AND ACTIONS IN CHILDREN, ADOLESCENTS, AND YOUNG ADULTS. Use with caution in patients with hypertension, tachycardia, or cardiovascular or cerebrovascular disease because of increased blood pressure and heart rate. Use with caution in patients experiencing urinary retention. Use with caution in nursing mothers. Pregnancy Category C.

Adverse Effects:

The most common adverse effects in children include dyspepsia, nausea, vomiting, fatigue, appetite suppression, dizziness, and mood swings. In adults the most common adverse effects also include dry mouth, constipation, impotence, urinary retention, insomnia, ejaculatory problems, decreased libido, and dysmenorrhea.

Patient Consultation:

  • May be taken without regard to meals.
  • May impair cognitive and motor performance. Use caution while operating machinery or when mental alertness is required.
  • Store in a cool, dry place away from sunlight and children.
  • Contact a physician if the above side effects are severe or persistent.
  • If a dose is missed, take is as soon as possible but do not take more than your normal daily dose in a 24 hour period.