Atomoxetine
Other CNS Drugs · Selective noradrenaline reuptake inhibitor
Indications
Treatment of attention deficit hyperactivity disorder (ADHD).
Dosage
Attention deficit hyperactivity disorder: Adults: >70 kg: Initial: 40 mg/day given every morning or evenly divided doses in morning & late afternoon/early evening Titrate: Increase after minimum of 3 day to target dose of about 80 mg/day. After 2-4 wk, may increase to max of 100 mg/day. Max: 100 mg/day. Children: Doses above 100 mg daily is not recommended for use. Total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening. Attention deficit hyperactivity disorder: Over 6 yr (body-weight under 70 kg), initially 500 mcg/kg daily for 7 days, increased according to response; usual maintenance dose 1.2 mg/kg daily, but may be increased to 1.8 mg/kg daily, max 120 mg daily; Over 6 yr (body-weight over 70 kg), initially 40 mg daily for 7 days, increased according to response; usual maintenance dose 80 mg daily, but may…
Adverse Effects
Abdominal pain, decreased appetite, weight loss, anorexia, early waking, somnolence, dizziness, irritability, mood swings, mydriasis, GI upset, skin reactions, increased pulse and BP, palpitations, chest pain, somnolence, agitation, anxiety, sleep disorder, dry mouth, hyperhidrosis, fatigue, asthenia, dysgeusia, chills, paraesthesia, tremor, hot flushes, dysuria, urinary retention, increased thirst, sexual dysfunction, menstrual disturbances, prostatitis, male genital pain. Discontinue if signs of jaundice and liver injury.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Caution advised or effect undetermined. Contraindications: Use of MAOIs within 14 days. Narrow-angle glaucoma, active or history of phaeochromocytoma, severe cardiovascular or cerebrovascular disease. Precautions: Hepatic or renal insufficiency, hypertension, tachycardia, cardiovascular or cerebrovascular disease. History of seizures; discontinue if occur. Congenital, acquired or family history of QT prolongation. Monitor pulse and BP periodically. Monitor growth, development, cognition and sexual maturation during long term treatment. Monitor for suicidal ideation, hostility, aggressive behaviour, depression, anxiety and emotional lability. CYP2D6 poor metabolisers. Elderly.
Interactions
MAOIs, fluoxetine, quinidine, terbinafine, other CYP2D6 inhibitors, salbutamol, other beta2-agonists, pressor agents, antidepressants, decongestants, drugs that prolong the QT interval, cause electrolyte imbalance or reduce seizure threshold, TCADS, SSRIs, antipsychotics, antihypertensives, venlafaxine, mirtazapine, pseudoephedrine, phenylephrine.
Advice to Patient
Take with or without meals. Take medication at same time daily. Do not open capsules, swallow whole. If capsule contents come in contact with your skin, immediately wash it. Contact prescriber if there is stomach upset, change in mood, anxiety, agitation, confusion, abnormal thoughts, yellowing of skin or eyes, depression, change in memory, chest pain, palpitations, fast heartbeat, prolonged or painful penile erection in male, muscle or skeletal pain or weakness, facial swelling, itching, rash, urinary retention, dark coloured urine. Avoid alcohol during therapy. Change position slowly from sitting or lying to standing. Check weight regularly during therapy.
Pharmacokinetics
The pharmacokinetics in pediatric patients =6 years of age have been shown to be similar to those of adult patients. Duration: Up to 24 hours. Absorption: Rapid. Metabolism: Hepatic. Bioavailability: 63% in extensive metabolizers; 94% in poor metabolizers. Half-life elimination: Atomoxetine: 5 hours (up to 24 hours in poor metabolizers). Active metabolites: 4-hydroxyatomoxetine: 6-8 hours. N-desmethylatomoxetine: 6-8 hours (34-40 hours in poor metabolizers). Time to peak, plasma: 1-2 hours; delayed 3 hours by high-fat meal. Excretion: Urine (80%, as conjugated 4-hydroxy metabolite; <3% is excreted unchanged); feces (17%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.