Atomoxetine Overview

Pronunciation: AT-oh-mox-e-teen
Drug Class: Adrenergic uptake inhibitors for ADHD
Dosage Forms: Capsules (10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg)
Generic Name: Atomoxetine
FDA Approval Date: November 26, 2002

Uses

Atomoxetine is primarily used to treat Attention Deficit Hyperactivity Disorder (ADHD) in both adults and children. It helps improve attention and focus and reduces hyperactivity and impulsiveness. Unlike other ADHD medications, Atomoxetine is not a stimulant and is not classified as a controlled substance. It’s often part of a broader treatment plan that includes psychological, educational, and social measures.

Mechanism of Action

Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI). It works by inhibiting the presynaptic norepinephrine transporter, which increases norepinephrine levels in the brain, thereby helping with ADHD symptoms. This mechanism is different from stimulant medications like methylphenidate or amphetamines, which primarily increase dopamine levels.

Side Effects

Common Side Effects:

• Gastrointestinal: Nausea, vomiting, upset stomach, constipation, dry mouth
• Appetite: Loss of appetite
• Mood: Mood changes, irritability
• Neurological: Dizziness, feeling tired
• Urinary: Urination problems
• Sexual: Impotence (trouble having an erection)

Serious Side Effects:

• Allergic Reactions: Hives, difficulty breathing, swelling of the face, lips, tongue, or throat
• Psychiatric: New or worsening anxiety, panic attacks, trouble sleeping, impulsive behavior, irritability, aggression, suicidal thoughts
• Cardiovascular: Chest pain, trouble breathing, fainting, signs of heart problems (like stroke or heart attack)
• Neurological: Hallucinations, new behavior problems, paranoia
• Liver: Stomach pain (upper right side), itching, flu-like symptoms, dark urine, jaundice
• Urological: Painful or difficult urination
• Priapism: A painful erection lasting more than 4 hours (rare)

Warnings

Contraindications:

• Narrow-angle glaucoma
• Adrenal gland tumor (pheochromocytoma)
• Severe heart or blood vessel problems
• Moderate to severe high blood pressure
• Recent use of MAO inhibitors (within the past 14 days)

Psychiatric: Atomoxetine may cause new or worsening psychosis, especially in those with a history of mental illness or bipolar disorder.

Cardiovascular: Risk of stroke, heart attack, and sudden death in individuals with pre-existing heart conditions.

Suicide Risk: Young people may have increased thoughts of suicide when starting Atomoxetine, particularly when the dose is adjusted.

Precautions Before Taking

Inform your doctor if you have:

• Heart issues: Including congenital heart defects, high blood pressure, or a family history of heart disease or sudden death.
• Psychiatric history: Such as depression, mental illness, bipolar disorder, or suicidal thoughts.
• Liver disease or other conditions that may require dosage adjustments.

Pregnancy & Breastfeeding

• Pregnancy: The effects of Atomoxetine on an unborn baby are unknown. Consult your doctor if you are pregnant or planning to become pregnant.
• Breastfeeding: Atomoxetine may not be safe to use while breastfeeding. Discuss the risks with your doctor.

Dosage

For Adults:

• Initial Dose: 40 mg/day orally
• Maintenance Dose: 80 mg/day after 3 days at the initial dose
• Maximum Dose: 100 mg/day after 2-4 weeks if needed

For Children:

• Under 70 kg:
  • Initial Dose: 0.5 mg/kg/day orally
  • Maintenance Dose: 1.2 mg/kg/day after 3 days
  • Maximum Dose: 1.4 mg/kg/day or 100 mg/day, whichever is less
• Over 70 kg:
  • Initial Dose: 40 mg/day orally
  • Maintenance Dose: 80 mg/day after 3 days
  • Maximum Dose: 100 mg/day after 2-4 weeks if needed

Note: Dosage may need adjustment in patients with hepatic impairment or those taking strong CYP2D6 inhibitors.

Drug Interactions

Atomoxetine can interact with various medications, including:

• Antidepressants
• Asthma medications
• Blood pressure medications
• Cold or allergy medications containing decongestants

Always inform your doctor of all medications you are taking to avoid potential interactions.

Missed Dose & Overdose

• Missed Dose: Take as soon as you remember, but skip it if it’s almost time for the next dose. Do not double the dose.
• Overdose: Seek emergency medical help. Symptoms may include drowsiness, dizziness, stomach problems, tremors, or unusual behavior.

Storage

Store Atomoxetine at room temperature (59 to 86°F or 15 to 30°C). Keep it in a safe place away from children and pets.

Note: 

The brand name displayed above is specific to this product. Brand names can vary depending on the manufacturer.