Atomoxetine is used to treat attention-deficit hyperactivity disorder (ADHD) as part of a total treatment plan, including psychological, social, and other treatments. It may help to increase the ability to pay attention, concentrate, stay focused, and stop fidgeting.
Norepinephrine reuptake inhibitor
The precise mechanism by which Atomoxetine produces its therapeutic effects in Attention Deficit Hyperactivity Disorder (ADHD) is unknown. But, it is thought to be related to selective inhibition of the pre-synaptic nor-epinephrine transporter. Atomoxetine is well-absorbed after oral administration and is minimally affected by food. It is eliminated primarily by oxidative metabolism through the cytochrome P450 2D6 (CYP2D6) enzymatic pathway.
Attention deficit hyperactivity disorder (initiated by a specialist) BY MOUTH Child 6-17 years (body-weight up to 70 kg): Initially 500 micrograms/kg daily for 7 days, dose is increased according to response; maintenance 1.2 mg/kg daily, 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, high daily doses to be given under the direction of a specialist; maximum 1.8 mg/kg per day; maximum 120 mg per day Child 6-17 years (body-weight 70 kg and above): Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80 mg daily, 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, high daily doses to be given under the direction of a specialist; maximum 120 mg per day Adult (body-weight up to 70 kg): Initially 500 micrograms/kg daily for 7 days, dose is increased according to response; maintenance 1.2 mg/kg daily, total daily dosemay be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 1.8 mg/kg per day; maximum 120 mg per day Adult (body-weight 70 kg and above): Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80-100 mg daily, 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, high daily doses to be given under the direction of a specialist; maximum 120 mg per day
Slower titration of Atomoxetine may be necessary in those patients who are also taking CYP2D6 inhibitor medicines. Monoamine Oxidase Inhibitors- Atomoxetine should not be taken with monoamine oxidase inhibitors (MAOIs) or within two weeks after discontinuing MAOIs. Treatment with MAOIs should not be initiated within two weeks after discontinuing Atomoxetine. Anti-hypertensive drugs and Vasopressor Agents- Because of possible effects on blood pressure, Atomoxetine should be used cautiously with Anti-hypertensive drugs and vasopressor agents or other drugs that increase blood pressure. Tricyclic Antidepressants- Atomoxetine can increase the adverse cardiovascular effects of tricyclic antidepressants if co-administered.
Phaeochromocytoma . severe cardiovascular disease . severe cerebrovascular disease QT-interval prolongation . aggressive behaviour . cardiovascular disease . cerebrovascular disease . emotional lability . history of seizures . hostility . hypertension . mania . psychosis . structural cardiac abnormalities . susceptibility to angle-closure glaucoma . tachycardia
Common or very common Abdominal pain . anorexia . anxiety . chills . constipation . depression . dermatitis . dizziness . drowsiness . dry mouth . dyspepsia . flatulence . flushing . headache . increased blood pressure . irritability . lethargy . malaise . mydriasis . nausea . palpitation . paraesthesia . prostatitis . rash . sexual dysfunction . sleep disturbances . sweating . tachycardia . taste disturbances . tremor . urinary dysfunction . vomiting Uncommon Aggression . cold extremities . emotional lability . hostility . hypoaesthesia . menstrual disturbances . muscle spasms . pruritus . psychosis . QT-interval prolongation . suicidal ideation . syncope . tics Rare Raynaud’s phenomenon . seizures Very rare Angle-closure glaucoma . hepatic disorders
PREGNANCY Manufacturer advises avoid unless potential benefit outweighs risk. BREAST FEEDING Avoid-present in milk in animal studies.
The most commonly reported gastrointestinal symptoms including somnolence, dizziness, tremor, and abnormal behaviour. Hyperactivity and agitation have also been reported. Signs and symptoms consistent with mild to moderate sympatheticnervous system activation (e.g. tachycardia, blood pressure increased, mydriasis, dry mouth) were also observed. Most events were mild to moderate. In some cases of overdose involving Atomoxetine, seizures and very rarely QT prolongation have been reported. There is limited clinical trial experience with Atomoxetine overdose. No fatal overdoses occurred in clinical trials.
Store in a cool and dry place, protected from light.
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