Atomoxetine
Indications
Atomoxetine is a non-stimulant medicine used to treat attention deficit hyperactivity disorder (ADHD) in children aged 6 years and over, teenagers and adults. ADHD causes difficulty paying attention, restlessness and acting without thinking. Atomoxetine is used as part of a full treatment plan that may also include behavioural, educational and social support.
How It Works
Atomoxetine blocks the reuptake (recycling) of noradrenaline, a chemical messenger in the brain. This raises noradrenaline and dopamine in the front part of the brain, which helps improve attention and reduce impulsive and hyperactive behaviour. Unlike stimulant medicines, it is not habit-forming. Its full effect builds up over several weeks.
Dosage and Administration
The dose is worked out by the specialist, based on body weight in children and adjusted step by step, so take it exactly as prescribed. It is usually taken once a day in the morning, or split into two doses (morning and late afternoon) if it causes stomach upset or sleepiness. It can be taken with or without food. Swallow capsules whole; do not open them, as the powder irritates the eyes. Do not stop suddenly without talking to your doctor.
Interactions
- MAO inhibitors (such as Selegiline or Linezolid): must not be taken together or within 2 weeks of each other.
- Fluoxetine, Paroxetine, Quinidine and Bupropion: raise atomoxetine levels; a lower dose may be needed.
- Salbutamol tablets or injections and other beta agonists: may increase heart rate and blood pressure.
- Medicines that raise blood pressure or affect heart rhythm (such as decongestants, some antipsychotics, Methadone or certain antibiotics).
Contraindications
Do not take if you are allergic to atomoxetine, have narrow-angle glaucoma, have a tumour of the adrenal gland (phaeochromocytoma), have serious heart or blood vessel disease or a stroke history where a rise in blood pressure could be dangerous, or have taken an MAO inhibitor in the last 2 weeks.
Side Effects
- Loss of appetite, stomach pain, nausea, vomiting.
- Headache, sleepiness, dizziness, tiredness.
- Mood swings, irritability.
- Increase in heart rate and blood pressure.
- In adults: dry mouth, trouble sleeping, difficulty passing urine, sexual problems.
- Slower growth or weight gain in some children.
Get urgent medical help for thoughts of suicide or self-harm, new or worse aggression or hostility, chest pain, fainting, a fast or irregular heartbeat, dark urine, yellow skin or eyes with stomach pain (signs of liver injury), a painful erection lasting more than 4 hours, seizures, or a severe allergic reaction.
Pregnancy and Lactation
There is limited information in pregnancy and breastfeeding. Tell your doctor if you are pregnant, planning pregnancy or breastfeeding; it should be used only if the benefit clearly outweighs the risk.
Precautions and Warnings
Children and teenagers taking atomoxetine have a small increased risk of suicidal thoughts, especially in the first months or after dose changes, so families should watch closely for mood or behaviour changes. Heart rate, blood pressure, height and weight should be checked regularly. Tell the doctor about any heart problems, high blood pressure, liver disease, seizures, bipolar disorder, depression or a family history of sudden death. It may affect alertness, so take care when driving.
Overdose
Overdose may cause sleepiness, agitation, shaking, fast heartbeat, stomach upset and, rarely, seizures or heart rhythm changes. Seek emergency medical help.
Therapeutic Class
Selective noradrenaline reuptake inhibitor (non-stimulant ADHD medicine).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Atomoxetine