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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Strattera
Generic Name
Atomoxetine Hydrochloride
Active Ingredient
AtomoxetineCategory
Other
Salt Form
Hydrochloride
Variants
7
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Strattera, you must consult a qualified healthcare professional.
| 18 mg/1 | CAPSULE | ORAL | 0002-3238 |
| 60 mg/1 | CAPSULE | ORAL | 0002-3239 |
| 100 mg/1 | CAPSULE | ORAL | 0002-3251 |
| 80 mg/1 | CAPSULE | ORAL | 0002-3250 |
Detailed information about Strattera
Atomoxetine is a selective norepinephrine reuptake inhibitor (SNRI) primarily used for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). As a non-stimulant medication, it provides an alternative for patients who do not tolerate or respond to traditional stimulant therapies.
For adults with ADHD, the standard starting dose of Atomoxetine is typically 40 mg once daily. This initial dose allows the body to acclimate to the medication and helps minimize gastrointestinal side effects. After a minimum of three days at this starting dose, healthcare providers usually increase the dosage to a target total daily dose of approximately 80 mg.
This target dose can be taken as a single dose in the morning or divided into two equal doses (morning and late afternoon/early evening) if side effects like nausea or insomnia occur. If the patient does not achieve an adequate clinical response after 2 to 4 weeks at 80 mg, the dose may be increased to a maximum of 100 mg daily. There is no clinical evidence that doses higher than 100 mg provide additional benefits, but they do significantly increase the risk of toxicity.
Atomoxetine is approved for children and adolescents weighing 70 kg (154 lbs) or less, and for those weighing more than 70 kg.
Atomoxetine is not approved for use in children under the age of 6, as safety and efficacy have not been established in this age group.
Specific dosage adjustments are generally not required for patients with renal insufficiency, as the kidneys are not the primary route of metabolism for the parent drug. However, Atomoxetine may increase blood pressure, so patients with end-stage renal disease should be monitored closely.
For patients with moderate hepatic impairment (Child-Pugh Class B), the initial and target doses should be reduced to 50% of the normal dose. For those with severe hepatic impairment (Child-Pugh Class C), the dose should be reduced to 25% of the normal dose.
Clinical studies did not include sufficient numbers of subjects aged 65 and older to determine whether they respond differently than younger subjects. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range.
Atomoxetine should be swallowed whole. Do not open, crush, or chew the capsules. The powder inside the capsule is a known ocular irritant; if a capsule is accidentally broken and the powder comes into contact with the eyes, they should be flushed immediately with water and medical advice sought.
If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not take two doses at once to make up for a missed one, as this increases the risk of adverse cardiovascular effects.
Signs of Atomoxetine overdose may include extreme drowsiness, agitation, hyperactivity, abnormal behavior, and gastrointestinal symptoms. More serious signs include tachycardia (rapid heart rate), hypertension (high blood pressure), and pupillary dilation (mydriasis). In some cases, seizures have been reported.
In the event of an overdose, contact a Poison Control Center (1-800-222-1222 in the US) or seek emergency medical attention immediately. Treatment is primarily supportive, focusing on maintaining an airway and monitoring cardiac and vital signs.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop the medication without medical guidance, as symptoms of ADHD may return.
Side effects of Atomoxetine often differ between pediatric and adult populations. In clinical trials, the most frequently reported adverse effects include:
Atomoxetine is a potent medication that affects the central nervous system and cardiovascular system. It is not a controlled substance, but it must be used under strict medical supervision. Patients should be screened for cardiovascular disease and psychiatric disorders before beginning treatment.
Suicidality in Children and Adolescents: Atomoxetine increased the risk of suicidal ideation (thoughts of suicide) in short-term studies of children and adolescents with ADHD. Anyone considering the use of Atomoxetine in a child or adolescent must balance this risk with the clinical need. Families and caregivers must be alerted to the need for daily observation and communication with the prescriber. Symptoms such as anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania have been reported in pediatric patients being treated with antidepressants and medications like Atomoxetine.
Atomoxetine is strictly contraindicated in the following scenarios:
Atomoxetine is classified as Pregnancy Category C (under the older FDA system). There are no adequate and well-controlled studies in pregnant women. Animal studies have shown some evidence of fetal toxicity at high doses. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
It is not known whether Atomoxetine or its metabolites are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Atomoxetine is administered to a nursing woman. The decision to breastfeed while taking Atomoxetine should be made in consultation with a pediatrician, considering the importance of the drug to the mother.
Atomoxetine is a highly selective inhibitor of the pre-synaptic norepinephrine transporter (NET). Its chemical structure is (R)-N-methyl-3-(2-methylphenoxy)-3-phenylpropylamine hydrochloride. It has a high affinity for the NET but low affinity for the serotonin (SERT) or dopamine (DAT) transporters. By blocking the NET, it prevents the reuptake of norepinephrine, thereby increasing the synaptic concentration of this neurotransmitter. In the prefrontal cortex, where dopamine transporters are scarce, Atomoxetine also results in increased dopamine levels because norepinephrine transporters can take up dopamine. Importantly, it does not affect dopamine in the striatum or nucleus accumbens, which explains its lack of abuse potential.
Atomoxetine does not act as a stimulant in the traditional sense. It does not cause a rapid increase in synaptic monoamines. Instead, its clinical effects develop over 2 to 4 weeks. It does not show a 'crash' or 'rebound' effect as the dose wears off, providing a smoother 24-hour symptom control compared to short-acting stimulants. It has minimal affinity for histaminergic, cholinergic, or alpha-adrenergic receptors, which limits certain types of side effects common in older psychiatric drugs.
Common questions about Strattera
Atomoxetine is primarily used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children, adolescents, and adults. It helps improve focus, reduce impulsivity, and decrease hyperactivity by increasing norepinephrine levels in the brain. Unlike most other ADHD medications, it is a non-stimulant and is not a controlled substance. This makes it an excellent option for patients who cannot tolerate stimulants or those with a history of substance abuse. Your doctor may also prescribe it off-label for certain mood or sleep disorders, though its main FDA-approved use remains ADHD.
The most common side effects include nausea, vomiting, upset stomach, and a decrease in appetite. Many patients also report feeling tired or sleepy, especially during the first few weeks of treatment. In adults, dry mouth and sexual side effects, such as erectile dysfunction or decreased libido, are frequently mentioned. Most of these side effects are dose-dependent and often improve as the body adjusts to the medication. Taking the capsule with a meal can significantly reduce the severity of gastrointestinal issues.
It is generally recommended to avoid or limit alcohol while taking Atomoxetine. While there is no specific dangerous chemical reaction between the two, alcohol can worsen side effects like dizziness, drowsiness, and impaired coordination. Furthermore, alcohol can interfere with the management of ADHD symptoms, potentially making the medication less effective. Since Atomoxetine is processed by the liver, combining it with heavy alcohol use may also increase the risk of liver strain. Always discuss your alcohol consumption habits with your healthcare provider before starting this treatment.
Atomoxetine is classified as Pregnancy Category C, meaning there is not enough human data to guarantee its safety during pregnancy. Animal studies have shown some potential for fetal harm at very high doses, but it is unclear if this applies to humans at standard doses. If you are pregnant or planning to become pregnant, you must weigh the risks of the medication against the risks of untreated ADHD. Some women may choose to stop the medication, while others may continue if their symptoms are severe. Consult your OB/GYN and psychiatrist to create a safe treatment plan.
Unlike stimulant medications that work within an hour, Atomoxetine takes time to build up in your system. Most patients begin to see some improvement in symptoms within 1 to 2 weeks of consistent use. However, the full therapeutic benefit is often not reached until 4 to 8 weeks after starting the medication or reaching the target dose. It is important to stay patient and take the medication every day as prescribed. If you do not feel any change after 6 weeks, talk to your doctor about a possible dose adjustment.
Atomoxetine does not typically cause a 'withdrawal' syndrome like stimulants or certain antidepressants might. However, if you stop taking it suddenly, your ADHD symptoms (such as inattention and impulsivity) will likely return to their baseline levels fairly quickly. It is always best to consult your healthcare provider before stopping any psychiatric medication. They may suggest a gradual reduction in dose to monitor how your symptoms return. Never stop the medication without medical supervision, especially if you are also taking other psychiatric drugs.
If you miss a dose, you should take it as soon as you remember that same day. However, if it is already close to the time for your next dose, skip the missed one and stay on your regular schedule. Do not take two doses at once to 'catch up,' as this can increase your heart rate and blood pressure to uncomfortable levels. Consistency is key with Atomoxetine to maintain steady levels in your brain. Setting a daily alarm or using a pill organizer can help you remember to take your medication at the same time each day.
Atomoxetine is much more likely to cause weight loss rather than weight gain, especially in children and adolescents. This is primarily due to the common side effect of decreased appetite. In clinical trials, many children experienced a temporary slowing of weight gain and height growth when starting the drug. Most patients eventually stabilize, but it is important for a doctor to monitor a child's growth on a regular basis. If weight loss becomes a significant concern, your doctor may suggest taking the medication after a large meal or adjusting the dosage.
Atomoxetine can interact with several types of medications, so it is vital to provide your doctor with a full list of everything you take. It should never be taken with MAOIs (a type of older antidepressant). Drugs that inhibit the CYP2D6 enzyme, such as Prozac (fluoxetine) or Paxil (paroxetine), can significantly increase the levels of Atomoxetine in your blood, requiring a lower dose. It can also interact with blood pressure medications and asthma inhalers like albuterol. Always check with a pharmacist before starting any new over-the-counter supplements or cold medicines.
Yes, Atomoxetine is available as a generic medication and is widely stocked by most pharmacies. The generic version is bioequivalent to the brand-name drug Strattera, meaning it contains the same active ingredient and works the same way in the body. Generic Atomoxetine is typically much more affordable than the brand-name version and is covered by most insurance plans. When switching from brand to generic, most patients do not notice any difference in efficacy or side effects. Ask your pharmacist if a generic version is available for your specific prescription.
Other drugs with the same active ingredient (Atomoxetine)
> Warning: Stop taking Atomoxetine and call your doctor immediately if you experience any of these serious symptoms.
Suicidal Ideation in Children and Adolescents: The FDA has issued a Black Box Warning for Atomoxetine regarding an increased risk of suicidal thinking and behavior in children and adolescents. In short-term studies, the risk was approximately 0.4% in patients taking Atomoxetine compared to 0% in the placebo group. No suicides occurred in these trials, but the risk of ideation is significant. Patients started on therapy must be observed closely for clinical worsening, suicidality, or unusual changes in behavior. This monitoring is most critical during the first few months of therapy or during dose adjustments.
Report any unusual symptoms or persistent side effects to your healthcare provider. Many side effects, particularly gastrointestinal ones, may diminish over time as your body adjusts to the medication.
Healthcare providers typically perform the following monitoring:
Atomoxetine may cause dizziness or somnolence (drowsiness) in some patients. Until you know how this medication affects you, use caution when driving a car, operating heavy machinery, or performing hazardous tasks.
While there is no direct chemical interaction between Atomoxetine and alcohol, alcohol can worsen certain side effects like dizziness, drowsiness, and impaired judgment. Additionally, alcohol can affect mood and impulse control, which may counteract the benefits of ADHD treatment. It is generally advised to avoid or strictly limit alcohol consumption while taking Atomoxetine.
Unlike stimulants, Atomoxetine does not typically require a slow taper to avoid withdrawal symptoms. However, ADHD symptoms will likely return once the medication is stopped. Always consult your doctor before stopping the medication to ensure a safe transition.
> Important: Discuss all your medical conditions, especially heart problems or mental health history, with your healthcare provider before starting Atomoxetine.
Atomoxetine is not known to interfere with most standard laboratory tests. However, it does not show up on standard 'amphetamine' drug screens because it is chemically distinct from stimulants. If you are undergoing a workplace drug test, you should still disclose your prescription to the testing facility.
| Interaction Type | Mechanism | Clinical Consequence |
|---|---|---|
| CYP2D6 Inhibition | Reduced clearance of Atomoxetine | Increased toxicity, higher side effect profile |
| Pharmacodynamic | Additive noradrenergic activity | Hypertensive crisis, tachycardia |
| Absorption | Gastric emptying delay (Food) | Delayed onset, reduced GI irritation |
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter cold medicines which may contain decongestants that increase blood pressure.
These conditions require a careful risk-benefit analysis by a specialist:
Patients who have demonstrated hypersensitivity (severe allergy) to Atomoxetine or any of the inactive ingredients in the capsule (such as starch or gelatin) must not take the medication. There is no known cross-sensitivity with stimulant medications (like Adderall or Ritalin), making Atomoxetine a safe alternative for those allergic to stimulants.
> Important: Your healthcare provider will evaluate your complete medical history, including heart health and eye health, before prescribing Atomoxetine.
Atomoxetine is approved for ADHD in children aged 6 years and older.
There is very limited data on the use of Atomoxetine in patients over 65. Because elderly patients are more likely to have decreased hepatic, renal, or cardiac function, and are more likely to be taking multiple medications (polypharmacy), they should be started on the lowest possible dose. Blood pressure and heart rate must be monitored closely due to the higher baseline risk of cardiovascular events in this age group.
In subjects with end-stage renal disease, Atomoxetine exposure was higher than in healthy subjects, but the difference was not considered clinically significant for those with mild to moderate impairment. No specific starting dose adjustment is required, but titration should be done slowly and with careful monitoring of blood pressure.
Hepatic impairment significantly increases Atomoxetine exposure.
Failure to adjust the dose in these patients can lead to toxic accumulation of the drug.
> Important: Special populations require individualized medical assessment and more frequent follow-up appointments.
|---|---|
| Bioavailability | 63% (Extensive Metabolizers) to 94% (Poor Metabolizers) |
| Protein Binding | 98.5% (primarily to Albumin) |
| Half-life | 5 hours (EMs) / 24 hours (PMs) |
| Tmax | 1 to 2 hours |
| Metabolism | Hepatic (CYP2D6) |
| Excretion | Renal (>80%), Fecal (<17%) |
Atomoxetine is classified as a Selective Norepinephrine Reuptake Inhibitor (SNRI). Within the field of ADHD treatment, it is categorized as a non-stimulant. It is chemically related to certain antidepressants (like fluoxetine) but is specifically optimized for its effects on the norepinephrine transporter to treat cognitive and behavioral symptoms of ADHD.