STRATTERA (Atomoxetine)

What is this medication?

Atomoxetine, Strattera
Selective Norepinephrine Reuptake Inhibitor

Atomoxetine, Strattera is officially indicated for the treatment of attention-deficit hyperactivity disorder.

“ALERT: US Boxed Warning

Suicidal ideation in children and adolescents:

Atomoxetine increased the risk of suicidal ideation in short-term studies in children or adolescents with attention deficit hyperactivity disorder (ADHD). Anyone considering the use of atomoxetine in a child or adolescent must balance this risk with the clinical need. Comorbidities occurring with ADHD may be associated with an increase in the risk of suicidal ideation and/or behavior. Closely monitor patients who are started on therapy for suicidality (suicidal thinking and behavior), clinical worsening, or unusual changes in behavior. Advise families and caregivers of the need for close observation and communication with the prescribing health care provider. Atomoxetine is approved for ADHD in pediatric and adult patients. Atomoxetine is not approved for major depressive disorder (MDD).

Pooled analyses of short-term (6- to 18-week), placebo-controlled trials of atomoxetine in children and adolescents (12 trials involving more than 2,200 patients, including 11 trials in ADHD and 1 trial in enuresis) have revealed a greater risk of suicidal ideation early during treatment in those receiving atomoxetine compared with placebo. The average risk of suicidal ideation in patients receiving atomoxetine was 0.4% compared with none in placebo-treated patients. No suicides occurred in these trials.”

How does this medication work? 

Strattera/Atomoxetine is a selective norepinephrine reuptake inhibitor with little to no activity at other neuronal reuptake pumps or receptors sites.

How should I take this medication? 

Attention Deficit Hyperactivity Disorder

Oral: Take 40mg daily and increase the dose after 3 days to 80mg daily.  Can be taken as a single daily dose in the morning or as an evenly split dose in the morning and evening.  The maximum daily dose is 100mg.

How to Take Atomoxetine, Strattera: Can be taken with or without food.  Do not crush, chew or open capsule, swallow whole.  Can be taken as a single daily dose in the morning or in two evenly spaced doses in the morning and later afternoon/evening.  

What should I watch for while using this medication?

Can cause aggressive behavior and hostility

Use with caution in patients with pre-existing cardiovascular disease, bipolar disorder, urinary retention, or bladder outlet obstruction

Patients who develop abnormally sustained or frequent and painful erections should discontinue therapy and seek immediate medical attention. 

Use with caution in patients with hepatic impairment

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Well tolerated, most side effects are mild to moderate in nature.  The most common side effects include:

>10%:

Central nervous system: Headache (19%; children and adolescents), insomnia (1% to 19%), drowsiness (8% to 11%)

Dermatologic: Hyperhidrosis (4% to 15%)

Gastrointestinal: Xerostomia (17% to 35%), nausea (7% to 26%), decreased appetite (15% to 23%), abdominal pain (7% to 18%), vomiting (4% to 11%), constipation (1% to 11%)

Genitourinary: Erectile dysfunction (8% to 21%)

Note this is not a complete list of side effects, only common ones