Atomoxetine hydrochloride

Brand names: Strattera

Why is Atomoxetine hydrochloride prescribed?

Strattera is used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD), a condition marked by either constant activity, a persistent inability to stay focused, or both. Medications such as Strattera should always be part of a comprehensive treatment program that includes psychological, educational, and social measures designed to remedy the problem.

Strattera is the first ADHD medication to avoid classification as a controlled substance (a drug with potential for abuse). It is thought to work by boosting levels of norepinephrine, one of the brain chemicals responsible for regulating activity. It is prescribed for children and adults.

Most important fact about Atomoxetine hydrochloride

During clinical trials, researchers found that Strattera slowed children's average rate of growth. It's not known whether final adult height and weight are affected, but the manufacturer recommends interrupting use of the drug if a child is not growing or gaining weight at the expected rate.

How should you take Atomoxetine hydrochloride?

Take Strattera exactly as prescribed; higher-than-recommended doses provide no additional benefit. Strattera may be taken with or without food.

• If you miss a dose...Take the forgotten dose as soon as you remember, but take no more than the prescribed daily total during any 24-hour period.

• Storage instructions...Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Strattera.

• Side effects in children may include:Appetite loss, constipation, cough, crying, diarrhea, dizziness, drowsiness, dry mouth, ear infection, fatigue, headache, indigestion, influenza, irritability, mood swings, nausea, runny nose, skin inflammation, stomach pain, vomiting, weight loss

• Side effects in adults may include:Abnormal dreams, abnormal orgasms, appetite loss, chills, constipation, diminished sex drive, dizziness, dry mouth, ejaculation disorders, erection problems, fatigue or sluggishness, fever, headache, hot flushes, impotence, indigestion, insomnia, gas, menstrual problems, muscle pain, nausea, palpitations, prostate inflammation, sinusitis, skin inflammation, sleep disorder, sweating, tingling, urinary problems, weight loss

Why should Atomoxetine hydrochloride not be prescribed?

Do not take Strattera within 2 weeks of taking any drug classified as an MAO inhibitor, such as the antidepressants Nardil and Parnate. The combination can cause severe—even fatal—reactions, including symptoms such as high fever, rigid muscles, rapid changes in heart rate, delirium, and coma.

You should also avoid Strattera if you have narrow angle glaucoma (high pressure in the eye), or if the drug causes an allergic reaction.

Special warnings about Atomoxetine hydrochloride

Strattera can speed up the heart and boost blood pressure. Use it with caution if you have high blood pressure, a rapid heart rate, heart disease, or any other circulation problem.

On the other hand, Strattera can also cause an attack of low blood pressure when you first stand up. Use it with caution if you have a condition, such as severe dehydration, that can cause low blood pressure.

Strattera should be discontinued if you develop signs of liver damage, including jaundice (yellowing of the skin and eyes), dark urine, flu-like symptoms, and/or itchy spots. See your doctor at the first sign of these symptoms for testing and possible treatment options.

If your child has ADHD and is becoming increasingly aggressive or hostile, this may be caused by Strattera. Contact your doctor immediately for proper evaluation.

Because Strattera sometimes causes sluggishness, be careful when operating machinery or driving until you know how the drug affects you.

Possible food and drug interactions when taking Atomoxetine hydrochloride

Remember that Strattera must never be combined with MAO inhibitors (see "Why should Atomoxetine hydrochloride not be prescribed?"). Also, the doctor will probably prescribe a lower dose of Strattera if you are taking one of the following:

Fluoxetine (Prozac)Paroxetine (Paxil)Quinidine (Quinidex)

Due to the possibility of boosted effects, you should check with your doctor before combining Strattera with the following:

Proventil and similar asthma medicationsDrugs that raise blood pressure, such as the phenylephrine in some over-the-counter cold medications.

If you are unsure about a particular medication—whether prescription or over-the-counter—make a point of asking your doctor.

Special information if you are pregnant or breastfeeding

Strattera has not been studied in pregnant women. If you are pregnant or plan to become pregnant, notify your doctor immediately. Strattera should not be taken during pregnancy unless its benefits justify the potential risk to the baby.

It is not known whether Strattera makes its way into breast milk. Caution is warranted if you plan to nurse.

Recommended dosage for Atomoxetine hydrochloride

The daily dose of Strattera can be taken as a single dose in the morning, or divided into two equal doses taken in the morning and late afternoon or early evening.

CHILDREN

For children and teenagers weighing up to 154 pounds, the usual starting dosage is 0.5 milligrams per 2.2 pounds of body weight per day. After at least 3 days, the doctor may increase the daily total to a recommended level of 1.2 milligrams per 2.2 pounds. Daily doses should never exceed 1.4 milligrams per 2.2 pounds or a total of 100 milligrams, whichever is less.

Strattera has not been tested in children under 6.

ADULTS

For adults and teenagers weighing over 154 pounds, the usual starting dosage is 40 milligrams per day. After at least 3 days, the doctor may increase the daily total to a recommended level of 80 milligrams. After another 2 to 4 weeks, dosage may be increased to a maximum of 100 milligrams daily

If you have liver problems, your dosage will be reduced.

Overdosage

There is limited information on Strattera overdose. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical treatment immediately.

• Signs of a Strattera overdose may include:
• Abnormal behavior, agitation, dilated pupils, dry mouth, hyperactivity, rapid heartbeat, sleepiness, stomach problems