Uses
What is atomoxetine used for?
Atomoxetine is commonly used to treat attention deficit and hyperactivity disorder (ADHD). It can help to increase attention, as well as decrease impulsiveness and hyperactivity.
Atomoxetine may also be used for other conditions as determined by your healthcare provider.
How does atomoxetine work (mechanism of action)?
Atomoxetine is a selective norepinephrine reuptake inhibitor. It may work by increasing the natural substance called norepinephrine in the brain.
How is atomoxetine supplied (dosage forms)?
Atomoxetine is available as Strattera and generic atomoxetine in the following dosage forms that are taken by mouth.
- 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg oral capsules
How should I store atomoxetine?
Atomoxetine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of atomoxetine?
The most common side effects of atomoxetine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Nausea
- Vomiting (children and teenagers)
- Tiredness (children and teenagers)
- Decreased appetite
- Upset stomach (children and teenagers)
- Dizziness
- Mood swings (children and teenagers)
- Constipation (adults)
- Dry mouth (adults)
- Sexual side effects such as problems getting or keeping an erection (adults)
- Trouble peeing (adults)
There may be other side effects of atomoxetine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of atomoxetine?
While less common, the most serious side effects of atomoxetine are described below, along with what to do if they happen.
Severe Allergic Reactions. Atomoxetine may cause allergic reactions, which can be serious. Stop using atomoxetine and get help right away if you or your child has any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Suicidal Thoughts or Actions. Atomoxetine may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you or your child has any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior such as increased aggression or hostility
Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking atomoxetine. Keep all appointments to have your blood checked. Call your healthcare provider right away if you or your child has any of the following symptoms of liver damage.
- Nausea or vomiting
- Stomach or belly pain
- Fever
- Weakness or unusual tiredness
- Itching
- Loss of appetite
- Light-colored poop
- Dark-colored pee
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Heart Attack and Stroke. Atomoxetine can increase your risk of a heart attack or stroke that can lead to death. This risk is increased in people with existing heart disease and with longer use of atomoxetine and higher doses. Do not take atomoxetine if you have had a recent heart attack without talking to your healthcare provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.
- Chest pain or pressure
- Fast or abnormal heartbeat
- Trouble breathing
- Pain in your back, jaw, throat, or arm
- Sweating, upset stomach, vomiting, or dizziness
- Sudden weakness on one side of your body
- Sudden and severe headache
- Slurred speech or trouble understanding speech
Increased Blood Pressure (Hypertension) and Increased Heart Rate (Tachycardia). Atomoxetine may increase your blood pressure and heart rate or make them worse if you have a history of high blood pressure and/or fast heart rate. Keep all appointments to have your blood pressure and heart rate measured. Call your healthcare provider if your blood pressure or heart rate increases while taking this medicine.
If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Increases in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.
- Sudden severe headache
- Chest pain
- Dizziness or confusion
- Trouble breathing
- Nausea/vomiting
- Blurry or other changes to vision
- Anxiety
- Buzzing in the ears
- Nosebleed
- Feeling of skipped heartbeats
New Psychotic or Manic Symptoms. People with no history of any psychotic illness or mania may experience symptoms. Before starting atomoxetine, people with bipolar disorder or risk factors for bipolar disorder, including personal or family history of mania and depression, should be adequately screened for risk of developing mania or mixed episodes while taking atomoxetine. Stop taking atomoxetine and get emergency help right away if you or your child have any of the following symptoms.
- Hearing voices
- Believing things that are not true
- Dramatic increase in energy
- Significant trouble sleeping
- Racing and fast-paced thoughts
- Engaging in reckless behavior
- Having unusually grand ideas
- Feeling excessively happy or irritable
- Talking more or faster than usual
Inability to Empty Bladder (Urinary Retention). Atomoxetine might make it harder to empty your bladder. You may have trouble starting or keeping a urine stream. Call your healthcare provider right away if you cannot empty your bladder.
Painful, Prolonged Erection (Priapism). Atomoxetine may cause an unwanted erection that is persistent, painful, and may occur without sexual arousal. Permanent damage to the penis may occur if priapism is not treated quickly. Stop taking atomoxetine and get emergency help right away if you have any of the following symptoms of priapism.
- Erection lasting for more than 4 hours
- Erection that is unrelated to sexual stimulation
- Painful or tender penis
Slowed Growth. Atomoxetine may slow a child's growth. Keep all appointments to have your child's height and weight measured.
Warnings & Precautions
Who should not use atomoxetine?
Allergies to Ingredients. People who are allergic to any of the following should not take atomoxetine.
- Atomoxetine
- Strattera
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific atomoxetine products they stock.
Narrow Angle Glaucoma. Do not take atomoxetine if you have narrow angle glaucoma.
Tumor in the Adrenal Glands (Pheochromocytoma). Do not take atomoxetine if you have pheochromocytoma or a history of the condition.
Drug Interactions. Atomoxetine should not be taken while you are using certain other medicines. Before taking atomoxetine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about atomoxetine before using it?
Do not take atomoxetine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share atomoxetine with other people, even if they have the same condition as you. It may harm them.
Keep atomoxetine out of the reach of children.
Do not chew, crush, or open atomoxetine capsules. Avoid coming in contact with an open or a broken atomoxetine capsule. Wash any surfaces that an open capsule touches, such as your hands. If you or your child gets any powder from the atomoxetine capsules in the eye, rinse well with water and call your healthcare provider right away.
Atomoxetine can affect you or your child’s alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how atomoxetine affects you or your child.
What should I tell my healthcare provider before using atomoxetine?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if atomoxetine is right for you or your child.
In particular, make sure that you discuss any of the following.
- High or low blood pressure
- Fast or irregular heartbeats
- Heart defects
- Stroke
- Heart disease
- Heart problems
- Family history of any heart problems or heart defects
- Suicidal thoughts or attempts
- Mental health problems such as depression, mania, bipolar, psychosis or any manic-depressive illness or any family history of mental health problems
- Liver problems
Pregnancy. It is not known if or how atomoxetine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use atomoxetine while you are pregnant or trying to get pregnant. If you become pregnant while taking atomoxetine, you can register for the National Pregnancy Registry of ADHD Medications by calling 866-961-2388 or at https://womensmentalhealth.org/adhdmedications/. This registry collects safety information about the use of ADHD medicines during pregnancy.
Breastfeeding. It is not known if atomoxetine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does atomoxetine interact with foods or drinks?
There are no known interactions between atomoxetine and foods or drinks.
There are no known interactions between atomoxetine and alcohol.
Does atomoxetine interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using atomoxetine.
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- A medicine for high blood pressure
- A beta 2 agonist that you swallow, such as albuterol or terbutaline (Brethine), which is a medicine used for asthma or chronic obstructive pulmonary disease (COPD) to aid in shortness of breath, wheezing, or coughing
- A decongestant that you spray in your nose or take by mouth, such as pseudoephedrine, phenylephrine, and oxymetazoline, which is used to treat congestion caused by a cold or allergies
Some other medicines may alter the blood levels of atomoxetine. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with atomoxetine. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much atomoxetine?
If you or someone else has used too much atomoxetine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of atomoxetine?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double doses.
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