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Atomoxetine

Medical and Pharmacy Editor:

Brand Name: Strattera

Generic Name: Atomoxetine

Drug Class: ADHD Agents

What Is Atomoxetine and How Does It Work?

Atomoxetine is used to treat attention-deficit hyperactivity disorder (ADHD) as part of a total treatment plan, including psychological, social, and other treatments. Atomoxetine may help to increase the ability to pay attention, concentrate, stay focused, and stop fidgeting. It is thought to work by restoring the balance of certain natural substances (neurotransmitters) in the brain.

Atomoxetine is available under the following different brand names: Strattera.

Dosages of Atomoxetine:

a

Dosage Forms and Strengths

Capsule

  • 10 mg
  • 18 mg
  • 25 mg
  • 40 mg
  • 60 mg
  • 80 mg
  • 100 mg

Dosage Considerations – Should be Given as Follows:

Attention-Deficit/Hyperactivity Disorder

  • Adult: 40 mg orally once daily initially; increased after 3 days or more to 80 mg orally once daily or divided every 12 hours; may be increased to up to 100 mg if optimal response is not achieved
  • Dosing considerations
    • When drug is coadministered with strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine) or used in patients known to be poor CYP2D6 metabolizers, decrease dosage; initiate with 40 mg/day, but do not exceed 80 mg/day
  • Pediatric:
    • Children over 6 years and up to 70 kg: 0.5 mg/kg orally once daily; increased after 3 days or more to target dosage of approximately 1.2 mg/kg orally once daily or divided every 12 hours; total daily dose not to exceed 1.4 mg/kg or 100 mg, whichever is less; no benefit observed with higher doses
    • Greater than 70 kg: 40 mg orally once daily initially; increased after 3 days or more to 80 mg orally once daily or divided every 12 hours; if necessary, may be increased after 2-4 additional weeks to 100 mg orally once daily
  • Dosing considerations
    • When drug is coadministered with strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine, quinidine) or used in patients known to be poor CYP2D6 metabolizers, decrease dosage
    • Up to 70 kg: 0.5 mg/kg/day initially; increased to usual target dosage of 1.2 mg/kg/day only if symptoms fail to improve after 4 weeks and initial dosage is well tolerated
    • Greater than 70 kg: 40 mg/day initially; not to exceed 80 mg/day

Dosing Modifications

  • Renal impairment: Dosage adjustment not necessary
  • Mild hepatic impairment (Child-Pugh class A): Dosage adjustment not necessary
  • Moderate hepatic impairment (Child-Pugh class B): Decrease initial and target dosage by 50%
  • Severe hepatic impairment (Child-Pugh class C): Decrease initial and target dosage by 75%

Administration

  • Must be swallowed whole with aid of liquids; must not be chewed, divided, or crushed
  • Administer once daily in morning, with or without food

Limitation of Use

  • In obstructive sleep apnea, indicated to treat excessive sleepiness and not as treatment for the underlying obstruction
Medically Reviewed by a Doctor on 8/11/2017



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