Atomoxetine Brand Name– Strattera
What is Atomoxetine
Atomoxetine (Strattera) is a selective norepinephrine reuptake inhibitor (SNRI) and the first nonstimulant drug approved for attention-deficit hyperactivity disorder (ADHD).
Atomoxetine was previously known as tomoxetine; however, the name was changed to prevent dispensing errors with the drug tamoxifen. It is structurally similar to fluoxetine, does not have a potential for abuse, and is not classified as a controlled substance.
Atomoxetine has been shown to be safe and effective in adolescents and children >= 6 years and adults with ADHD per DSM-IV criteria (for inattentive subtype and both inattentive and hyperactive/impulsive subtypes).
Prior to initial FDA approval, four randomized, placebo-controlled studies demonstrated effectiveness in children and adolescents; 2 studies were positive in adults.
Primary outcome measures included the ADHD Rating Scale IV Parent Version (ADHDRS) for children and the Total ADHD Symptom score for adults. Gastrointestinal and central nervous system adverse effects were reported most commonly.
Indications
- attention-deficit hyperactivity disorder (ADHD)
Side Effects
- abdominal pain
- abnormal dreams
- agitation
- alopecia
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- asthenia
- back pain
- blurred vision
- chest pain (unspecified)
- chills
- conjunctivitis
- constipation
- depression
- diarrhea
- dizziness
- drowsiness
- dysgeusia
- dysmenorrhea
- dyspepsia
- dysuria
- ejaculation dysfunction
- elevated hepatic enzymes
- emotional lability
- fatigue
- flushing
- growth inhibition
- hallucinations
- headache
- hepatic failure
- hepatic necrosis
- hepatitis
- hostility
- hyperbilirubinemia
- hyperhidrosis
- hypertension
- hypoesthesia
- impotence (erectile dysfunction)
- increased urinary frequency
- insomnia
- irritability
- jaundice
- lethargy
- libido decrease
- mania
- menstrual irregularity
- muscle cramps
- mydriasis
- myocardial infarction
- nausea
- orgasm dysfunction
- orthostatic hypotension
- palpitations
- paresthesias
- pelvic pain
- peripheral vasoconstriction
- priapism
- prolonged bleeding time
- prostatitis
- pruritus
- psychosis
- QT prolongation
- rash
- restlessness
- rhabdomyolysis
- seizures
- sinus tachycardia
- stroke
- suicidal ideation
- syncope
- testicular pain
- tremor
- urinary retention
- urinary urgency
- urticaria
- vomiting
- weight loss
- xerostomia
Monitoring Parameters
- blood pressure
- growth rate
- heart rate
- weight
Contraindications
- alcoholism
- arteriosclerosis
- bipolar disorder
- bradycardia
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cardiomyopathy
- cerebrovascular disease
- children
- closed-angle glaucoma
- congenital heart disease
- constipation
- coronary artery disease
- dehydration
- depression
- diabetes mellitus
- driving or operating machinery
- ethanol intoxication
- females
- geriatric
- GI obstruction
- growth inhibition
- heart failure
- hepatic disease
- hepatitis
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypovolemia
- ileus
- jaundice
- long QT syndrome
- malnutrition
- mania
- MAOI therapy
- myocardial infarction
- orthostatic hypotension
- pheochromocytoma
- pregnancy
- prostatic hypertrophy
- psychosis
- QT prolongation
- seizure disorder
- seizures
- stroke
- suicidal ideation
- syncope
- tachycardia
- thyroid disease
- urinary retention
- ventricular arrhythmias
- ventricular dysfunction
Interactions
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Oxycodone
- Acetaminophen; Pseudoephedrine
- Acrivastine; Pseudoephedrine
- Alfuzosin
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine; Celecoxib
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Anagrelide
- Apomorphine
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Oxycodone
- Atazanavir; Cobicistat
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azithromycin
- Bedaquiline
- Benzphetamine
- Betrixaban
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Celecoxib
- Ceritinib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chloroquine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Cimetidine
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clozapine
- Cobicistat
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Crizotinib
- Dacomitinib
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasatinib
- Degarelix
- Delavirdine
- Desflurane
- Desipramine
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Deutetrabenazine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmethylphenidate
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diethylpropion
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dobutamine
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Dopamine
- Doxepin
- Dronedarone
- Droperidol
- Droxidopa
- Duloxetine
- Edoxaban
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Entrectinib
- Ephedrine
- Epinephrine
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Ethanol
- Ezogabine
- Fexofenadine; Pseudoephedrine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluvoxamine
- Foscarnet
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Givosiran
- Glasdegib
- Goserelin
- Granisetron
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxychloroquine
- Hydroxyzine
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Ibutilide
- Iloperidone
- Imatinib
- Imipramine
- Inotuzumab Ozogamicin
- Iobenguane I 131
- Isocarboxazid
- Isoflurane
- Isoniazid, INH
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Leuprolide
- Leuprolide; Norethindrone
- Levofloxacin
- Levomilnacipran
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Loratadine; Pseudoephedrine
- Macimorelin
- Maprotiline
- Mefloquine
- Mepenzolate
- Meperidine; Promethazine
- Methadone
- Methamphetamine
- Methscopolamine
- Methylphenidate
- Metronidazole
- Midodrine
- Midostaurin
- Mifepristone
- Mirabegron
- Mirtazapine
- Monoamine oxidase inhibitors
- Moxifloxacin
- Naproxen; Pseudoephedrine
- Nicardipine
- Nilotinib
- Nitroglycerin
- Norepinephrine
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Oritavancin
- Osimertinib
- Oxaliplatin
- Oxycodone
- Paliperidone
- Panobinostat
- Paroxetine
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2b
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenelzine
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Pimavanserin
- Pimozide
- Pitolisant
- Posaconazole
- Prilocaine; Epinephrine
- Primaquine
- Procainamide
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Pseudoephedrine
- Quetiapine
- Quinidine
- Quinine
- Racepinephrine
- Ranolazine
- Rasagiline
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Rivaroxaban
- Rolapitant
- Romidepsin
- Saquinavir
- Scopolamine
- Selegiline
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Siponimod
- Solifenacin
- Sorafenib
- Sotalol
- Sunitinib
- Tacrolimus
- Tamoxifen
- Tapentadol
- Telavancin
- Telithromycin
- Terbinafine
- Tetrabenazine
- Thioridazine
- Tipranavir
- Tolterodine
- Toremifene
- Tranylcypromine
- Trazodone
- Trifluoperazine
- Trimipramine
- Triptorelin
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Voriconazole
- Vorinostat
- Ziprasidone
