Atomoxetine

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

  1. abdominal pain
  2. abnormal dreams
  3. agitation
  4. alopecia
  5. anaphylactoid reactions
  6. angioedema
  7. anorexia
  8. anxiety
  9. asthenia
  10. back pain
  11. blurred vision
  12. chest pain (unspecified)
  13. chills
  14. conjunctivitis
  15. constipation
  16. depression
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dysgeusia
  21. dysmenorrhea
  22. dyspepsia
  23. dysuria
  24. ejaculation dysfunction
  25. elevated hepatic enzymes
  26. emotional lability
  27. fatigue
  28. flushing
  29. growth inhibition
  30. hallucinations
  31. headache
  32. hepatic failure
  33. hepatic necrosis
  34. hepatitis
  35. hostility
  36. hyperbilirubinemia
  37. hyperhidrosis
  38. hypertension
  39. hypoesthesia
  40. impotence (erectile dysfunction)
  41. increased urinary frequency
  42. insomnia
  43. irritability
  44. jaundice
  45. lethargy
  46. libido decrease
  47. mania
  48. menstrual irregularity
  49. muscle cramps
  50. mydriasis
  51. myocardial infarction
  52. nausea
  53. orgasm dysfunction
  54. orthostatic hypotension
  55. palpitations
  56. paresthesias
  57. pelvic pain
  58. peripheral vasoconstriction
  59. priapism
  60. prolonged bleeding time
  61. prostatitis
  62. pruritus
  63. psychosis
  64. QT prolongation
  65. rash
  66. restlessness
  67. rhabdomyolysis
  68. seizures
  69. sinus tachycardia
  70. stroke
  71. suicidal ideation
  72. syncope
  73. testicular pain
  74. tremor
  75. urinary retention
  76. urinary urgency
  77. urticaria
  78. vomiting
  79. weight loss
  80. 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
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