Monograph Details
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Central Nervous System
> ADHD/narcolepsy
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STRATTERA |
| Manufacturer |
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Lilly, Eli and Company |
| Legal Classification |
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Rx
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| Pharmacological Class |
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SNRI (selective norepinephrine reuptake inhibitor). |
| Generic Name |
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Atomoxetine HCl 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg; caps. |
| Indications |
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Attention deficit hyperactivity disorder (ADHD). |
| Adults and Children |
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Swallow whole. Give once daily in the AM, or in 2 evenly divided doses (in AM and late afternoon/early PM). <6years: not recommended. Acute: ≥6years (≤70kg): initially 0.5mg/kg per day; increase after at least 3 days to 1.2mg/kg per day; max 1.4mg/kg or 100mg per day (whichever is less); (>70kg): initially 40mg/day; increase after at least 3 days to 80mg/day, then after 2–4 weeks may increase to max 100mg/day. Maintenance: 6–15years: continue with same dose, reevaluate periodically; see literature. Concomitant potent CYP2D6 inhibitors: titrate above initial dose at 4-week intervals only if needed. Hepatic insufficiency (moderate): reduce dose by 50%; (severe): reduce dose by 75%. May discontinue without tapering. |
| Contraindications |
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During or within 14 days of MAOIs. Narrow angle glaucoma. |
| Precautions |
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Hypertension. Tachycardia. Structural cardiac abnormalities. Cardio- or cerebrovascular disease. Poor metabolizers (CYP2D6). Hepatic insufficiency (discontinue if jaundice or elevated liver enzymes occur; do not restart). Psychoses. Bipolar disorder. Depression. Monitor growth, BP/pulse (esp. at baseline and after dose increases), worsening aggressive behavior or hostility. Children or adolescents: suicidal ideation (monitor before, during therapy and dose adjustments). Reevaluate periodically. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers. |
| Interactions |
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MAOIs: see Contraindications. May be potentiated by CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine). Increased cardiovascular effects with albuterol, pressor agents. |
| Adverse Reactions |
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GI upset, fatigue, decreased appetite, weight loss, dizziness, headache, somnolence, mood swings, tachycardia, hypertension, orthostatic hypotension, mydriasis; rare: severe liver injury. Adults also: dry mouth, insomnia, sexual dysfunction, urinary retention, dysmenorrhea, hot flush. |
| How Supplied |
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Caps—30 |
| Additional Resources |
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• Related Prescribing Note |
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