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Strattera is the first non–stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). It is sold in the form of the hydrochloride salt of atomoxetine. This chemical is manufactured and marketed under the brand name Strattera; by Eli Lilly and Company and as a generic Attentin by Torrent Pharmaceuticals. There is currently no generic available within the United States due to patent restrictions.
Atomoxetine is used to treat attention-deficit hyperactivity disorder (ADHD) as part of a total treatment plan, including psychological, social, and other treatments. It 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.
How to use Atomoxetine Capsule
Read the Medication Guide provided by your pharmacist before you start using atomoxetine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication with or without food as directed by your doctor, usually 1 to 2 times a day. The first dose is usually taken when you wake up in the morning. If a second dose is prescribed, take it as directed by your doctor, usually in the late afternoon/early evening. Taking this medication late in the day may cause trouble sleeping (insomnia).
Swallow the capsules whole. Do not crush, chew, or open the capsules. If the capsule is accidentally opened or broken, avoid contact with the powder and wash away any loose powder as soon as possible with water. If the powder gets in your eyes, flush with plenty of water right away and contact your doctor.
The dosage is based on your medical condition, response to treatment, and other drugs you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Do not increase your dose or take this drug more often than directed.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.
Tell your doctor if your condition does not improve or if it worsens.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.
Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products or diet aids).
10 mg,18 mg,25 mg,40 mg,60 mg,80 mg, 100 mg
Dosage Considerations – Should be Given as Follows:
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
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
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
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
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%
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
Before taking atomoxetine,
tell your doctor and pharmacist if you are allergic to atomoxetine, any other medications, or any of the ingredients in atomoxetine capsules.
tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking them within the past 2 weeks. Your doctor will probably tell you not to take atomoxetine. If you stop taking atomoxetine, you should wait at least 2 weeks before you start taking an MAO inhibitor.
tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: albuterol syrup or tablets (Proventil, Ventolin), amiodarone (Cordarone, Pacerone), bupropion (Wellbutrin), chlorpheniramine (antihistamine in cold medications),cimetidine (Tagamet), clomipramine (Anafranil), fluoxetine (Prozac, Sarafem), haloperidol (Haldol), metaproterenol syrup or tablets , medications for high blood pressure, methadone (Dolophine), metoclopramide (Reglan), nefazodone, paroxetine (Paxil), quinidine, ritonavir (Norvir), and sertraline (Zoloft). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had glaucoma (an eye disease that may cause vision loss), or pheochromocytoma (a tumor on a small gland near the kidneys). Your doctor will probably tell you not to take atomoxetine.
tell your doctor if anyone in your family has or has ever had an irregular heartbeat or has died suddenly. Tell your doctor if you have recently had a heart attack and if you have or have ever had a heart defect, high blood pressure, an irregular heartbeat, hardening of the arteries, heart or blood vessel disease, or other heart problems. Your doctor will examine you to see if your heart and blood vessels are healthy. Your doctor will probably tell you not to take atomoxetine if you have a heart condition or if there is a high risk that you may develop a heart condition.
tell your doctor if you or anyone in your family has or has ever had depression, bipolar disorder (manic depressive disorder; a condition that causes episodes of depression, episodes of frenzied, abnormal excitement and other abnormal moods), or has ever thought about or attempted suicide. Also tell your doctor if you have or have ever had seizures, or liver disease.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking atomoxetine, call your doctor.
you should know that atomoxetine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
you should know that atomoxetine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
you should know that atomoxetine should be used as part of a total treatment program for ADHD, which may include counseling and special education. Make sure to follow all of your doctor’s and/or therapist’s instructions.
you should know that your blood pressure may increase during your treatment with atomoxetine. Your doctor will monitor your blood pressure during your treatment.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
erectile dysfunction (trouble getting or keeping an erection) or reduced sex drive
fainting or feeling lightheaded after getting up from a sitting or lying position
painful menstruation (periods)
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
increased blood pressure
palpitations (feeling your heart beat quickly or irregularly)
problems with urination
signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, loss of appetite, pale stools, dark urine)
Stop taking the medication and seek immediate medical attention if any of the following occur:
an erection lasting longer than 4 hours
symptoms of a serious allergic reaction (e.g., hives, swelling of the face and throat, difficulty breathing)
thoughts of suicide or hurting yourself
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
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