Brand and Generic Names
- Brand name = Strattera®
10 mg (white)
18 mg (white and orange)
25 mg (blue and white)
40 mg (blue)
60 mg (blue and orange)
80 mg (brown and white)
100 mg (brown)
- Generic name = atomoxetine
What is Strattera® and what does it treat?
Atomoxetine is a prescription medication that is used to treat children over 6 years old, adolescents, and adults with attention-deficit hyperactivity disorder (ADHD). It is the first and so far, only, medicine FDA approved for ADHD that is not a stimulant.
ADHD is associated with severe inattention, hyperactivity, and impulsivity that interfere with an individual’s ability to function in school, at work, or in social settings. Examples of functionally impairing ADHD symptoms include making careless mistakes, losing things necessary for tasks, the inability to sit still and focus, and interrupting or intruding on others.
Adults have similar symptoms but display less hyperactivity compared to children. Adults with ADHD may be more prone to procrastination, becoming easily frustrated and taking on many tasks at once while accomplishing none of them. A person may have severe inattention without hyperactivity or impulsivity and still meet criteria for the diagnosis of ADHD. Atomoxetine may be less likely to exacerbate or cause tics compared to stimulant medications.
Scientific literature shows that atomoxetine is effective in decreasing inattention and hyperactive/impulsive symptoms as measured on various rating scales. Atomoxetine is an option for those who have not responded to or cannot tolerate stimulants, or in those who may benefit from a medication with low to no abuse potential. It works with different chemicals in the body, called neurotransmitters, than the traditional stimulants.
Atomoxetine is used as an adjunct to psychological, educational, social, and other remedial measures (i.e., appropriate educational placement, appropriate career selection) in the treatment of ADHD.
What is the most important information I should know about Strattera®?
- It may take several weeks before you feel better. Do not stop taking this medication without talking to your doctor first.
- Atomoxetine should also be avoided in those with high blood pressure, blood vessel problems, blood disorders, heart disease, tachycardia (rapid heart rate), and narrow angle glaucoma (eye disease) since it can worsen these conditions as well.
- Individuals taking atomoxetine should avoid becoming dehydrated since dehydration increases the risk of hypotension (decreased blood pressure) caused by this medicine.
- Atomoxetine may cause dizziness and drowsiness. Individuals taking atomoxetine should avoid driving, operating machinery, or performing other hazardous activities until they know how this medicine affects them.
- The safety and effectiveness has not been established for this medicine for children less than 6 years of age. Atomoxetine may also increase the risk of suicidal thinking in children and adolescents with ADHD. Close monitoring for signs of suicidality (increased aggression, hostility, agitation, irritability, suicidal thinking or behaviors) in individuals of all ages started on atomoxetine therapy is essential.
- Atomoxetine should not be used at the same time or within two weeks of taking a medication class called monoamine oxidase inhibitors (MAOIs), usually used to treat depression. MAOIs include phenelzine (Nardil®), tranylcypromine (Parnate®), and selegiline (EMSAM®). Some medications also have MAOI-like activity, such as linezolid (Zyvox), and should be avoided as well. Using atomoxetine within two weeks of, or at the same time as MAOIs can result in dangerously high blood pressure that can be fatal.
- Atomoxetine is not a stimulant medication and therefore is not considered a controlled substance by the Drug Enforcement Agency (DEA). Atomoxetine has not been shown to have abuse potential. However, like all medications, atomoxetine should only be used as directed and only by the person it is prescribed for.
Are there specific concerns about Strattera® and pregnancy?
- No adequate and well-controlled studies have been conducted in pregnant women. Atomoxetine should not be used during pregnancy unless the potential benefit justifies the potential risk to the fetus. The effect of atomoxetine on labor and delivery in humans is unknown. Atomoxetine and/or its metabolites were excreted in the milk of rats. It is not known if atomoxetine is excreted in human milk. Caution should be exercised if atomoxetine is administered to a nursing woman.
- If you are planning to become pregnant, notify your healthcare provider so that he/she can best manage your medications.
What should I discuss with my healthcare provider before taking Strattera®?
- Symptoms that are most bothersome to you about your condition
- If you have thoughts of suicide
- Medications you have taken in the past to treat ADHD, mood or thought organization
- All other medications, herbal or nutritional supplements you are currently taking and any medication allergies you have
- Any medication side effects you may have experienced in the past or are currently experiencing
- If you have or have had:
- liver problems, high blood pressure, heart problems, irregular heartbeat, low blood pressure, depression, bipolar disorder or other psychiatric disorders
- If you are trying to become pregnant, are already pregnant, or are breast-feeding.
- If you use any illegal drugs or alcohol.
How should I take Strattera®?
- Take atomoxetine exactly as prescribed by your doctor.
- Take each dose with a full glass (8 ounces) of water.
- Atomoxetine may be taken with or without food.
- Atomoxetine should be taken regularly to get the most benefit.
- Swallow capsule whole; do not open capsule to “sprinkle” on food
- Store all medications, including atomoxetine, away from moisture and heat.
What happens if I miss a dose of Strattera®?
- If you miss a dose, take the missed dose as soon as you remember during the same day. If you do not remember until the next day, skip the missed dose and take only the doses scheduled for that day. Do not take more than the prescribed total daily amount of atomoxetine in any 24-hour period.
What should I avoid while taking Strattera®?
You should not drink alcohol or take illegal drugs while taking atomoxetine. The effects of these substances and atomoxetine are unpredictable and may also reduce the effectiveness of the medicine.
What happens if I overdose with Strattera®?
- Symptoms of atomoxetine overdose may include sleepiness, drowsiness, agitation, hyperactivity, abnormal behavior, upset stomach, diarrhea, blurred vision, fast heartbeat and dry mouth. Seizures and abnormal heart rhythms may also occur with overdose.Seek emergency medical attention immediately if overdose, whether intentional or accidental, occurs.
- If an overdose occurs, whether intentional or accidental, immediate medical attention may be necessary. Call your doctor or emergency medical service (911). You may also contact the poison control center (1-800-222-1222).
What are the possible side effects of Strattera®?
Common side effects include upset stomach, nausea, or vomiting, decreased appetite, constipation, dry mouth, insomnia, decreased libido or sexual side effects, menstrual cycle changes, hot flushes, or sweating, fatigue, unusual tiredness or weakness, feeling of sluggishness, sedation, sleepiness, irritability or mood swings
Contact your healthcare provider immediately if there is an allergic reaction (difficulty breathing, closing of the throat, swelling of the lips, tongue, or face, hives)
In rare cases, atomoxetine has been associated with liver damage. Contact your healthcare provider if you notice dark urine, have flu-like symptoms, persistent anorexia, itchiness, abdominal pain, or yellowing of the eyes or skin.
In rare cases, atomoxetine can increase suicidal thinking and behavior. Close monitoring is needed particularly in the first weeks to months of therapy.
Are there any risks for taking Strattera® for long periods of time?
Growth effects with atomoxetine are possible but are significantly less likely compared to stimulants like methylphenidate or mixed amphetamine salts. A decrease in weight in children taking atomoxetine was less than 2 pounds over two years. The decrease in height over two years in children taking atomoxetine was less than a quarter of an inch.
What other medications interact with Strattera®?
Newer antidepressants – Some of the newer antidepressants can increase the effects of Stattera, including Prozac® (fluoxetine) and Paxil® (paroxetine)
Blood pressure medications
Blood pressure medications can become less effective when used with atomoxetine. Monitor blood pressure closely and let your healthcare provider know if you have a problem with high blood pressure.
Medications for the heart
Cardioquin or Dura-Tabs (quinidine) can increase the effects of atomoxetine.
Let your healthcare provider know if you are taking this medication.
Medications for asthma/difficulty breathing
Albuterol can increase the risk of high blood pressure and rapid heart beat (tachycardia) when taking atomoxetine.
Medications used for ADHD or weight loss or to increase alertness
Taking atomoxetine with other medications that have stimulant effects can increase the effects and adverse effects of atomoxetine. These include: Vyvanse® (lisdexamfetamine) Dexedrine® (dextroamphetamine), Adderall® (mixed amphetamine salts), methylphenidate (Ritalin®, Methylin®, Concerta®, Daytrana® patch), dexmethylphenidate (Focalin®), Meridia® (sibutramine), phenylephrine, guarana, and caffeine.
Atomoxetine should not be taken together with or within 14 days of taking a monoamine oxidase inhibitor (MAOI) as mentioned above.
Many other medications may interact with atomoxetine. Talk to your doctor or pharmacist before taking any prescription or over-the-counter medicines, including herbal products, during treatment with atomoxetine.
How long does it take for Strattera® to work?
It may take 4 – 8 weeks after an effective dose is reached for atomoxetine to reach maximum effectiveness. However, improvements in some symptoms may occur sooner, within 2 to 4 weeks.