| DRUG | SUPPLIED | DOSE | COMMENTS |
|---|---|---|---|
| ATOMOXETINE (Paeds) (Strattera) Mechanism of action: Non-stimulant selective norepinephrine reuptake inhibitor Ref: 4, 44, 83, 145, 146, 160 Last update: 2021-06-23 |
Capsule: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg Note: Capsule should not be opened (irritating to eyes) |
Children (>= 6 yr and >= 20 kg) and Adolescents <70 kg: (round dose to nearest available capsule size) Initial dose: 0.5 mg/kg/dose PO daily x 7-14 days Step 2: If initial dose tolerated can increase to 0.8 mg/kg/dose PO daily x 7-14 days Step 3: if Step 2 dose tolerated can increase to 1.2 mg/kg/dose PO daily. Re-evaulate after 30 days and adjust for response if necessary. Children and Adolescents >70 kg and Adults: Initial dose: 40 mg PO daily x 7-14 days Step 2: If initial dose tolerated can increase to 60 mg PO daily x 7-14 days Step 3: if Step 2 dose tolerated can increase to 80 mg PO daily. If optimal response not obtained after 2-4 additional weeks, may increase to 100 mg daily Maximum dose: 1.4 mg/kg/24 hr or 100 mg (whichever is less) |
Non-stimulant, norepinephrine reuptake inhibitor for treatment of ADHD Usually taken in the morning; best taken on a full stomach to avoid adverse GI effects. Dose can be given at bedtime with food to improve tolerability (or in divided doses BID, but this increases daily cost). May take several weeks to see therapeutic effects. In CYP 2D6 poor metabolizers atomoxetine AUC approx. 6.5 fold higher, peak levels approx. 3.5--fold higher, compared to those with normal CYP 2D6 activity. Drug interactions: significantly increased atomoxetine levels with strong CYP 2D6 inhibitors (e.g. bupropion, fluoxetine, paroxetine) Capsules should not be opened. No known withdrawal syndrome; may be discontinued without tapering of the dose. Common side effects: abdominal pain, nausea, somnolence, decreased appetite, irritability. Prescribers must be aware of warnings issued by Health Canada regarding the use of ADHD medications. Refer to the Health Canada website. Standard Prescription: atomoxetine __mg PO daily (__mg/kg/24 hr) |