ATOMOXETINE
(Strattera)Standard Prescription
atomoxetine __mg PO daily (__mg/kg/24 hr)
Dosages
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)
Mechanism of Action
Non-stimulant selective norepinephrine reuptake inhibitor
Forms Supplied
Capsule: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg
Note: Capsule should not be opened (irritating to eyes)
Note: Capsule should not be opened (irritating to eyes)
Comments
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.
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.
References
4, 44, 83, 145, 146, 160
Last Edited
2021-06-23 04:56:52