- Capsules: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80mg, 100 mg
Generic name: atomoxetine (AT oh mox e teen)
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
What is Strattera and what does it treat?
Atomoxetine is a prescription medication that is used to treat individuals with attention-deficit hyperactivity disorder (ADHD).
Symptoms of ADHD interfere with an individual’s ability to function at school or work or in social settings and include:
- Inattention (e.g., making careless mistakes, losing things necessary for tasks)
- Hyperactivity (e.g., inability to sit still)
- Impulsivity (e.g., interrupting or intruding on others)
Hyperactivity is less common in adults. A person may have severe inattention without hyperactivity or impulsivity.
Atomoxetine is used in addition to non-medication treatments to manage ADHD symptoms.
What is the most important information I should know about Strattera?
It may take several weeks before you notice the full benefits of this medication. It is important to continue taking atomoxetine as directed, even if you do not notice immediate improvement.
Are there specific concerns about Strattera and pregnancy?
If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with ADHD who wish to become pregnant face important decisions. Untreated ADHD has risks for the fetus as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
Regarding breastfeeding, caution is advised since it is not know if atomoxetine passes into human breast milk.
What should I discuss with my healthcare provider before taking Strattera?
- Symptoms of your condition that bother you the most
- If you have thoughts of suicide or harming yourself
- If you experience side effects from your medications, discuss them with your provider. Some side effects pass with time, but others may require changes in the medication.
- Any other psychiatric or medical problems you have, including heart disease
- All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
- Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
- If you are pregnant, plan to become pregnant, or are breast-feeding
- If you drink alcohol or use drugs
How should I take Strattera?
Atomoxetine is usually taken 1 to 2 times per day with or without food.
The dose usually ranges from 20 mg to 100 mg. Only your healthcare provider can determine the correct dose for you.
Capsules should be swallowed whole, not crushed or chewed.
Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking you medication.
What happens if I miss a dose of Strattera?
If you miss a dose of atomoxetine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your healthcare provider. Do not double your next dose or take more than what is prescribed.
What should I avoid while taking Strattera?
Avoid drinking alcohol or using illegal drugs while you are taking this medication. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
What happens if I overdose with Strattera?
If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of atomoxetine does not exist.
What are the possible side effects of Strattera?
Common Side Effects
- Upset stomach, nausea, vomiting, decreased appetite, constipation, dry mouth, feeling sleepy, sluggish or weak during the day, trouble sleeping at night
- Decreased libido or sexual side effects
Rare Side Effects
- Menstrual cycle changes, urinary retention, hot flushes, sweating, severe fatigue, irritability or mood swings, increased heart rate and blood pressure
- Rarely, a painful prolonged erection has been reported in child, adolescent and adult males
- Risk of switching to hypomania and mania, particularly in individuals with bipolar disorder
Serious Side Effects
- Liver toxicity, increased suicidal thoughts, angioedema, and cardiovascular complications
Are there any risks for taking Strattera for long periods of time?
There are no known problems associated with long term use of atomoxetine
What other medications interact with Strattera?
Atomoxetine should not be taken with or within 2 weeks of monoamine oxidase inhibitors (MAOIs), which are usually used to treat depression. These include phenelzine (Nardil®), tranylcypromine (Parnate®), selegiline (EMSAM®), isocarboxazid (Marplan®), and rasagiline (Azilect®)
The antibiotic linezolid (Zyvox®) should be avoided as well because it may act similar to a MAOI. Taking atomoxetine with or within 2 weeks of MAOIs drugs similar to MAOIs can result in dangerously high blood pressure that can lead to death.
The following medications may increase the levels and effects of atomoxetine
- Paroxetine (Paxil®), Fluoxetine (Prozac®), and Quinidine (Quinidex®)
Medications for asthma/difficulty breathing (e.g. albuterol) can increase the risk of high blood pressure and rapid heart rate (tachycardia) when taking atomoxetine.
Because of atomoxetine’s possible effect on blood pressure it should be cautiously used with other medications that increase or decrease blood pressure.
How long does it take for Strattera to work?
It may take 4 - 8 weeks to get the maximum benefit once the right dose is determined. However, improvements in some symptoms may occur sooner.
Summary of FDA Black Box Warnings
Suicidal Thoughts or Actions
- Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
- In short-term studies, atomoxetine increased the risk of suicidality in children, adolescents, and young adults when compared to placebo.
- Patients should be closely monitored for suicidality (suicidal thinking and behavior), worsening of symptoms, or changes in behavior.
- Families and caregivers should be advised of the need for close observation and communication with the prescriber.
Suicidal Ideation in Children and Adults
In short-term studies, an increased risk of suicidal ideation was seen in children or adolescents treated with atomoxetine for ADHD. When choosing this medication, this risk must be balanced with the potential benefits. Patients should be closely monitored for suicidality (suicidal thinking and behavior), worsening of symptoms, or changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber.
the College of Psychiatric and Neurologic Pharmacists