Class: Norepinephrine Reuptake Inhibitor, CNS Stimulant
Dosage Forms. Capsule: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg
Common FDA Label Indication, Dosing, and Titration.
1. ADHD: Children >6 y of age and weighing 70 kg or less, 0.5 mg/kg/d po, may titrate to lower of 1.4 mg/kg/d po or 100 mg/d po; Children >6 y and weighing >70 kg, 40 mg/d po, may titrate to 100 mg/d po; Adults, 40 mg po daily, may titrate to 100 mg/d po
Off-Label Uses. None
MOA. Atomoxetine is a selective norepinephrine reuptake inhibitor that produces therapeutic effects in patients with ADHD. The exact mechanism of how selective inhibition of presynaptic norepinephrine exerts effects in ADHD has not been determined.
Drug Characteristics: Atomoxetine
Medication Safety Issues: Atomoxetine
Drug Interactions: Atomoxetine
Adverse Reactions: Atomoxetine
Efficacy Monitoring Parameters. Improvement of mental and behavioral symptoms of ADHD.
Toxicity Monitoring Parameters. BP and heart rate. Signs of clinical worsening, suicidality, or unusual changes in behavior; particularly at start of and during first few months of therapy or when dose is adjusted. Aggressive behavior or hostility, new onset or worsening; in pediatric patients at start of treatment.
Key Patient Counseling Points. Avoid activities requiring mental alertness or coordination until drug effects are realized. Growth rate and weight may need to be monitored more frequently in children. Report new or worsened psychiatric problems, chest pain, palpitations, dyspnea, or signs/symptoms of cardiac dysrhythmias, MI, or cerebrovascular accident.
Clinical Pearls. Safety and effectiveness not established in children <6 y of age. Increased risk of suicidal ideation in short-term studies in children or adolescents with ADHD. Monitor patients closely for suicidality (suicidal thinking and behavior), clinical worsening, or unusual changes in behavior. Close observation and communication with the prescriber by families and caregivers is recommended.