Atomoxetine

What is atomoxetine?

Atomoxetine is used as part of a total treatment program to increase the ability to pay attention and decrease impulsiveness and hyperactivity in children and adults with ADHD. Atomoxetine is in a class of medications called selective norepinephrine reuptake inhibitors. It works by increasing the levels of norepinephrine, a natural substance in the brain that is needed to control behavior.

How should this medicine be used?

Atomoxetine comes as a capsule to take by mouth. It is usually taken either once a day in the morning, or twice a day in the morning and late afternoon or early evening. Atomoxetine may be taken with or without food. Take atomoxetine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take atomoxetine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow atomoxetine capsules whole; do not open, chew, or crush them. If a capsule is accidentally broken or opened, wash away the loose powder with water right away. Try not to touch the powder and be especially careful not to get the powder in your eyes. If you do get powder in your eyes, rinse them with water right away and call your doctor.

Your doctor will probably start you on a low dose of atomoxetine and increase your dose after at least 3 days. Your doctor may increase your dose again after 2–4 weeks. You may notice improvement in your symptoms during the first week of your treatment, but it may take up to one month for you to feel the full benefit of atomoxetine.

Atomoxetine may help to control the symptoms of ADHD but will not cure the condition. Continue to take atomoxetine even if you feel well. Do not stop taking atomoxetine without talking to your doctor.

What special precautions should I follow?

Before taking atomoxetine,

• ​​tell your doctor and pharmacist if you are allergic to atomoxetine, any other medications, or any of the ingredients in atomoxetine capsules.
• Some medications should not be taken with atomoxetine. Other medications may cause dosing changes or extra monitoring when taken with atomoxetine. Make sure you have discussed any medications you are currently taking or plan to take before starting atomoxetine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking atomoxetine, please get the advice of your doctor or pharmacist..
• Tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate).
• tell your doctor if you have or have ever had glaucoma (an eye disease that may cause vision loss), or pheochromocytoma (a tumor on a small gland near the kidneys). Your doctor will probably tell you not to take atomoxetine.
• tell your doctor if anyone in your family has or has ever had an irregular heartbeat or has died suddenly. Tell your doctor if you have recently had a heart attack and if you have or have ever had a heart defect, high blood pressure, an irregular heartbeat, hardening of the arteries, heart or blood vessel disease, or other heart problems. Your doctor will examine you to see if your heart and blood vessels are healthy. Your doctor will probably tell you not to take atomoxetine if you have a heart condition or if there is a high risk that you may develop a heart condition.
• tell your doctor if you or anyone in your family has or has ever had depression, bipolar disorder (manic depressive disorder; a condition that causes episodes of depression, episodes of frenzied, abnormal excitement and other abnormal moods), or has ever thought about or attempted suicide. Also tell your doctor if you have or have ever had seizures, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking atomoxetine, call your doctor.
• you should know that atomoxetine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• you should know that atomoxetine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
• you should know that atomoxetine should be used as part of a total treatment program for ADHD, which may include counseling and special education. Make sure to follow all of your doctor's and/or therapist's instructions.
• you should know that your blood pressure may increase during your treatment with atomoxetine. Your doctor will monitor your blood pressure during your treatment.

What side effects can this medication cause?

Atomoxetine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• heartburn
• nausea
• vomiting
• loss of appetite
• weight loss
• constipation
• stomach pain
• gas
• dry mouth
• excessive tiredness
• dizziness
• headache
• mood swings
• decreased sex drive or ability
• difficulty urinating
• painful or irregular menstrual periods
• muscle pain
• sweating
• hot flashes
• unusual dreams
• burning or tingling in the hands, arms, feet, or legs

Some side effects can be serious. If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section, call your doctor immediately:

• fast or pounding heartbeat
• chest pain
• shortness of breath
• slow or difficult speech
• dizziness or faintness
• weakness or numbness of an arm or leg
• itchy skin
• dark urine
• yellowing of your skin or eyes
• flu-like symptoms
• pain in the upper right part of your stomach
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty swallowing or breathing
• hives
• rash
• abnormal thoughts
• hallucinating (seeing things or hearing voices that do not exist)
• erection that lasts for several hours or longer
• seizures

Atomoxetine may slow down children's growth or weight gain. Your child's doctor will probably monitor your child carefully during his or her treatment with atomoxetine. Talk to your child's doctor about the risks of giving this medication to your child.

Atomoxetine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• sleepiness
• agitation
• an increase in activity or talking
• abnormal behavior
• stomach problems
• wide pupils (black circles in the middle of the eyes)
• fast heartbeat
• dry mouth

🔗 Reference: https://medlineplus.gov/druginfo/meds/a603013.html