Forget about Attention Deficit Hyperactivity Disorder with Strattera Atomoxetine

Strattera is a medicine that contains an active substance called Atomoxetine. It belongs to a group of medicines called selective noradrenaline reuptake inhibitors.

Strattera Atomoxetine is well absorbed after oral administration and food has no effect on the effects of this drug. The vast majority of Strattera is metabolized via CYP2D6 enzyme, and that’s why this medicine can interact with inhibitors or inducers of CYP2D6 enzymes.



Strattera is indicated in the treatment of attention deficit hyperactivity disorder (ADHD). The effectiveness of the drug in the treatment of this disorder was confirmed in seven clinical studies in children and adults.

Precautions

As with most drugs that affect neurotransmitters in the brain, Strattera Atomoxetine can also cause an increased risk of suicidal thoughts and behaviors. The risk of suicidal behavior is higher in children and adolescents. The patient and his/her closest friends and family should be advised to report any suspicious behavior to the doctor, as in certain situations patients with suicidal thoughts do not want to report to their doctor. However, no suicide has been reported so far in patients who have used Strattera.

Strattera Atomoxetine should not be administered concomitantly with drugs called MAO inhibitors (monoamino oxidase inhibitors), such as Tranylcypromine, Moclobemide, Isocarboxazid, Selegiline, Rasagiline, and Linezolid. Strattera can increase monoamine levels in the brain, just like MAO inhibitors, which can lead to rigidity, hyperthermia, myoclonus, extreme agitation, delirium, and coma.

For this reason, Strattera Atomoxetine should not be administered concurrently with these medicines. You must wait at least 2 weeks after an MAO inhibitor is discontinued in order to start the Strattera treatment.

This drug should not be used in patients with narrow-angle glaucoma, as this drug may cause mydriasis (dilation of the pupil) and increase eye pressure, which may worsen the symptoms of glaucoma.

Patients who have pheochromocytoma (an adrenal gland tumor) should not use this medicine, as there is an increased risk of developing hypertensive crises.

Post-marketing studies have demonstrated that Strattera Atomoxetine can cause severe damage to the liver. In clinical studies involving more than 6000 patients, this side effect was not observed. However, if you notice signs of liver damage, you should contact your doctor immediately. Regular monitoring of liver function at the beginning of therapy is recommended (at least during the first month of the therapy).

There have been cases of sudden death in patients with cardiac abnormalities or other cardiac problems and have used Strattera. For this reason, this medicine should not be used in patients with cardiomyopathy, severe arrhythmias, cardiac abnormalities, and angina pectoris. Atomoxetine can increase blood pressure and heart rate. For this reason, it must be very carefully applied in patients who have hypertension or tachycardia.

Also, there have been reported cases of orthostatic hypotension induced by this drug. Orthostatic hypotension is characterized by loss of consciousness/fainting when suddenly getting up from a sitting or lying position.

Post-marketing studies have also demonstrated that Strattera Atomoxetine can provoke priapism – a painful erection that lasts more than 4 hours.


Dosage

The recommended starting dose for children who weigh up to 70 kg is 0.5mg/kg of body weight. The dosage should be increased after three days to 1.2mg/kg of body weight. Strattera should be administered once a day or twice a day (dose divided into two equal doses), in the morning and in the evening.

The maximum daily dose for patients who weigh up to 70 kg is 1.4mg/kg of body weight. No increased efficacy was observed with doses greater than 1.2mg/kg.

The Meds4sure recommended starting dose for children and adults who weigh more than 70 kg is 40mg once a day. The dosage should be increased after three days at 80mg once daily or 40mg in the morning and 40mg in the evening. After 2-4 weeks, the dose can be increased to a maximum of 100mg daily.

It is best to swallow the capsule with a glass of plain water, regardless of the meal.

Use of Strattera Atomoxetine during Pregnancy and Breastfeeding

According to the FDA, Strattera Atomoxetine belongs to the group C because studies in rabbits have shown that the use of this drug during pregnancy can increase the risk of developing abnormal carotid artery or the absence of the subclavian artery. It has also been established that the use of Strattera during pregnancy can increase the risk of spontaneous abortion. For this reason, use of this medicine during pregnancy is not recommended.

Strattera Atomoxetine is excreted in rat milk, but there is no data on whether this medicine is excreted in the breast milk. Due to potentially dangerous adverse effects on infants, the use of this medication during the breastfeeding is not recommended.

Side Effects

Strattera Atomoxetine may cause the following side effects:

  • Abdominal pain
  • Nausea
  • Vomiting
  • Malaise
  • Irritability
  • Weight loss
  • Loss of appetite
  • Headache
  • Dizziness
  • Skin rash
  • Mood swings
  • Insomnia
  • Tremor
  • Depression
  • Conjunctivitis
  • Constipation
  • Early morning awakening
  • Palpitations
  • Tachycardia
  • Hypertension
  • Hypotension
  • Sinusitis
  • Decreased libido
  • Urinary retention
  • Irregular menstrual periods
  • Hot flushes
  • Suicidal thoughts
Tell your doctor if you notice any of these adverse effects.

Interactions

The concomitant use of Strattera Atomoxetine with the following drugs is not recommended:
  • MAO inhibitors, such as Moclobemide, Isocarboxazid, Tranylcypromine, Rasagiline, Selegiline, and Linezolid. These drugs are used in the treatment of depression, Parkinson's disease and bacterial infections.
  • Anagrelide (brand name Agrylid) – a drug used to treat essential thrombocytosis. The concomitant administration with this medicine increases the risk of serious cardiac arrhythmias.
  • Amiodarone – an antiarrhythmic agent. The concomitant administration with this medicine increases the risk of arrhythmias.
  • Dolasetron (brand name Anzamet) – a drug used to prevent nausea that occurs in patients on chemotherapy. The concomitant administration with this drug increases the risk of serious arrhythmias.
  • Leflunomide (brand name Arava) and Teriflunomide (brand name Aubagio) – drugs used to treat rheumatoid arthritis. The continuous administration with these medicines increases the risk of liver damage.
  • Arsenic trioxide – a drug used to treat acute promyelocytic leukemia. The concomitant administration with this medicament increases the risk of arrhythmias.
Tell your physician about all medicines and herbal remedies you are using.

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