Atomoxetine Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Atomoxetine Capsule (atomoxetine hydrochloride) is a prescription selective norepinephrine reuptake inhibitor (SNRI) used to treat attention-deficit hyperactivity disorder (ADHD) in children 6 years and older, adolescents, and adults. It is not a stimulant and is not a controlled substance. It works by increasing a brain chemical called noradrenaline to help improve attention and reduce impulsiveness and hyperactivity. It carries a boxed warning regarding increased risk of suicidal thoughts in children and teenagers.

What is Atomoxetine Capsule

Atomoxetine is a prescription medicine used to treat attention-deficit hyperactivity disorder (ADHD). It is not a stimulant and is not a controlled substance.

Atomoxetine Capsule uses

• Treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children 6 years and older, adolescents, and adults

Benefits of Atomoxetine Capsule

• May help increase attention and decrease impulsiveness and hyperactivity in people with ADHD
• Used as part of a total treatment program that may also include counseling, education, and social support

How Atomoxetine Capsule works

Atomoxetine works by increasing the amount of a natural brain chemical called noradrenaline (norepinephrine), which helps increase attention and reduce impulsiveness and hyperactivity.

Atomoxetine Capsule dosage

Atomoxetine capsules can be taken with or without food. Swallow the capsule whole with water or another liquid; do not crush, break, chew, or open it. Avoid touching a broken or opened capsule; wash hands right away if you do touch one, and rinse eyes with water and get medical advice if the contents touch your eyes. It is usually taken once a day in the morning, or as two doses split between morning and late afternoon/early evening. Take it at the same time each day to help you remember.

If you miss a dose, take it as soon as you remember that day, but do not double up doses or take more than your total daily amount in 24 hours. This medicine can be stopped without gradually lowering the dose first. Children should take this medicine with help from an adult.

Available forms and strengths

• Capsule
• Solution (oral liquid)

Side effects of Atomoxetine Capsule

Common

• Nausea
• Vomiting
• Upset stomach
• Constipation
• Dry mouth
• Loss of appetite or decreased appetite
• Mood changes or mood swings
• Feeling tired or fatigue
• Dizziness
• Urination problems
• Impotence (trouble having an erection)
• Headache
• Trouble sleeping or early morning waking
• Decreased weight
• Irritability

Serious

• Signs of an allergic reaction such as hives, difficulty breathing, or swelling of the face, lips, tongue, or throat
• New or worsening anxiety, panic attacks, trouble sleeping, feeling impulsive, irritable, agitated, hostile, aggressive, restless, or hyperactive
• Depression or thoughts about suicide or hurting yourself
• Signs of heart problems such as chest pain, trouble breathing, or feeling like you might pass out
• Signs of psychosis such as hallucinations, new behavior problems, aggression, hostility, or paranoia
• Signs of liver problems such as upper right stomach pain, itching, flu-like symptoms, dark urine, or yellowing of the skin or eyes
• Painful or difficult urination
• An erection that is painful or lasts longer than 4 hours (priapism)
• Slowed growth (height and weight) in children
• Seizures
• Fainting

Warnings and precautions

• Atomoxetine carries a boxed warning (the strongest FDA warning) because it can increase the risk of suicidal thoughts in children and teenagers with ADHD. Patients should be closely watched, especially early in treatment or after a dose change.
• This medicine can cause severe liver injury in rare cases, including liver failure. Stop the medicine and contact a doctor right away if signs of liver problems appear.
• Sudden death, stroke, and heart attack have occurred in some people taking atomoxetine, especially those with existing heart problems or structural heart defects.
• Atomoxetine should not be taken with, or within 14 days of taking, a monoamine oxidase inhibitor (MAOI), as this combination can cause serious, sometimes fatal reactions.
• The medicine should not be used by people with narrow-angle glaucoma, a history of pheochromocytoma (an adrenal gland tumor), or severe cardiovascular disorders that could worsen with increased heart rate or blood pressure.
• New psychotic symptoms (like hallucinations or false beliefs) or manic symptoms can occur even in people with no prior history of these problems.
• The medicine can cause serious allergic reactions, including anaphylaxis and severe swelling, which can be life-threatening.
• Rare cases of priapism (prolonged, painful erection lasting more than 4 hours) have occurred and require prompt medical attention.
• The capsule contents can irritate the eyes. Do not open the capsules; if the contents contact your eyes, rinse right away with water and seek medical advice.
• It is not known whether atomoxetine will harm an unborn baby. Tell your doctor if you are pregnant or planning to become pregnant. This medicine should generally not be used during pregnancy unless your doctor has specifically advised it.
• It is not known if atomoxetine passes into breast milk. You should either avoid taking this medicine while breastfeeding or stop breastfeeding, based on your doctor's advice.
• Atomoxetine can be given to patients with kidney problems, including end-stage renal disease, using the normal dosing regimen, since exposure to the drug did not differ once corrected for body weight dose.
• People with liver problems may need a lower dose because the medicine is removed from the body more slowly, increasing its effects.
• Drinking alcohol along with atomoxetine did not appear to change the intoxicating effects of alcohol, based on studies.
• This medicine can make you drowsy, dizzy, or less alert. Be careful driving a car or operating machinery until you know how it affects you.

Storage

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light
• Keep from freezing
• Keep out of the reach of children
• Do not keep outdated medicine or medicine no longer needed
• Ask your healthcare professional how you should dispose of any medicine you do not use
• Throw away unused oral liquid 45 days after first opening the bottle

When to see a doctor

• Get emergency help for signs of a serious allergic reaction, such as difficulty breathing, swelling of the face, lips, tongue, or throat, or hives
• Call your doctor right away if you notice signs of liver problems such as pain or tenderness in the upper right stomach, dark urine, yellowing of the skin or eyes, loss of appetite, nausea, or unexplained flu-like symptoms
• Seek immediate help if you or your child have thoughts of suicide or self-harm, or notice new or worsening depression, anxiety, agitation, irritability, or unusual changes in behavior
• Call your doctor right away if you experience chest pain, trouble breathing, or fainting, as these may be signs of a serious heart problem
• Seek prompt medical attention if you have an erection that lasts more than 4 hours
• Contact your doctor immediately or go to the nearest emergency department if you notice signs of new psychosis, such as hallucinations or confusion, or symptoms of mania like extreme overactivity or elation
• If you suspect an overdose, contact your doctor, poison control, or go to the emergency department right away, even if there are no symptoms yet

Alternatives

• Methylphenidate
• Guanfacine
• Bupropion