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Strattera Fact Sheet

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Medication Name (brand): 
Strattera
Medication Name (clinical): 
atomoxetine
Manufacturer: 

Eli Lilly, patent expires 2016

Indications: 

Attention Deficit/Hyperactivity Disorder in children and adults

Mechanism: 

Blocks reuptake of norepinephrine

Dosing: 
  • Supplied in 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, and 100 mg capsules.

  • Standard dosing for children is to begin with 0.4-0.5 mg/kg QAM or BID, and increase after about a week to a target dose of 1.2 mg/kg. In adults, start with 40 mg QAM, and increase to 40 mg BID or 80 mg QAM after 3-7 days. Maximum recommended dose is 100 mg/day or 1.4 mg/kg, whichever is lower.
  • Studies have shown that once daily dosing is as effective as BID dosing, but BID dosing is better tolerated in terms of GI side effects.
  • Decrease dose in hepatic impairment; no dosage reduction required in renal impairment.

Side Effects: 
  • Most common are poor appetite, nausea, and sedation. Weight loss has been reported in some trials. In adults, constipation, dry mouth, urinary retention, and sexual dysfunction have been reported.

  • Severe liver damage has been reported, but this is very rare. There are minor increases in pulse and BP.
  • Black Box Warning: In clinical trials, SSRIs and SNRIs increased the risk of suicidality in children (from 2% to 4%). No actual suicides occurred in these trials, and none of the trials included MAOIs, but all antidepressants are required to carry this warning anyway.

Drug-drug Interactions: 
  • Metabolized by 2D6, so reduce its dosage when combined with Prozac or Paxil.

  • It can potentiate the effect of albuterol on increasing pulse and BP, so be cautious about combining the two.
  • Does not inhibit hepatic metabolism, so does not affect levels of other drugs.
  • Can be safely combined with stimulants, as it does not increase BP and pulse beyond effects produced by stimulants alone.
  • Although it is 98% protein bound, it has no effect on levels of coumadin or dilantin.
  • Contraindicated with MAOIs.

Pharmokinetics: 

Half-life is 5 hours. Maximum plasma concentration 1-2 hours after ingestion. 98% protein bound.

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