ATOMOXETINE

Indications & Dose:

Attention deficit hyperactivity disorder (initiated by a specialist)

• BY MOUTH

Child 6–17 years (body-weight up to 70 kg): Initially 500 micrograms/kg daily for 7 days, dose is increased according to response; maintenance 1.2 mg/kg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 1.8 mg/kg per day; maximum 120 mg per day

Child 6–17 years (body-weight 70 kg and above): Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80 mg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 120 mg per day

Adult (body-weight up to 70 kg): Initially 500 micrograms/kg daily for 7 days, dose is increased according to response; maintenance 1.2 mg/kg daily, total daily dosemay be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 1.8 mg/kg per day; maximum 120 mg per day

Adult (body-weight 70 kg and above): Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80–100 mg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 120 mg per day

Adult, adolescents, child >6 yr (>70 kg): • Attention deficit hyperactivity disorder:

Initiate at 40 mg/day; increase in 3 day increments to target dose of 80mg qAM or bid (AM & late afternoon); (max 100 mg/ day)

• Depression: 40-65 mg/day divided bid

Child >6yr (up to 70 kg) : • Attention deficit hyperactivity disorder. Initiate at 0.5 mg/kg/day; in crease in 3 day increments to target dose of 1.2 mg/kg/day qAM or bid (qAM & q late afternoon); (max:100mg). 

Contraindications:

Narrow angle glaucoma 

Side Effects:

CNS: Dizziness, headache, somnolence, insomnia, mood swings, anxiety, fatigue, mania

CV Tachycardia, hypertension, orthostatic hypotension

EENT: Mydriasis

GI: Nausea, vomiting, dyspepsia, anorexia, dry mouth, abdominal pain

GU: Urinary retention, urinary hesitation, decreased libido, impotence

METAB: Weight loss

RESP: Cough

SKIN: Rash, pruritus 

Cautions:

Precautions:

Hypertension, tachycardia, ischemic cardiovascular disease, liver disease, history of drug abuse 

Interaction:

Drugs

MAOIs: Hypertensive crisis

Albuterol, other b-agonists: Potentiated effects on the cardiovascular system

CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine): Increased levels of atomoxetine 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; excretion into breast milk unknown; use caution in nursing mothers 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: