Description

Simple

A medication used to manage Attention Deficit Hyperactivity Disorder (ADHD) by improving the ability to pay attention and control impulses.

Clinical

A selective norepinephrine reuptake inhibitor (SNRI) used in the management of Attention Deficit Hyperactivity Disorder (ADHD).

Overview

Atomoxetine is a selective norepinephrine (NE) reuptake inhibitor used for the treatment of attention deficit hyperactivity disorder (ADHD). Also known as the marketed product Strattera, atomoxetine is used with other treatment modalities (psychological, educational, cognitive behaviour therapy, etc) to improve developmentally inappropriate symptoms associated with ADHD including distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. Although the underlying pathophysiology that causes ADHD remains unclear, evidence suggests that dysregulation in noradrenergic and dopaminergic pathways plays a critical role in suboptimal executive functioning within prefrontal regions of the brain, which are involved in attention and memory.[5] Atomoxetine has been shown to specifically increase NA and DA within the prefrontal cortex, but not in the nucleus accumbens (NA) or striatum.[Read more

Pharmacology

Indication

Atomoxetine is indicated for the treatment of attention deficit hyperactivity disorder (ADHD) in children and adults.

Pharmacodynamic

Atomoxetine is a selective norepinephrine (NE) reuptake inhibitor used for the treatment of attention deficit hyperactivity disorder (ADHD). Atomoxetine has been shown to specifically increase norepinephrine and dopamine within the prefrontal cortex, which results in improved ADHD symptoms.[ Read more

Mechanism of action

Atomoxetine is known to be a potent and selective inhibitor of the norepinephrine transporter (NET),[ Read more

Absorption

The pharmacokinetic profile of atomoxetine is highly dependent on cytochrome P450 2D6 genetic polymorphisms of the individual.[ Read more

Protein binding

At therapeutic concentrations, 98.7% of plasma atomoxetine is bound to protein, with 97.5% of that being bound to albumin, followed by alpha-1-acid glycoprotein and immunoglobulin G.[ Read more

Volume of distribution

The reported volume of distribution of oral atomoxetine was 1.6-2.6 L/kg. The steady-state volume of distribution of intravenous atomoxetine was approximately 0.85 L/kg.[ Read more

Clearance

The clearance rate of atomoxetine depends the CYP2D6 genetic polymorphisms of the individual and can range of 0.27-0.67 L.h/kg.[ Read more

Half life

The reported half-life depends on the CYP2D6 genetic polymorphisms of the individual and can range from 3 to 5.6 hours.[ Read more

Route of elimination

Atomoxetine is excreted primarily as 4-hydroxyatomoxetine-O-glucuronide, mainly in the urine (greater than 80% of the dose) and to a lesser extent in the feces (less than 17% of the dose). Only a small fraction (less than 3%) of the atomoxetine dose is excreted as unchanged atomoxetine, indicating e... Read more

Toxicity

There is limited clinical trial experience with atomoxetine overdose. During postmarketing, there have been fatalities reported involving a mixed ingestion overdose of atomoxetine capsules and at least one other drug. There have been no reports of death involving overdose of atomoxetine capsules alo... Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Nausea US
  • adult
  • Kind: experimental
    • Percent: 26%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Dry Mouth US
    • adult
  • Kind: experimental
    • Percent: 20%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Headache US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 19%
  • Kind: placebo
    • Percent: 15%
  • Clinical Trial
    Abdominal Pain US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 18%
  • Kind: placebo
    • Percent: 10%
  • Clinical Trial
    Decreased appetite US
    • adult
  • Kind: experimental
    • Percent: 16%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Decreased appetite US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 16%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Insomnia US
    • adult
  • Kind: experimental
    • Percent: 15%
  • Kind: placebo
    • Percent: 8%
  • Clinical Trial
    Vomiting US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 11%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Somnolence US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 11%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Insomnia US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 6-11%
  • Clinical Trial
    Changes in heart rate US
  • Kind: experimental
    • Percent: 5-10%
  • Clinical Trial
    Changes in blood pressure US
  • Kind: experimental
    • Percent: 5-10%
  • Clinical Trial
    Fatigue US
    • adult
  • Kind: experimental
    • Percent: 10%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Nausea US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 10%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Constipation US
    • adult
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Somnolence US
    • adult
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 5%
  • Clinical Trial
    Dizziness US
    • adult
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Fatigue US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Erectile Dysfunction US
    • adult
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Abdominal Pain US
    • adult
  • Kind: experimental
    • Percent: 7%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Constipation US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-7%
  • Kind: placebo
    • Percent: 0-1%
  • Clinical Trial
    Weight decreased US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 4-7%
  • Clinical Trial
    Depression US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 4-7%
  • Clinical Trial
    Weight decreased US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 4-7%
  • Clinical Trial
    Irritability US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Urinary hesitation US
    • adult
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Tremor US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-5%
  • Clinical Trial
    Irritability US
    • adult
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Dizziness US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Excoriation US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 2-4%
  • Clinical Trial
    Sedation US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 2-4%
  • Clinical Trial
    Vomiting US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Dyspepsia US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Abnormal dreams US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Hyperhidrosis US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Ejaculation disorder US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Ejaculation delayed US
    • adult
  • Kind: experimental
    • Percent: 4%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Middle insomnia US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Conjunctivitis US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Syncope US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Palpitations US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Chills US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Paraesthesia US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Weight decreased US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Anorexia US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Sleep Disorder US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Libido decreased US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Host flush US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Dysmenorrhea US
    • adult
  • Kind: experimental
    • Percent: 3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Mydriasis US
    • adolescent
    • children
  • Kind: experimental
    • Percent: 1-2%
  • Clinical Trial

    Contraindications

    • Regions: Canada
    • Patient Conditions:
        • Name: Advanced arteriosclerosis
        • Drugbank Id: DBCOND0107486
    • Regions: Canada
    • Patient Conditions:
        • Name: Moderate to Severe Hypertension
        • Drugbank Id: DBCOND0042937
    • Regions: Canada
    • Patient Conditions:
        • Name: Hyperthyroidism
        • Drugbank Id: DBCOND0009048
    • Route:
      • Oral
    • Dose Form:
      • Capsule
    • Hypersensitivity:
      • true
    • Regions: US
    • Regions: US
    • Patient Conditions:
        • Name: Narrow angle glaucoma
        • Drugbank Id: DBCOND0104923
    • Regions: US
    • Patient Conditions:
        • Name: Pheochromocytoma
        • Drugbank Id: DBCOND0002904
    • Regions: US
    • Patient Conditions:
        • Name: Severe cardiovascular disorders
        • Drugbank Id: DBCOND0107565
        • Modification Of:
          • Base:
            • Name: Cardiovascular Disorders
            • Drugbank Id: DBCOND0055730
          • Severity:
            • Includes:
              • severe
    • Regions: US
    • With Categories:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996

    Food Interactions

    Take with or without food.