Atomoxetine is used to treat ADHD or attention deficit hyperactivity disorder (hyperactive, impulsive, inattentive, poor behavioural condition) in adults and children aged 6 years and older.
This medicine is meant to be taken as part of a complete ADHD care programme which includes psychological, educational and social measures.
Take Atomoxetine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Atomoxetine is available as a capsule or as an oral solution.
If you are given the capsule, swallow it whole with a glass of water. Do not crush, chew or open the capsule as this medicine is an eye irritant. If the capsule contents accidentally come in contact with your eyes, rinse it immediately with water. Wash your hands and any contaminated surface as soon as possible. Alert your doctor if you start to have any problems with your eyes.
If you are given the oral solution, use the oral dosing syringe supplied with each bottle to measure out your dose.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Atomoxetine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
If you missed a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose to make up for the missed dose.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- narrow-angle glaucoma (increased pressure in the eyes)
- with or a history of phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
- severe heart problems e.g. heart attack, heart failure, irregular or abnormal heartbeat, chest pain, severe high blood pressure, narrowing of the blood vessels of the heart
- blood vessel problems in the brain e.g. stroke, aneurysm (weakness and bulging of the blood vessel wall in the brain)
as Atomoxetine may not be suitable for you.
Do not take Atomoxetine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) in the last 14 days.
Inform your doctor if you have the following conditions:
- other co-existing disorders with ADHD e.g. anxiety disorder, depression, tics related to Tourette’s syndrome (a disorder characterised by repetitive and uncontrollable speech or body movements), bipolar disorder (mood changes between feeling very high and very low)
- with or a family history of QT interval prolongation (heart rhythm disorder)
- heart disease e.g. rapid heartbeat
- high or low blood pressure
- history of epilepsy (fits or seizures)
- history of bladder problems e.g. bladder obstruction, difficulty passing urine
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Atomoxetine to a child.
A certain enzyme called CYP2D6 is involved in the metabolism of this medicine. Individuals who are poor metabolisers of CYP2D6 may experience enhanced side effects of Atomoxetine (e.g. dry mouth, constipation, lack of appetite, sleep disturbance) that may require dose adjustments. Although not routinely done, your doctor may advise you to undergo genetic testing to check if this medicine is best suited for you. If you know you have this gene type, inform your doctor.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your blood pressure and pulse may rise to unsafe levels without you noticing it. You may need to monitor your blood pressure and pulse regularly.
- This medicine may reduce the rate of growth of children. Monitoring of the height and weight may be needed.
- You may need to have routine tests (e.g. liver function, ECG) while you are being treated with Atomoxetine. Your doctor will advise you about how often you will need to have these tests.
- Monitoring of signs of suicidal thoughts or attempts, and unusual changes in behaviour may also be needed.
Atomoxetine may cause dizziness, tiredness, or somnolence (suddenly falling asleep during your daily activities such as eating and watching television). If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: headache, nausea, vomiting, dry mouth, loss of appetite, constipation, stomach pain or wind, indigestion, difficulty sleeping, increased sweating, hot flushes, tremors, and numbness or tingling sensation in the hands or feet.
Men may experience sexual dysfunction and women may experience irregular or painful menstruation while taking this medicine. You may discuss with your doctor if you are concerned about these side effects.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swollen eyes, face or throat
- fast or irregular heartbeat, chest pain, unexplained fainting or loss of consciousness
- severe stomach pain, unusual tiredness, yellowing of the skin or eyes, dark coloured urine
- difficulty or hesitancy in passing out urine
- having thoughts of self-harm
- unusual changes in mood or behaviour (being too depressed, aggressive, agitated, hostile, highly irritable, or having compulsive and impulsive behaviour)
- hallucinations (seeing, hearing or feeling things that are not existent)
- delusional thinking (not being able to tell what is real from what is imagined)
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Atomoxetine if you are currently taking or have taken a medicine that is used to treat depression known as a monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat depression e.g. fluoxetine, paroxetine, bupropion, imipramine, venlafaxine, mirtazapine
- medicine for cold or nasal congestion e.g. phenylephrine, pseudoephedrine
- antibiotics e.g. moxifloxacin, erythromycin
- lithium (medicine for mood disorders)
- terbinafine (medicine to treat fungal infection)
- quinidine (medicine for irregular heartbeat)
- salbutamol (medicine for asthma)
- cisapride (medicine for digestive problems)
- methadone (medicine to treat addiction to certain substance)
- mefloquine (medicine used to treat malaria)
This list does not include all medicines that may interact with Atomoxetine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.