Chemical Name: Atomoxetine
Brand name: Strattera
What is Atomoxetine?
It is available under the brand name Strattera, a selective norepinephrine reuptake inhibitor not classified as a stimulant. Stimulants such as Modafinil and Armodafinil (Artvigil) are drugs that increase the activity of the central nervous system along with producing euphoric effects and having a high addiction potential. SNRIs are a group of drugs that increase the level of serotonin and nor-epinephrine but have negligible addiction potential because of which they are approved for medical use.
What is Atomoxetine used for?
It is primarily used in the treatment of ADHD (Attention Deficit Hyperactivity Disorder), a chronic condition resulting in attention difficulties, hyperactivity, and impulsiveness. It is preferred for the above problem because of the relatively low abuse potential associated with its use. Atomoxetine can be used on its own or in combination with other prescription stimulants. Off-label, it is used in the treatment of mood disorders, eating disorders, cognitive dysfunction, and addictions.
What is the mechanism of action?
It primarily works by inhibiting the reuptake or re-absorption of norepinephrine and dopamine back into the system. Norepinephrine, or noradrenaline, is a hormone and neurotransmitter located in the CNS that plays an important role in a person’s mood and ability to concentrate. Dopamine is responsible for the alertness and arousal functions of people. Increased extracellular levels of either neurotransmitter result from inhibition of their reuptake, which aids in the management of ADHD and other symptoms.
What are the approved strengths and doses?
Atomoxetine comes in strengths of 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, and 100mg. The strength is as follows:
- In children and adults weighing up to 70 kg, the drug is administered at a starting daily dose of 0.5 mg/kg. This is then increased within 3 days to a total dose of 1.2mg/kg. This can be administered at one dose or divided into two even doses.
- In children and adults over 70 kg, it is administered at an initial total dose of 40mg. This is then increased within 3 days to a total daily dose of 80mg. Within 2-4 weeks, the dose is increased to a total dose of 100mg in patients who have not yet received an optimum response.
How long does Atomoxetine take to start working?
You may notice an improvement in your symptoms in the first week of your treatment. However, you may need a month’s time to see the full benefits.
How long does Atomoxetine stay in your system?
The medicine stays in your system for about 5.2 hours to 21.6 hours.
What are Atomoxetine’s side effects?
Some common side effects include nausea, vomiting, diarrhea, headache, dizziness, loss of appetite, gastrointestinal problems, muscle pain, sweating, hot flashes, and tingling sensations in hands and feet.
Rare side effects: yellowing of skin or eyes, difficulty swallowing or breathing, hives, itchy skin, flu-like symptoms, seizures, fast or irregular heartbeat, slurred speech, hallucinations, mood swings, decreased sex drive, and irregular menstrual periods.
What are the precautionary measures?
- Tell your doctor if you are allergic to Atomoxetine.
- Before taking the medicine, you must tell your doctor if you are dealing with health issues such as glaucoma, heart problems, mental or mood disorders, liver disorders, high blood pressure, etc.
- Atomoxetine makes you dizzy or drowsy, and thus a user should not drive a vehicle after taking the medicine.
- Its long-term usage in children affects their growth, weight, etc.
- This medicine must be used with great caution in expecting women.
- It is not known if Atomoxetine passes into breast milk.
Atomoxetine drug interactions
Certain medicines interact with Atomoxetine, causing severe side effects and vice versa. MAO inhibitors such as moclobemide, rasagiline, tranylcypromine, linezolid, etc. interfere with this medicine. Most MAO inhibitors should not be ingested at least two weeks before and after treatment with Atomoxetine.
Some medicines used for the treatment of coughs and colds should be used with caution as they are known to increase heart rate and/or blood pressure.
Is Atomoxetine’s price in Canada covered by insurance?
Atomoxetine in Canada is available in both brand and generic versions. While the branded version of Strattera is markedly expensive, the generic Atomoxetine costs little and is covered by Medicare and insurance. The amount covered by insurance depends on
- Your chosen type of health insurance
- The tier of the formulary allocated to the medication. Atomoxetine falls into tier 4 of 5 tiers of the formulary. The higher the tier, the more the patient has to pay for the medication.
- The quantity limit set by the insurance company you have opted for