Drug Details

ATOMOXETINE

Dr C P Ravikumar
 
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Dr. C P Ravi Kumar

Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology, The Krishna Institute of Medical Sciences (KIMS), Mahadevapura, Bangalore

 

What is Atomoxetine?

Atomoxetine classified under SNRIs (serotonin-norepinephrine reuptake inhibitors) helps manage attention-deficit hyperactivity disorder (ADHD) by enhancing focus and decreasing impulsive behaviour.

What are the indications of Atomoxetine?

  • Attention deficit hyperactivity disorder
  • Neurogenic orthostatic hypotension (off label)

How is Atomoxetine sold/available in the market?

  • Capsules

How does Atomoxetine functions in my body?

Atomoxetine is classified under SNRIs (serotonin-norepinephrine reuptake inhibitors). It works by blocking a protein called the pre-synaptic norepinephrine transporter, which affects brain chemicals linked to hyperactivity and impulse control. Blocking this protein may help reduce ADHD symptoms.

When Atomoxetine should be consumed?

This medicine is usually prescribed up to 2 times a day. Dosage adjustments are made based on the individual response and side effects experienced.
  • Once a day: take this medicine in the morning
  • Twice a day: take one dose in the morning and 2nd dose in the evening
Take the medicine at the same time every day to see the improvement

How Atomoxetine should be consumed?

Oral capsules:

  • Take Atomoxetine capsules as a whole. Do not open, or chew them.

  • If the capsule breaks or opens by accident, quickly wash away any powder with water. Don’t touch the powder, and be careful not to get it in your eyes. If it does get in your eyes, rinse them with water immediately and call your doctor.

Does Atomoxetine show its effect immediately?

You might start feeling better in the first week, but it can take up to a month to feel the full effects of Atomoxetine.

Is there any harm in drinking alcohol if I take Atomoxetine?

Drinking alcohol is not recommended as it increases the side effects, worsens symptoms and makes you drowsy.

Who should avoid taking Atomoxetine?

  • Do not give this medicine to a child without a doctor’s approval.

  • Patients with narrow angle glaucoma and irregular heart beat or any heart disease

  • Patients with Pheochromocytoma – tumour of adrenal gland

  • If your family member ever had mental illness, low blood pressure, liver disease or sudden death

Do I need to continue Atomoxetine after my symptoms get better?

If you stop taking Atomoxetine suddenly, you probably won’t have withdrawal symptoms, but your old symptoms might come back. If you don’t want to keep taking it, be sure to talk to your doctor first.

What are the side effects of atomoxetine?

Every drug has their own side effects. But some may experience, and some do not have any side effects.
Taking Atomoxetine could result in certain side effects. Reach out to your doctor immediately if any of these symptoms are getting worsened and do not subside.

Common side effects:

  • Gastrointestinal: Vomiting, Constipation, Stomach pain, Decreased appetite 
  • Neurological: Headache, Dizziness, Trouble sleeping
  • Mouth-related: Dry mouth (feeling unusually dry or sticky)

Rare side effects: (Contact your doctor/ seek medical attention immediately)

  • Cardiac: Irregular heartbeat (arrhythmia)
  • Psychiatric: Mood or behavior changes such as anxiety, confusion, or suicidal thoughts
  • Urinary: Difficulty or painful urination
You may experience rash, hives, itching, redness, or swelling. If any of these occur, discontinue the medication and seek medical attention immediately.
 
 
atomoxetine feature image

How to cope up with Atomoxetine Side Effects?

  • Nausea or stomach upset: Take with food or after meals.

  • Headache: Stay hydrated, rest, and use mild pain relievers if advised.

  • Dry mouth: Sip water often or chew sugar-free gum.

  • Insomnia: If Once daily, take in the morning, avoid caffeine late in the day.

  • Loss of appetite: Eat small, frequent, healthy meals.

  • Dizziness: Get up slowly and stay hydrated.

  • Mood changes: Inform your doctor right away.

What should I watch for while I’m taking Atomoxetine?

  • This medicine might make you feel sleepy or dizzy. Don’t drive, use tools, or do anything that needs full attention until you know how it affects you.

  • Visit your doctor regularly so they can check how the medicine is working. It might take a few weeks to feel the full effect.

  • Atomoxetine can raise your blood pressure, so your doctor will check it from time to time while you’re on this medicine.

What medications should I avoid while taking Atomoxetine?

This medication should not be taken with any of the following:

  • Medications for depression, anxiety, or mental health conditions

  • Medications for lung conditions, such as albuterol

  • Mono amine oxidase inhibitors like selegiline, isocarboxazid 

  • Caution to be taken with medications for high blood pressure, heart disease, or irregular heartbeat  

Do not take any OTC/ herbal medications without informing to the doctor.

Is it safe to take Atomoxetine during pregnancy?

Atomoxetine isn’t usually recommended during pregnancy unless your doctor decides the benefits outweigh the risks.

Summary

Atomoxetine is a non-stimulant SNRI used to treat ADHD, helping improve focus and reduce impulsive behavior. It works by increasing norepinephrine levels in the brain. Common side effects include headache, vomiting, dry mouth, constipation, dizziness, and sleep trouble. Avoid alcohol and interacting medicines, and always consult your doctor before stopping. Atomoxetine is not usually recommended during pregnancy unless your doctor decides the benefits outweigh the risks. It may take a few weeks to show full effect.
 

Author:

  1. Dr. Likitha B S, Pharm. D, Clinical Pharmacologist, Aster Hospitals, Bengaluru
  2. Dr Praveen Kumar, B. Pharm, Pharm D(PB), Lead Clinical Pharmacologist, REGIONAL HEAD KIMS Hospitals, Bengaluru
  3. Dr. C. P. Ravi Kumar Lead & Senior Consultant – Paediatric Neurology KIMS HOSPITALS BENGALURU
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