Strattera
Strattera - General Information
Strattera is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). It is sold in the form of the hydrochloride salt of atomoxetine. This chemical is manufactured and marketed under the brand name Strattera® by Eli Lilly and Company and as a generic Attentin by Torrent Pharmaceuticals. There is currently no generic available within the United States due to patent restrictions. [Wikipedia]
Pharmacology of Strattera
Strattera is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). Strattera is classified as a norepinephrine reuptake inhibitor, and is approved for use in children, adolescents, and adults. However, its efficacy has not been studied in children under six years old. Its advantage over stimulants for the treatment of ADHD is that it has less abuse potential than stimulants, is not scheduled as a controlled substance and has proven in clinical trials to offer 24 hour coverage of symptoms associated with ADHD in adults and children.
Strattera for patients
Patients should read Information for Patients before starting therapy with STRATTERA and when the prescription is renewed.
Patients initiating STRATTERA should be cautioned that liver dysfunction may develop rarely. Patients should be instructed to contact their physician immediately should they develop pruritus, dark urine, jaundice, right upper quadrant tenderness, or unexplained "flu-like" symptoms.
Patients should be instructed to call their doctor as soon as possible should they notice an increase in aggression or hostility.
Patients should consult a physician if they are taking or plan to take any prescription or over-the-counter medicines, dietary supplements, or herbal remedies.
Patients should consult a physician if they are nursing, pregnant, or thinking of becoming pregnant while taking STRATTERA.
Patients may take STRATTERA with or without food.
If patients miss a dose, they should take it as soon as possible, but should not take more than the prescribed total daily amount of STRATTERA in any 24-hour period.
Patients should use caution when driving a car or operating hazardous machinery until they are reasonably certain that their performance is not affected by atomoxetine.
Strattera Interactions
Drug-Drug Interactions
Albuterol - STRATTERA should be administered with caution to patients being treated with systemically-administered (oral or intravenous) albuterol (or other beta2 agonists) because the action of albuterol on the cardiovascular system can be potentiated resulting in increases in heart rate and blood pressure.
CYP2D6 inhibitors - Atomoxetine is primarily metabolized by the CYP2D6 pathway to 4-hydroxyatomoxetine. In EMs, selective inhibitors of CYP2D6 increase atomoxetine steady-state plasma concentrations to exposures similar to those observed in PMs. Dosage adjustment of STRATTERA may be necessary when coadministered with CYP2D6 inhibitors, e.g., paroxetine, fluoxetine, and quinidine. In EM individuals treated with paroxetine or fluoxetine, the AUC of atomoxetine is approximately 6- to 8-fold and Css,max is about 3- to 4-fold greater than atomoxetine alone.
In vitro studies suggest that coadministration of cytochrome P450 inhibitors to PMs will not increase the plasma concentrations of atomoxetine.
Pressor agents - Because of possible effects on blood pressure, STRATTERA should be used cautiously with pressor agents.
Strattera Contraindications
Additional information about Strattera
Strattera Indication: For the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD).
Mechanism Of Action: The precise mechanism by which atomoxetine produces its therapeutic effects in Attention-Deficit/Hyperactivity Disorder (ADHD) is unknown, but is thought to be related to selective inhibition of the pre-synaptic norepinephrine transporter, as determined in ex vivo uptake and neurotransmitter depletion studies.
Drug Interactions: Amiodarone The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Chloroquine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Diphenhydramine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Fluoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Fluphenazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Haloperidol The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Isocarboxazid Possible severe adverse reaction with this combination
Lomustine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Mibefradil The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Paroxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Perphenazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Phenelzine Possible severe adverse reaction with this combination
Primaquine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Propafenone The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Propoxyphene The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Quinacrine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Quinidine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Quinidine barbiturate The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Rasagiline Possible severe adverse reaction with this combination
Ritonavir The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Terbinafine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Thioridazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Vinorelbine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Tranylcypromine Possible severe adverse reaction with this combination
Yohimbine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine
Food Interactions: Take without regard to meals.
In the presence of food, the absorption rate is reduced, without the quantity absorbed being affected.
Generic Name: Atomoxetine
Synonyms: Tomoxetina [Spanish]; Tomoxetine; Tomoxetine [INN]; Tomoxetinum [Latin]
Drug Category: Antidepressants; Central Nervous System Agents; Adrenergic Uptake Inhibitors
Drug Type: Small Molecule; Approved
Other Brand Names containing Atomoxetine: Strattera;
Absorption: Atomoxetine is rapidly absorbed after oral administration, with absolute bioavailability of about 63% in EMs and 94% in PMs. Drugs that elevate gastric pH (magnesium hydroxide/aluminum hydroxide, omeprazole) have no effect on atomoxetine bioavailability. Absorption is minimally affected by food.
Toxicity (Overdose): The most commonly reported symptoms accompanying acute and chronic overdoses are somnolence, agitation, hyperactivity, abnormal behavior, and gastrointestinal symptoms.
Protein Binding: At therapeutic concentrations, 98% of atomoxetine in plasma is bound to protein, primarily albumin.
Biotransformation: Atomoxetine is primarily metabolized by the CYP2D6 pathway to 4-hydroxyatomoxetine. 4-Hydroxyatomoxetine is equipotent to atomoxetine as an inhibitor of the norepinephrine transporter but circulates in plasma at much lower concentrations (1% of atomoxetine concentration in EMs and 0.1% of atomoxetine concentration in PMs).
Half Life: 5 hours
Dosage Forms of Strattera: Capsule Oral
Capsule Oral
Capsule Oral
Capsule Oral
Capsule Oral
Capsule Oral
Chemical IUPAC Name: (3R)-N-methyl-3-(2-methylphenoxy)-3-phenylpropan-1-amine
Chemical Formula: C17H21NO
Atomoxetine on Wikipedia: https://en.wikipedia.org/wiki/Atomoxetine
Organisms Affected: Humans and other mammals
