Atomoxetine is used to treat attention deficit hyperactivity disorder (ADHD).
ADHD is a behavioural condition characterised by inattentiveness, hyperactivity, and impulsiveness.
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 and oral solution.
If you are taking the capsule, swallow it whole with a glass of water. Do not crush, chew or open the capsule, as the contents of the capsule can irritate your eyes. If the contents of the capsule come into contact with your eyes, rinse the eye 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 taking the oral solution, use the measuring spoon or cup provided to measure 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 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.
Take the missed dose 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 under any circumstances.
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 eye)
- current or history of phaeochromocytoma (rare tumour of the adrenal gland causing high blood pressure)
- severe heart problems e.g. severe high blood pressure, heart failure (weakness and inability of the heart to pump blood), chest pain, irregular or abnormal heartbeat, narrowing of the blood vessels of the heart, abnormally thick heart muscle, heart attack, inherited heart disease
- disease of the blood vessels supplying 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) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor if you have the following conditions:
- known, suspected or family history of QT interval prolongation (heart rhythm disorder)
- low or high blood pressure
- problems with sudden changes in your blood pressure or heart rate
- anxiety disorder
- tics related to Tourette’s syndrome (a disorder characterised by sudden, repetitive, and uncontrollable body movements or vocal sounds)
- bipolar disorder (mental condition that causes extreme mood changes between feeling very high [mania] and very low [depression])
- history of epilepsy (fits or seizures)
- history of bladder problems e.g. inability to completely empty the bladder when urinating, bladder blockage
- 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. Children may be more sensitive to the side effects. This medicine may reduce the rate of growth of children. Monitoring of their height and weight may be needed.
Some genetic traits can affect this medicine’s level in the blood. A certain enzyme called CYP2D6 is involved in the breakdown of this medicine in the body. Individuals who have reduced CYP2D6 activity, also known as poor metabolisers of CYP2D6 may experience enhanced effects from Atomoxetine 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.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Evaluation of your heart condition and assessment of risk factors for bipolar disorder may be done before treatment to know if this medicine is suited for you to take.
- Routine tests (e.g. liver function, ECG [test used to record the electrical activity of the heart]) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure and heart rate may rise to unsafe levels without you noticing it. Monitor your blood pressure and heart rate regularly during treatment.
- Regular monitoring for signs of bipolar disorder, Tourette’s syndrome, anxiety, and depression 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, constipation, stomach pain or wind, indigestion, loss of appetite, weight loss, difficulty sleeping, irritability, increased sweating, hot flushes, tremors, and numbness or tingling sensation in the hands or feet.
Men may experience sexual problems 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 face, eyes or mouth
- signs and symptoms of heart attack e.g. chest pain, tightness or pressure, pain that may spread to the arms, jaw, neck, shoulder or back, shortness of breath, lightheadedness
- fast or irregular heartbeat, chest pain, unexplained fainting or loss of consciousness
- weakness or numbness on one side of the body, trouble speaking, vision problems, changes in balance or coordination
- 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)
- fits or seizures
- difficulty or hesitancy in passing out urine
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
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. Do not take MAOIs within 14 days of stopping Atomoxetine.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat depression e.g. fluoxetine, paroxetine, imipramine, venlafaxine, mirtazapine, bupropion
- medicines for colds or nasal congestion e.g. phenylephrine, pseudoephedrine
- medicines used to treat malaria (a disease characterised by chills, fever and sweating that is transmitted to people through the bite of an infected mosquito) e.g. mefloquine, chloroquine
- medicines for irregular heartbeat e.g. quinidine
- medicines for high blood pressure
- certain antibiotics e.g. moxifloxacin, erythromycin
- strong painkillers e.g. tramadol, methadone
- lithium (medicine for mood disorders)
- salbutamol (asthma medicine)
- terbinafine (medicine to treat fungal infection)
- cisapride (medicine that reduces stomach acid production)
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.
Avoid alcohol.
Store in a cool, dry place away from the reach of children.
The oral solution should be used within 45 days after opening.
Medicines must not be used past the expiry date.
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