Atomoxetine

The dose of atomoxetine depends on the needs of the person taking the medication. The daily dose of atomoxetine is based on body weight and is taken once daily or twice daily. The dose is started low and increased gradually. Doses above 100 mg daily are not recommended. Atomoxetine may be taken with or without food. Swallow the capsules whole, and do not open the capsules.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Atomoxetine be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Atomoxetine at room temperature, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may increase your heart rate; it may increase your blood pressure; it may cause mood swings; it may cause nausea or, rarely, vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

10 mg
Each hard gelatin capsule with a white opaque cap and white opaque body, filled with a white to off-white powder with small agglomerates and imprinted "A10" on body and cap contains atomoxetine hydrochloride equivalent to 10 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch, sodium lauryl sulfate, gelatin, and titanium dioxide.

18 mg
Each hard gelatin capsule with a yellow opaque cap and white opaque body, filled with a white to off-white powder with small agglomerates and imprinted "A18" on body and cap contains atomoxetine hydrochloride equivalent to 18 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch, sodium lauryl sulphate, gelatin, titanium dioxide, and D&C Yellow No. 10.

25 mg
Each hard gelatin capsule with a blue opaque cap and white opaque body, filled with a white to off-white powder with small agglomerates and imprinted "A25" on body and cap contains atomoxetine hydrochloride equivalent to 25 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch, sodium lauryl sulphate, gelatin, titanium dioxide, FD&C Blue No. 1/Brilliant Blue FCF, and D&C Yellow No. 10.

40 mg
Each hard gelatin capsule with a blue opaque cap and blue opaque body, filled with a white to off-white powder with small agglomerates and imprinted "A40" on body and cap contains atomoxetine hydrochloride equivalent to 40 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch, sodium lauryl sulphate, gelatin, titanium dioxide, FD&C Blue No. 1/Brilliant Blue FCF, and D&C Yellow No. 10.

60 mg
Each hard gelatin capsule with a blue opaque cap and yellow opaque body, filled with a white to off-white powder with small agglomerates and imprinted "A60" on body and cap contains atomoxetine hydrochloride equivalent to 60 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch, sodium lauryl sulphate, gelatin, titanium dioxide, D&C Yellow No. 10, FD&C Blue No. 1, and Brilliant Blue FCF.

80 mg
Each hard gelatin capsule with an orange opaque cap and a white opaque body. and Imprinted "rph" on cap and "A132" on body, contains atomoxetine hydrochloride equivalent to 80 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch and dimeticone; capsule shell: gelatin, titanium dioxide and red iron oxide.

100 mg
Each hard gelatin capsule with an orange opaque cap and a white opaque body. and Imprinted "rph" on cap and "A131" on body, contains atomoxetine hydrochloride equivalent to 100 mg of atomoxetine. Nonmedicinal ingredients: pregelatinized starch and dimeticone; capsule shell: gelatin, titanium dioxide and red iron oxide.

Do not take atomoxetine if you:

• are allergic to atomoxetine or any ingredients of the medication
• have an overactive Thyroid gland
• have advanced hardening of the arteries
• have heart disease
• have moderate-to-severe high blood pressure
• have narrow-angle Glaucoma
• have a pheochromocytoma (a type of tumour of the adrenal glands)
• have taken a type of medication known as an MAO inhibitor (e.g., Phenelzine, Tranylcypromine, Moclobemide) within the past 2 weeks - do not start treatment with an MAO inhibitor until at least 2 weeks after discontinuing atomoxetine treatment

Do not give Atomoxetine to children under 6 years of age.

There may be an interaction between atomoxetine and any of the following:

• Abiraterone
• antiarrhythmics (e.g., Amiodarone, Disopyramide, dofetilide, Flecainide, procainamide, quinidine)
• antipsychotics (e.g., Aripiprazole, Chlorpromazine, Clozapine, Haloperidol, thioridazine)
• asunaprevir
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• blood pressure medications
• fast acting bronchodilators (e.g., salbutamol, terbutaline)
• long acting bronchodilators (e.g., formoterol, salmeterol)
• Bupropion
• caffeine
• chloroquine
• Cinacalcet
• Cobicistat
• Darifenacin
• darunavir
• decongestant cold medications (e.g., phenylephrine, Pseudoephedrine)
• decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
• delavirdine
• dipivefrin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Domperidone
• Duloxetine
• isoniazid
• ketoconazole
• Linezolid
• lopinavir
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methadone
• mifepristone
• Modafinil
• monoamine oxidase inhibitors (MAOI; e.g., phenelzine, tranylcypromine, moclobemide, Selegiline)
• other medications for ADHD (e.g., Dextroamphetamine, Methylphenidate)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Ofloxacin,)
• rilpivirine
• ritonavir
• serotonin reuptake inhibitors (e.g., Fluoxetine, Paroxetine, Sertraline)
• Tetrabenazine
• theophyllines (e.g., Aminophylline, Oxtriphylline, Theophylline)
• Trazodone
• tricyclic antidepressasnts (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• xylometazoline
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• tyrosine kinase inhibitors (e.g., imatinib, Lapatinib, Nilotinib, Pazopanib, Sunitinib)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Atomoxetine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Atomoxetine.

Behavioural and emotional changes: Atomoxetine may cause some people to experience unusual feelings of aggression, hostility, or anxiety. They may have hallucinations or have impulsive or disturbing thoughts of harming themselves. If you experience these side effects (or notice them in a family member who is taking Atomoxetine), contact your doctor immediately. Your doctor will monitor you closely for these side effects while you are taking Atomoxetine.

Blood pressure: People with low blood pressure or high blood pressure should be closely monitored by their doctor while they are taking Atomoxetine. Atomoxetine can increase blood pressure or can cause dizziness or fainting for people who have low blood pressure. If you have low blood pressure or high blood pressure, discuss with your doctor how Atomoxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Atomoxetine, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Atomoxetine may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how Atomoxetine affects you.

Exercise: If you participate in strenuous exercise or activities, consult your doctor before taking atomoxetine.

Growth and weight gain: Atomoxetine can cause children to lose weight and can slow their growth rate. Your doctor will monitor for slowed growth while they are taking Atomoxetine. Children who are not growing or gaining weight as expected may need to stop their treatment with Atomoxetine, as recommended by their doctor.

Heart problems: Atomoxetine can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. If you have heart problems, including an irregular heartbeat or a family history of sudden death related to heart disease, discuss with your doctor how Atomoxetine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Atomoxetine, and whether any special monitoring is needed. Atomoxetine is generally not recommended for people with known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart).

Kidney function: Kidney Disease or reduced kidney function may cause Atomoxetine to build up in the body, causing side effects. People with kidney problems may need lower doses of Atomoxetine. People with kidney problems should discuss with their doctor how Atomoxetine may affect their medical conditions, how their medical condition may affect the dosing and effectiveness of Atomoxetine, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Atomoxetine to build up in the body, causing side effects. People with decreased liver function may require lower doses of Atomoxetine. In rare cases, atomoxetine may cause liver injury. Anyone taking atomoxetine should report yellow eyes or skin, dark urine, itching, upper-right abdominal pain, or unexplained flu-like symptoms to their doctor.

Long-term use: If you use Atomoxetine for a long period of time, you will need regular heart checkups by your doctor.

Suicidal or agitated behaviour: People taking Atomoxetine may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. If you experience these side effects or notice them in a family member who is taking Atomoxetine, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking Atomoxetine.

Stopping the medication: Check with your doctor before stopping Atomoxetine.

Urinary Tract Problems: Atomoxetine can cause problems with bladder emptying and urinary tract function. If you experience difficulty starting to urinate or increased frequency of needing to urinate, contact your doctor.

Pregnancy: Atomoxetine should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Atomoxetine, contact your doctor immediately.

Breast-feeding: It is not known if atomoxetine passes into breast milk. If you are a breast-feeding mother and are taking Atomoxetine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Atomoxetine have not been established for young children. Atomoxetine should not be used by children under 6 years of age.

This pharmacologic treatment should be an integral part of a global treatment program that could include supportive psychological, educational or other measures. This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. The capsule of this medication should not be opened, crushed or chewed. This medication may be taken with or without food. If it were, however, to cause stomach problems (nausea or irritation), taking the product with food could provide relief.