Atomoxetine (Strattera)

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Generic Name: atomoxetine (AT oh mox e teen)

Brand name: Strattera®

• Capsules: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg

All FDA warnings are at the end of this fact sheet. Please consult them before taking this medication.

What is atomoxetine and what does it treat?

Atomoxetine is a prescription medication that is used to treat attention-deficit hyperactivity disorder (ADHD).

Symptoms of ADHD interfere can affect a person’s ability to function at school, work or in social settings. Symptoms can include:

• Inattention (e.g., making careless mistakes, losing things necessary for tasks)
• Hyperactivity (e.g., inability to sit still)
• Impulsivity (e.g., interrupting or intruding on others)

Hyperactivity is less common in adults. A person may have severe inattention without hyperactivity or impulsivity.

Atomoxetine is used in addition to non-medication treatments to manage ADHD symptoms.

What is the most important information I should know about atomoxetine?

It may take several weeks before you notice the full benefits of this medication. It is important to continue taking atomoxetine as directed, even if you do not notice immediate improvement.

Are there specific concerns about atomoxetine and pregnancy?

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with ADHD who wish to become pregnant face important decisions. Untreated ADHD has risks for the fetus as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

Caution is advised with breastfeeding since it is not known if atomoxetine passes into human breast milk.

What should I discuss with my health care provider before taking atomoxetine?

• Symptoms of your condition that bother you the most
• If you have thoughts of suicide or harming yourself
• If you experience side effects from your medication as some side effects pass with time, but others may require changes in the medication.
• Any other psychiatric or medical problems you have, including heart or liver disease, narrow angle glaucoma or a rare tumor called pheochromocytoma
• All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
• Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
• If you are pregnant, plan to become pregnant, or are breastfeeding
• If you drink alcohol or use drugs

How should I take atomoxetine?

Atomoxetine is usually taken one to two times per day with or without food.

The dose usually ranges from 20 mg to 100 mg. Only your health care provider can determine the correct dose for you.

Capsules should be swallowed whole, not crushed, chewed or opened.

Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking you medication.

What happens if I miss a dose of atomoxetine?

If you miss a dose of atomoxetine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What should I avoid while taking atomoxetine?

Avoid drinking alcohol or using illegal drugs while you are taking this medication. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What happens if I overdose with atomoxetine?

If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of atomoxetine does not exist.

What are the possible side effects of atomoxetine?

Common side effects

• Upset stomach, nausea, vomiting, decreased appetite, constipation, dry mouth, headache
• Feeling sleepy during the day or trouble sleeping at night
• Decreased libido or sexual side effects

Rare side effects

• Increased heart rate and blood pressure
• Menstrual cycle changes, urinary retention or hesitancy, flushing/sweating, irritability, or mood swings
• Rarely, a painful prolonged erection has been reported in males. Seek medical help right away if this occurs.
• Risk of switching to hypomania and mania, particularly in individuals with bipolar disorder

Serious side effects

• Liver toxicity, increased suicidal thoughts, angioedema, and cardiovascular complications

Are there any risks for taking atomoxetine for long periods of time?

There are no known problems associated with long term use of atomoxetine.

What other medications may interact with atomoxetine?

The following medications may increase the levels and effects of atomoxetine:

• Paroxetine (Paxil®), Fluoxetine (Prozac®), and Quinidine (Quinidex®)

Atomoxetine should not be taken with or within 2 weeks of monoamine oxidase inhibitor antidepressants (MAOIs), including phenelzine (Nardil®), Tranylcypromine (Parnate®), selegiline (Emsam®), and isocarboxazid (Marplan®) or the antibiotic linezolid (Zyvox®). Taking atomoxetine with or within 2 weeks of MAOIs can result in seizures, fever or dangerously high blood pressure that can lead to death.

Because of atomoxetine’s possible effect on blood pressure, it should be used cautiously with other medications that increase or decrease blood pressure. Medications for asthma/difficulty breathing (e.g., albuterol) can increase the risk of high blood pressure and rapid heart rate (tachycardia) when taking atomoxetine.

How long does it take for atomoxetine to work?

It may take 4-8 weeks to get the maximum benefit once the right dose is determined. However, improvements in some symptoms may occur sooner.

Summary of Black Box Warnings

Suicidal Thoughts or Actions in Children, Teens, and Young Adults

• Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
• In short-term studies, atomoxetine increased the risk of suicidality in children, adolescents, and young adults when compared to placebo.
• Patients should be closely monitored for suicidality (suicidal thinking and behavior), worsening of symptoms, or changes in behavior especially when atomoxetine is first started or the dose is increased.
• Families and caregivers should be advised of the need for close observation and communication with the prescriber if any of these signs are seen.

Last Reviewed: January 2024

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Important Disclosure: This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

©2023 The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). AAPP and NAMI make this document available under the Creative Commons Attribution-NoDerivatives 4.0 International License. Last Updated: January 2016.