‹
atomoxetine
Strattera
Non-stimulant ADHD agent⚠ Unverified beta content
At a glance
- Class
- Selective norepinephrine reuptake inhibitor (non-controlled)
- Black box
- ⚠ Suicidal thoughts and behaviors in pediatric patients ≥6 years
- Key monitoring
- Blood pressure & heart rate
- Suicidality / mood / behavior
- Liver injury signs (jaundice, dark urine, abdominal pain)
- Usual adult dose
- Adults and children ≥70 kg (label): Start 40 mg/day; target 80 mg/day; max 100 mg/day
- Call provider / escalate if
- Yellow skin/eyes, dark urine, right-sided abdominal pain, itching (liver injury) • Suicidal thoughts or behavior, aggression, hostility • Chest pain, fainting, palpitations
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- atomoxetine (Strattera) — selective norepinephrine reuptake inhibitor (non-controlled).
- Used for: ADHD.
Usual adult dosing
- Adults and children ≥70 kg (label): Start 40 mg/day; target 80 mg/day; max 100 mg/day (Once daily in the morning or divided BID (AM and late afternoon/early evening). May increase to 100 mg after 2–4 weeks if needed.)
- Strong CYP2D6 inhibitors / poor metabolizers: Slower titration (see label)
- Hepatic impairment: Reduced dose (see label)
Boxed warning
- Suicidal thoughts and behaviors in pediatric patients ≥6 years: increased risk of suicidal ideation in short-term studies; monitor closely, especially initial months and dose changes.
Monitor
- Blood pressure & heart rate [Baseline, after dose increases, periodically]
- Suicidality / mood / behavior [Every visit; closely early (esp. pediatric)]
- Liver injury signs (jaundice, dark urine, abdominal pain)
Nursing priorities
- Baseline BP, HR, weight; cardiac history; liver disease.
- Personal/family history of bipolar disorder, mania, suicidality.
- Capsules must be swallowed whole (do not open – ocular irritant).
- Check BP/HR at baseline, after dose increases and periodically.
- Educate about liver injury signs; report jaundice/dark urine/RUQ pain immediately.
Major interactions
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days: Serious, sometimes fatal reactions – contraindicated.
- Strong CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine, bupropion): Increased atomoxetine exposure – slow titration.
Key teaching
- Take it every day. It can take several weeks to work. Swallow capsules whole; do not open them.
- Call right away for yellow skin or eyes, dark urine, or belly pain on the right side – it can rarely harm the liver.
- Tell your provider about new thoughts of hurting yourself, agitation, or mood changes, especially in the first months.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Suicidal thoughts and behaviors in pediatric patients ≥6 years: increased risk of suicidal ideation in short-term studies; monitor closely, especially initial months and dose changes.
Other serious warnings
- Severe liver injury (stop and do not restart if jaundice or lab evidence)
- Serious cardiovascular reactions; increased BP/HR
- Psychotic/manic symptoms; aggression/hostility
- Urinary retention
- Priapism
- Growth effects in children
- Hypersensitivity
- Contraindicated with MAOIs (or within 14 days) and in narrow-angle glaucoma
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
- Blood pressure & heart rateWhen: Baseline, after dose increases, periodically
- Suicidality / mood / behaviorWhen: Every visit; closely early (esp. pediatric)
- Liver injury signs (jaundice, dark urine, abdominal pain)Obtain LFTs if suspected; discontinue permanently if liver injury
- Weight / growth (children)
- Urinary retention
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
Assessment
- Baseline BP, HR, weight; cardiac history; liver disease.
- Personal/family history of bipolar disorder, mania, suicidality.
- Current meds – especially strong CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion) and MAOIs.
Interventions
- Capsules must be swallowed whole (do not open – ocular irritant).
- Check BP/HR at baseline, after dose increases and periodically.
- Educate about liver injury signs; report jaundice/dark urine/RUQ pain immediately.
- Monitor for suicidal thinking and behavior changes (esp. young patients).
- Benefit takes weeks; not a controlled substance.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Yellow skin/eyes, dark urine, right-sided abdominal pain, itching (liver injury)
- Suicidal thoughts or behavior, aggression, hostility
- Chest pain, fainting, palpitations
- New hallucinations or manic symptoms
- Erection lasting more than 4 hours
- Unable to urinate
- Severe allergic reaction (rash, swelling, trouble breathing)
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Decreased appetite, nausea, dry mouth
- Insomnia / somnolence
- Headache, dizziness
- Constipation
- Increased heart rate / blood pressure
- Urinary hesitancy/retention
- Sexual dysfunction
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days MajorSerious, sometimes fatal reactions – contraindicated.
- Strong CYP2D6 inhibitors (fluoxetine, paroxetine, quinidine, bupropion) MajorIncreased atomoxetine exposure – slow titration.
- Antihypertensives / pressor agentsAdditive BP increase – monitor.
- Albuterol (systemic or high-dose)Increased cardiovascular effects.
- QT-prolonging drugsUse caution (label notes QT considerations).
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
- Take it every day. It can take several weeks to work. Swallow capsules whole; do not open them.
- Call right away for yellow skin or eyes, dark urine, or belly pain on the right side – it can rarely harm the liver.
- Tell your provider about new thoughts of hurting yourself, agitation, or mood changes, especially in the first months.
- It can raise your heart rate and blood pressure; keep your checkups.
- Tell your provider about all medicines you take – some (like fluoxetine or paroxetine) raise atomoxetine levels.
- Tell your provider if you have trouble peeing, or a painful erection that lasts hours.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- ADHD (≥6 years and adults)
Dosing
- Adults and children ≥70 kg (label): Start 40 mg/day; target 80 mg/day; max 100 mg/dayOnce daily in the morning or divided BID (AM and late afternoon/early evening). May increase to 100 mg after 2–4 weeks if needed.
- Strong CYP2D6 inhibitors / poor metabolizers: Slower titration (see label)
- Hepatic impairment: Reduced dose (see label)
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
Prescriber-oriented details; limited in this beta.
hepatic Adjustment
- Moderate impairment: 50% of usual dose; severe: 25% (label).
cyp Notes
- CYP2D6 substrate; poor metabolizers ~10× higher exposure; titrate slower with strong inhibitors.
Sources: FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [E
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): STRATTERA (ATOMOXETINE HYDROCHLORIDE) CAPSULE [ELI LILLY AND COMPANY]
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified
Reviewer notes – please double-check
- Confirmed against the DailyMed Strattera label (Jul 2026 version) at time of drafting; still unverified by a clinician.