Atomoxetine: Difference between revisions
| [unchecked revision] | [checked revision] |
MDElliottMD (talk | contribs) Auto-created stub |
MDElliottMD (talk | contribs) parser-claude: Atomoxetine MedTemplate refill, Top 300 stub upgrade |
||
| (8 intermediate revisions by the same user not shown) | |||
| Line 2: | Line 2: | ||
| generic = Atomoxetine | | generic = Atomoxetine | ||
| brand = Strattera | | brand = Strattera | ||
| classes = NRI, ADHD medicine | | structure = | ||
| mechanism = Selective norepinephrine reuptake | | classes = [[:Category:NRIs|Selective norepinephrine reuptake inhibitor (NRI)]], [[:Category:ADHD medicines|ADHD medicine]] | ||
| uses = <vote slug="adhd-atomoxetine-use">Attention-deficit/hyperactivity disorder (FDA, ages 6+ and adult; the first non-controlled FDA-approved ADHD medicine)</vote> | |||
| starting_dose = Children ≤70 kg: 0.5 mg/kg/day, titrate to 1.2 mg/kg/day after 3 days. Adults and children >70 kg: 40 mg PO once daily for 3 days, then 80 mg/day, then if needed 100 mg/day after 2-4 weeks | |||
| preparations = Capsules 10, 18, 25, 40, 60, 80, 100 mg | |||
| fda_max = 100 mg/day (adult); 1.4 mg/kg/day or 100 mg total (pediatric, whichever lower) | |||
| pill_id = | |||
| routes = Oral | |||
| onset = ADHD effect emerges over 1-2 weeks (slower than psychostimulants); full effect 4-6 weeks | |||
| duration = 24 hours (once-daily or split BID dosing) | |||
| halflife = ~5 hours in extensive CYP2D6 metabolizers; ~21 hours in CYP2D6 poor metabolizers<ref name="strattera-label">FDA Prescribing Information, Strattera (atomoxetine hydrochloride), Eli Lilly, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021411s044lbl.pdf</ref> | |||
| bioavailability = ~63% (oral; extensive first-pass)<ref name="strattera-label" /> | |||
| pregnancy = Limited human data.{{citation needed}} | |||
| legal = [[USLegal:Prescription only|Rx-only]] in US. '''Not a controlled substance''', the principal clinical selling point versus psychostimulant ADHD options. Carries the antidepressant-class '''Boxed Warning''' for suicidal ideation in pediatric patients<ref name="strattera-label" /> | |||
| mechanism = <vote slug="atomoxetine-mech-claim">Selective inhibition of the presynaptic norepinephrine transporter (NET). Increases extracellular norepinephrine and, in the prefrontal cortex, dopamine (since prefrontal dopamine reuptake is largely NET-mediated in that region, accounting for the ADHD efficacy despite no direct dopamine targeting).</vote> '''Not a psychostimulant''': no euphoric or rewarding effect, no abuse liability, no Schedule classification. CYP2D6 substrate with a strong pharmacogenomic signal: poor metabolizers have approximately 5-10-fold higher plasma exposure than extensive metabolizers, and CPIC provides CYP2D6 dosing guidance<ref name="cpic-atomoxetine">CPIC Guideline for Atomoxetine and CYP2D6 Genotype, 2019. https://cpicpgx.org/guidelines/cpic-guideline-for-atomoxetine-based-on-cyp2d6-genotype/</ref>. | |||
}} | }} | ||
== References == | |||
<references /> | |||
[[Category:NRIs]] | |||
[[Category:ADHD medicines]] | |||
Latest revision as of 07:08, 23 May 2026
Atomoxetine
Strattera
Experience
No personal reports yet
No clinical reports yet
Log in to add your own experience.
Problems
No problems yet. Be the first to suggest one.
+ Add a problemTitration strategies
No titration strategies yet. Be the first to suggest one.
Effects
No effects listed yet. Be the first to suggest one.
Relevant anecdote
No anecdotes yet. Share a relevant one.
Relevant Literature
No literature entries yet.
Log in to submit relevant literature.
Pharmacy
Starting dose
Children ≤70 kg: 0.5 mg/kg/day, titrate to 1.2 mg/kg/day after 3 days. Adults and children >70 kg: 40 mg PO once daily for 3 days, then 80 mg/day, then if needed 100 mg/day after 2-4 weeks
Preparations
Capsules 10, 18, 25, 40, 60, 80, 100 mg
US FDA Max
100 mg/day (adult); 1.4 mg/kg/day or 100 mg total (pediatric, whichever lower)
Common uses
Classification(s)
Pharmacology
Routes
Oral
Onset
ADHD effect emerges over 1-2 weeks (slower than psychostimulants); full effect 4-6 weeks
Duration
24 hours (once-daily or split BID dosing)
Half-life
~5 hours in extensive CYP2D6 metabolizers; ~21 hours in CYP2D6 poor metabolizers[2]
Bioavailability
~63% (oral; extensive first-pass)[2]
Pregnancy
Limited human data.[citation needed]
Legal status
Purported mechanism
Selective inhibition of the presynaptic norepinephrine transporter (NET). Increases extracellular norepinephrine and, in the prefrontal cortex, dopamine (since prefrontal dopamine reuptake is largely NET-mediated in that region, accounting for the ADHD efficacy despite no direct dopamine targeting).0 Not a psychostimulant: no euphoric or rewarding effect, no abuse liability, no Schedule classification. CYP2D6 substrate with a strong pharmacogenomic signal: poor metabolizers have approximately 5-10-fold higher plasma exposure than extensive metabolizers, and CPIC provides CYP2D6 dosing guidance[1].
References
- ↑ CPIC Guideline for Atomoxetine and CYP2D6 Genotype, 2019. https://cpicpgx.org/guidelines/cpic-guideline-for-atomoxetine-based-on-cyp2d6-genotype/
- ↑ 2.0 2.1 2.2 FDA Prescribing Information, Strattera (atomoxetine hydrochloride), Eli Lilly, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021411s044lbl.pdf