Formulary
Atomoxetine: Indications, Dosing, Side Effects and Interactions
Atomoxetine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Atomoxetine: Indications, Dosing, Side Effects and Interactions
Atomoxetine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Attention deficit hyperactivity disorder (initiated by a specialist)**
- **Child** (By Mouth): 6-17 years (body-weight 70 kg and above) Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80 mg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 120 mg per day.
- **Adult** (By Mouth): (body-weight 70 kg and above) Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80-100 mg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 120 mg per day.
**Attention deficit hyperactivity disorder (initiated by a specialist) for atomoxetine**
- **Child 6-17 years (body-weight up to 70 kg)** (By mouth): Initially 500 micrograms/kg daily for 7 days, dose is increased according to response; maintenance 1.2 mg/kg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 1.8 mg/kg per day; maximum 120 mg per day.
- **Child 6-17 years (body-weight 70 kg and above)** (By mouth): Initially 40 mg daily for 7 days, dose is increased according to response; maintenance 80 mg daily, total daily dose may be given either as a single dose in the morning or in 2 divided doses with last dose no later than early evening, high daily doses to be given under the direction of a specialist; maximum 120 mg per day.
Cautions
Aggressive behaviour; cardiovascular disease; cerebrovascular disease; emotional lability; history of seizures; hostility; hypertension; mania; psychosis; QT-interval prolongation; structural cardiac abnormalities; susceptibility to angle-closure glaucoma; tachycardia
Contraindications
Phaeochromocytoma; severe cardiovascular disease; severe cerebrovascular disease
Side effects
Common or very common Anxiety; appetite decreased; arrhythmias (uncommon in children); asthenia; chills (in adults); constipation; depression; dizziness; drowsiness; dry mouth (in adults); feeling jittery (in adults); flatulence (in adults); gastrointestinal discomfort; genital pain (rare in children); headaches; hyperhidrosis (uncommon in children); menstrual cycle irregularities (in adults); mood altered; mydriasis (in children); nausea; palpitations (uncommon in children); prostatitis (in adults); sensation abnormal (uncommon in children); sexual dysfunction (rare in children); skin reactions; sleep disorders; taste altered (in adults); thirst (in adults); tremor (uncommon in children); urinary disorders (rare in children); vasodilation (in adults); vomiting; weight decreased Uncommon Behaviour abnormal; chest pain (very common in children); dyspnoea; feeling cold (in adults); hypersensitivity; muscle spasms (in adults); peripheral coldness (in adults); QT interval prolongation; suicidal behaviour; syncope; tic (very common in children); vision blurred Rare or very rare Hallucination (uncommon in children); hepatic disorders; psychosis (uncommon in children); Raynaud's phenomenon; seizure (uncommon in children) Frequency not known Sudden cardiac death
Interactions
**Other interactions (3):**
- There may be increased risk of convulsions when antidepressants are given with atomoxetine.
- These include certain tricyclic antidepressants (e.g.
- Other drugs metabolised by CYP2D6: Fluoxetine is a strong inhibitor of CYP2D6 enzyme, therefore concomitant therapy with drugs also metabolised by this enzyme system may lead to drug interactions,...
Pregnancy
Manufacturer advises avoid unless potential benefit outweighs risk.
Breast feeding
Avoid-present in milk in animal studies.
Hepatic impairment
Dose adjustments Manufacturer advises halve dose in moderate impairment and quarter dose in severe impairment.
Medicinal forms
Solution,Capsule,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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