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Atomoxetine for attention deficit hyperactivity disorder (ADHD)
Atomoxetine for ADHD
This leaflet is about the use of atomoxetine for attention-deficit hyperactivity disorder (ADHD). Medicines are a part of a comprehensive treatment programme that includes behavioural therapy. The diagnosis of ADHD must have been confirmed by a specialist.
This leaflet is for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adults. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again
Do not suddenly stop giving atomoxetine without talking to your doctor first.
Name of medicine
Brand names: Strattera®
Why is it important to take this medicine?
Atomoxetine will help to reduce the symptoms of hyperactivity and impulsive behaviour and increase attention and concentration span. It is used as part of a comprehensive treatment programme that includes behavioural therapy.
What is atomoxetine available as?
- Capsules: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg; these contain gelatin.
- Liquid medicine: 4 mg in 1 mL oral solution; this contains sorbitol.
When should I give atomoxetine?
Atomoxetine is usually given once or twice each day. Your doctor will tell you how often to give it.
- Once a day: this should be in morning.
- Twice a day: this should be once in the morning and once in the late afternoon. It should not be given too close to bedtime.
Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.
How much should I give?
Your doctor will work out the amount of atomoxetine (the dose) that is right for your child. The dose will be shown on the medicine label.
Your doctor will probably start with a low dose and then increase it gradually to find the lowest dose that works for your child.
It is important that you follow your doctor’s instructions about how much to give.
How should I give it?
Capsules should be swallowed with a glass of water, milk or juice with or without food. Your child should not chew the capsule.
Liquid medicine: Measure out the right amount using an oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
The liquid medicine should not be mixed in to food or drinks as this can decrease the amount your child gets.
When should the medicine start working?
It will take a few weeks for atomoxetine to work properly, so you may not see much difference in your child’s symptoms to start with. It is important that you continue to give the medicine as you have been told to by your doctor.
What if my child is sick (vomits)?
- If your child is sick less than 30 minutes after having a dose of atomoxetine, give them the same dose again.
- If your child is sick more than 30 minutes after having a dose of atomoxetine you do not need to give them another dose. Wait until the next normal dose.
If your child is sick again, seek advice from your family doctor, pharmacist or hospital.
What if I forget to give it?
If you usually give it once a day: Give the missed dose when you remember during the day, as long as this is at least 12 hours before the next dose is due.
If you normally give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7 am, you can give the missed dose at any time up to 11 am. If you remember after that time, do not give the missed dose. Just give the next dose as usual.
Never give a double dose of atomoxetine.
What if I give too much?
You are unlikely to cause harm if you give an extra dose of atomoxetine by mistake. If you think you may have given your child too much atomoxetine, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Side effects you must do something about
If your child has dark urine, a yellowish tinge to their skin or the whites of the eyes, tenderness on the right side of the stomach just below the ribs, feelings of sickness (nausea), tiredness, itching, or flu-like symptoms, contact your doctor straight away as there may be a problem with your child’s liver.
Occasionally some children who take atomoxetine have suicidal thoughts (thoughts of killing themselves) or become hostile (aggressive, arguing a lot, angry) or may seem emotionally unstable. If your child has any of these reactions, or you are at all worried, contact your doctor straight away.
Other side-effects you need to know about:
- When your child first starts taking atomoxetine, they may have headaches, lose their appetite, feel sick (nausea) or be sick (vomit), have stomach pain and feel sleepy. These effects should wear off after 1-2 weeks as your child’s body gets used to the medicine.
- Your child may seem irritable and have mood swings.
- Your child may feel dizzy or light-headed, especially when standing up. Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or light-headed.
- They may have problems sleeping or feel lethargic (tired).
- They may get constipation (difficulty doing a poo), Encourage them to drink plenty of fluid and to eat food that contains fibre (e.g. wholemeal foods, fruit and vegetables).
- They may get a rash, or swollen, reddened and itchy skin. Contact your doctor or pharmacist if this becomes troublesome.
- Your child may lose some weight during the first few months of treatment. Contact your doctor if you are concerned.
- Atomoxetine may affect the growth of some children. The specialist will monitor your child’s growth.
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side-effects to a UK safety scheme at www.mhra.gov.uk/yellowcard
Can other medicines be given at the same time as atomoxetine?
- You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
- Atomoxetine should not be taken with some medicines. Tell your doctor and pharmacist about any other medicines your child is taking before giving atomoxetine.
Tell your doctor or pharmacist if your child has taken a medicine known as a monoamine oxidase inhibitor (MAOI), for example phenelzine, in the last 2 weeks (used to treat depression and other mental health problems).
- Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.
Is there anything else I need to know about this medicine?
Atomoxetine may harm an unborn baby. If your daughter or a young woman in your care is sexually active, it is important that she uses adequate contraception to prevent pregnancy and continues to use it for at least month after stopping atomoxetine. The contraceptive pill can be used when taking atomoxetine.
- If your daughter or a young woman in your care thinks she might be pregnant, she should see her doctor as soon as possible, but keep taking atomoxetine in the meantime.
- Whilst taking atomoxetine, your child will need to have their pulse and blood pressure checked regularly. Your doctor will tell you how often.
General advice about medicines
- Try to give medicines at about the same times each day, to help you remember.
- If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
- Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
- Make sure that the medicine you have at home has not reached the ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
Where I should keep this medicine?
- Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
- The liquid medicine can only be used for a limited time once it has been opened. Write the date that you start it on the bottle and make sure you follow the instructions on the bottle about how long you can keep it.
- Make sure that children cannot see or reach the medicine.
- Keep the medicine in the container it came in.
Who to contact for more information
Your doctor, pharmacist will be able to give you more information about atomoxetine and about other treatments for ADHD.
You can also get useful information from:
Version 2, August 2019. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: August 2022.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.