Medicines

Atomoxetine for ADHD

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. 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

Atomoxetine

Brand names: Strattera

Why is it important for my child to take Atomoxetine?

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 start your child on a low dose and then gradually increase it over a few days or weeks as your child gets used to the medicine and depending on how they respond to it. If you are not sure how much to give, check with your doctor, epilepsy nurse or pharmacist.

It is important that you follow your doctor’s instructions about how much to give.

How should I give Atomoxetine?

Capsules

  • Capsules should be swallowed with a glass of water, squash or juice. Your child should not chew the capsule.

Liquid medicine

  • Shake the medicine well. 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.

Atomoxetine can be taken with or without food

When should the medicine start working?

It may take a few weeks for Atomoxetine to work properly, so your child may still have their symptoms for a while. 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, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

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 remember after this time, do not give the missed dose. Wait until the next usual dose.

If you usually 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 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Atomoxetine by mistake. If you are concerned that you may have given too much, 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

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.

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, tiredness, itching, or flu-like symptoms, contact your doctor straight away as there may be a problem with your child’s liver.

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 eat food that contains fibre (wholemeal foods, fruit and vegetables).
  • Atomoxetine may affect the growth of some children. The specialist will monitor your child’s growth.
  • Your child may lose some weight during the first few months of treatment. Contact your doctor if you are concerned.

  • They may get a rash or swollen, reddened, itchy skin. Contact your doctor or pharmacist if this becomes troublesome.

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 or pharmacist about any other medicines your child is taking before giving Atomoxetine.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Tell your doctor or pharmacist if your child has taken a medicine known as a monoamine oxidase inhibitor (MAOI) e.g. phenelzine, in the last 2 weeks (used to treat depression and other mental health problems).

Is there anything else I need to know about this medicine?

  • Atomoxetine may harm an unborn baby. If your daughter is sexually active, it is important that she uses adequate contraception to prevent pregnancy and continues it for at least 1 month after stopping Atomoxetine.
  • If your daughter thinks she may be pregnant, she should see her doctor as soon as possible but continue taking Atomoxetine in the meantime.
  • The oral contraceptive pill can be used safely in women or girls taking Atomoxetine.
  • Your doctor will check your child’s blood pressure and pulse rate regularly while taking Atomoxetine.

General advice about medicines

  • 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 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.
  • 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 medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight.
  • Keep the medicine in the container it came in.
  • Some liquid medicine does not keep for long once opened. Write the date that you start it on the bottle and do not keep the medicine for longer than stated on the label.
  • Make sure that children cannot see or reach the medicine.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Atomoxetine and about other treatments for ADHD.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

ADDISS (ADHD Information Services)

020 8952 2800

www.addiss.co.uk/

Copyright disclaimer

Version [1]. © NPPG, RCPCH and WellChild, all rights reserved. Review 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.