mph Bangladesh


(at' oh mox e teen)

PCaution when used during lactation : Caution during pregnancy

Molecule Info

Indication(s) & Dosage

Attention deficit hyperactivity disorder
Adult: Initially, 40 mg daily, may increase gradually after at least 7 days to 80 mg daily; up to 100 mg daily may be used after 2-4 wk. 
Child: For adolescents and children (>6 yr): < 70 kg: Initially, 500 mcg/kg/day, may increase gradually to 1.2 mg/kg/day, up to 100 mg daily or 1.4 mg/kg/day whichever is lower; >70 kg: Initially, 40 mg daily, may increase gradually after at least 7 days to 80 mg daily, up to 100 mg daily may be used after 2-4 wk. 
Hepatic impairment: Moderate impairment: Reduce dose by 50%. Severe impairment: Reduce dose by 75%.

Administration May be taken with or without food. Swallow whole, do not open cap.

Symptoms include somnolence, agitation, hyperactivity, abnormal behaviour, mydriasis, tachycardia, dry mouth and GI symptoms. Gastric emptying and use of activated charcoal may reduce drug absorption; monitor patient and provide supportive treatment. Dialysis may not be beneficial 

Contraindications Angle-closure glaucoma. Not to be used with or within 14 days of discontinuing treatment with MAOIs.
Special Precautions

Monitor height and wt gain especially during the initial period of treatment; dose reduction or treatment interruption may be needed in children whose growth or wt gain is not satisfactory. Patients with high BP or cardiovascular conditions that may be worsened by increases in BP or heart rate. Caution when used in patients with a history of psychotic illness or bipolar disorder. May increase the risk of urinary obstruction or hesitancy. Monitor for signs of clinical worsening, suicidal tendency or unusual behavioural changes especially during the start of treatment and during dose changes. Safety and efficacy have not been established in patients <6 yr. Not recommended for use in pregnancy 

Adverse Drug Reaction(s) GI disturbances, anorexia and wt loss, fatigue. CNS symptoms e.g. headache, insomnia, sleep disturbances, dizziness, irritability and emotional lability. Cough, sinusitis or rhinorrhoea, urinary hesitancy or retention. Reduced libido and sexual dysfunction. Skin rashes, increased sweating and hot flushes.
Drug Interactions May cause additive effect when used with drugs that increase BP. May potentiate the effect of salbutamol on the CVS. Increased risk of seizures when used with drugs that are known to lower seizure threshold. May increase risk of cardiac events when used with drugs that affect cardiac conduction or electrolyte balance, or that inhibit CYP2D6 (e.g. chlorpromazine, delavirdine, fluoxetine, miconazole, pergolide, quinidine, ritonavir).
Potentially Fatal: Concurrent use with or within 2 wk of discontinuing MAOIs may cause serious toxicity (e.g. hyperthermia, rigidity, myoclonus, mental status changes, autonomic instability, neuroleptic malignant syndrome). Combined use is contraindicated.

Pregnancy Category (FDA) Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Storage Oral: Store at 15-30°C.
Pharmacology Atomoxetine hydrochloride selectively inhibits the reuptake of noradrenaline. It is used in the treatment of attention deficit hyperactivity disorder in adults and children aged >6 yr.
Absorption: Good absorption after oral admin. Bioavailability ranges from 63-94% depending on whether the patient is an extensive or poor metaboliser.
Distribution: About 98% bound to plasma proteins.
Metabolism: Mainly metabolised by cytochrome P450 isoenzyme CYP2D6 to the active metabolite 4-hydroxyatomoxetine.
Excretion: Largely excreted in the urine mainly as glucuronide metabolites; <17% of a dose is excreted in the faeces. Elimination half-life ranges from 5.2-21.6 hr.
ATC Classification N06BA09 - atomoxetine, in the class of centrally-acting sympathomimetics. Used as CNS stimulant.

Brand/Product Info

Total Products : 1 
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
SUEV 10 Square Pharmaceuticals Ltd. Atomoxetine 10mg Capsule 3x10's: 240.90 MRP

Gen. MedInfo


Studies have shown that children and teenagers with attention-deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) who take atomoxetine are more likely to think about killing themselves than children and teenagers with ADHD who do not take atomoxetine.

While your child is taking atomoxetine, you should watch his or her behavior very carefully, especially at the beginning of treatment and any time his or her dose is increased or decreased. Your child may develop serious symptoms very suddenly, so it is important to pay attention to his or her behavior every day. Ask other people who spend a lot of time with your child, such as brothers, sisters, and teachers to tell you if they notice changes in your child's behavior. Call your child's doctor right away if your child experiences any of these symptoms: acting more subdued or withdrawn than usual; feeling helpless, hopeless, or worthless; new or worsening depression; thinking or talking about harming or killing him- or herself or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; irritability; aggressive or violent behavior; acting without thinking; extreme increase in activity or talking; frenzied, abnormal excitement; or any other sudden or unusual changes in behavior.

Your child's doctor will want to see your child often while he or she is taking atomoxetine, especially at the beginning of his or her treatment. Your child's doctor may also want to speak with you or your child by telephone from time to time. Be sure that your child keeps all appointments for office visits or telephone conversations with his or her doctor.

Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with atomoxetine and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( or the manufacturer's website to obtain the Medication Guide.

Talk to your doctor about the risks of giving atomoxetine to your child, of using other treatments for your child's condition, and of not treating your child's condition.


Why is this medication prescribed?

Atomoxetine is used as part of a total treatment program to increase the ability to pay attention and decrease impulsiveness and hyperactivity in children and adults with attention deficit hyperactivity disorder (ADHD). Atomoxetine is in a class of medications called selective norepinephrine reuptake inhibitors. It works by increasing the levels of norepinephrine, a natural substance in the brain that is needed to control behavior.

How should this medicine be used?

Atomoxetine comes as a capsule to take by mouth. It is usually taken either once a day in the morning, or twice a day in the morning and late afternoon or early evening. Atomoxetine may be taken with or without food. However, taking atomoxetine with food may help prevent the medication from upsetting your stomach. Take atomoxetine at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take atomoxetine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow atomoxetine capsules whole; do not open, chew, or crush them. If a capsule is accidentally broken or opened, wash away the loose powder with water right away. Try not to touch the powder and be especially careful not to get the powder in your eyes. If you do get powder in your eyes, rinse them with water right away and call your doctor.

Your doctor will probably start you on a low dose of atomoxetine and increase your dose after at least 3 days. Your doctor may increase your dose again after 2-4 weeks. You may notice improvement in your symptoms during the first week of your treatment, but it may take up to one month for you to feel the full benefit of atomoxetine.

Atomoxetine may help control the symptoms of ADHD but will not cure the condition. Continue to take atomoxetine even if you feel well. Do not stop taking atomoxetine without talking to your doctor.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking atomoxetine,
  • tell your doctor if you are allergic to atomoxetine, any other medications, or any of the inactive ingredients in atomoxetine capsules.
  • tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocaraboxazid, phenelzine, selegiline, and tranylcypromine, or if you have stopped taking them within the past 2 weeks. Your doctor will probably tell you not to take atomoxetine. If you stop taking atomoxetine, you should wait at least 2 weeks before you start taking an MAO inhibitor.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: salbutamol/albuterol syrup or tablets (Ventolin), amiodarone, bupropion, chlorpheniramine (antihistamine in cold medications),cimetidine, clomipramine (Anafranil), fluoxetine, haloperidol, metaproterenol syrup or tablets , medications for high blood pressure, methadone, metoclopramide, nefazodone, paroxetine, quinidine, ritonavir, and sertraline. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you have or have ever had glaucoma (an eye disease that may cause vision loss). Your doctor may tell you not to take atomoxetine.
  • tell your doctor if anyone in your family has or has ever had an irregular heartbeat or has died suddenly. Also tell your doctor if you have recently had a heart attack and if you have or have ever had a heart defect, an irregular heartbeat, heart or blood vessel disease, or other heart problems. Your doctor will probably examine you to see if your heart and blood vessels are healthy. Your doctor may tell you not to take atomoxetine if you have a heart condition or if there is a high risk that you may develop a heart condition.
  • tell your doctor if you or anyone in your family has or has ever had depression or bipolar disorder (manic depressive disorder; a condition that causes episodes of depression, episodes of frenzied, abnormal excitement and other abnormal moods) or has ever thought about or attempted suicide. Also tell your doctor if you have or have ever had high or low blood pressure, seizures, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking atomoxetine, call your doctor.
  • you should know that atomoxetine may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • you should know that atomoxetine has caused severe liver damage in some patients. Call your doctor right away if you have any of the following symptoms: itchy skin, dark urine, yellowing of your skin or eyes, pain in the upper right part of your stomach, or flu-like symptoms.
  • you should know that atomoxetine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
  • you should know that atomoxetine should be used as part of a total treatment program for ADHD, which may include counseling and special education. Make sure to follow all of your doctor's and/or therapist's instructions.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Do not take more than the prescribed daily amount of atomoxetine in 24 hours.

What side effects can this medication cause?

Atomoxetine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • heartburn

  • nausea

  • vomiting

  • loss of appetite

  • weight loss

  • constipation

  • stomach pain

  • gas

  • dry mouth

  • excessive tiredness

  • dizziness

  • headache

  • mood swings

  • decreased sex drive or ability

  • difficulty urinating

  • painful or irregular menstrual periods

  • muscle pain

  • sweating

  • hot flashes

  • unusual dreams

  • burning or tingling in the hands, arms, feet, or legs

 Some side effects can be serious. If you experience any of the following symptoms, or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS section, call your doctor immediately:

  • fast or pounding heartbeat

  • chest pain

  • shortness of breath

  • slow or difficult speech

  • dizziness or faintness

  • weakness or numbness of an arm or leg

  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

  • hoarseness

  • difficulty swallowing or breathing

  • hives

  • rash

  • abnormal thoughts

  • hallucinating (seeing things or hearing voices that do not exist)

  • erection that lasts for several hours or longer

  • seizures

Atomoxetine may cause sudden death in children and teenagers with heart defects or serious heart problems. This medication also may cause sudden death, heart attack or stroke in adults, especially adults with heart defects or serious heart problems. Talk to your doctor about the risks of taking this medication or of giving this medication to your child.

Atomoxetine may slow down children's growth or weight gain. Your child's doctor will probably monitor your child carefully during his or her treatment with atomoxetine. Talk to your child's doctor about the risks of giving this medication to your child.

Atomoxetine may cause other side effects. Consult your doctor if you have any unusual problems while taking this medication. This medication may cause other side effects.  Consult your doctor if you have any unusual problems while taking this.

In case of emergency/overdose

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, call local medical emergency services.

Symptoms of overdose may include:
  • sleepiness

  • agitation

  • an increase in activity or talking

  • abnormal behavior

  • stomach problems

  • wide pupils (black circles in the middle of the eyes)

  • fast heartbeat

  • dry mouth

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

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