Atomoxetine

Your doctor will start you on a low dose for a week before gradually increasing it to the right treatment dose for you. If you are under 18, your weight will be used to calculate your dose.

You will normally start to feel some benefits in the first week of treatment, but it can take eight to 12 weeks for the full effects to be reached. You may get additional benefits if you continue to take it longer.

If you are already taking a central nervous system stimulant like methylphenidate, your doctor may advise you to overlap this with atomoxetine for a few weeks as you switch treatments. This lets the atomoxetine build up in your system and have the chance to start working before you stop the stimulant.

Some young people have experienced growth delay in weight and height when they start to take atomoxetine. This has been linked to having a lower appetite – a side effect of the medicine. Over time, most of these young people have caught up with their peers.

Make sure that you get your height and weight checked before you start taking atomoxetine, and at regular intervals while you are taking it.

Sometimes the doctor might stop the medicine or change the dose for a while to let you catch up on weight and height, and then start it again.

Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking atomoxetine.

A very common side effect of atomoxetine is a dry mouth. Over a long time, this can increase your risk of developing tooth decay or gum disease. Make sure you brush your teeth well and have regular dental check-ups. Speak to your dentist, doctor or pharmacist about things you can do to help.

You may want to let your family and friends know you are taking atomoxetine so they can support you and help you look out for side effects.

Atomoxetine can make you feel tired and sleepy.
It has also made some people find it difficult to get to sleep and stay asleep. Some people also wake up early in the morning and are unable to get back to sleep.

If you think your medicine is making your sleep worse, or if you feel sleepy and tired all the time and this doesn’t improve with time, go back to your doctor and discuss what changes could be made to help. This may include switching the timing of the dose or changing to a different medication.

Alcohol

It may be possible to drink some alcohol in moderation while taking atomoxetine, but having the two together might make you very sleepy.
During the first week and when your dose is increased it might be best to stop drinking alcohol until you see how the medicine affects you.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

We do not have any information about using atomoxetine with drugs as not enough research has been carried out. There may be some reactions if you mix it with drugs, which could be dangerous, but we do not know what they are.

It is advisable to avoid the use of street drugs or ‘legal highs’. There is no regulation of these, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Get more advice on drugs and alcohol.

Atomoxetine does not mix well with some other medicines, including herbal remedies. If you are taking other medicines, atomoxetine may affect how well they work or may cause side effects. Tell your doctor about these before you start your treatment.

Some medicines can slow down how quickly atomoxetine is removed from the body, and your doctor may need to adjust the dose of your medication if they are taken together.
Talk to your pharmacist if you buy any medications over the counter to treat common illnesses like colds and flu, or medications that you put on your skin.

You should not take atomoxetine if you have taken a medicine known as a monoamine oxidase inhibitor (MAOI) antidepressant like phenelzine, isocarboxazid, tranylcypromine or moclobemide in the last two weeks.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with atomoxetine. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

Atomoxetine capsules contain gelatine. If you need to avoid animal products such as gelatine, please note that this is often found in capsules but also in some tablet formulations. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

You can also take atomoxetine as a liquid. The oral solution contains sorbitol and anyone with hereditary fructose intolerance should not take this. It also contains sucralose, but this should not affect your blood sugars if you are diabetic.

There are several companies that manufacture this medicine and the non-active ingredients are likely to vary between products.
Always let your pharmacist know if you have any food allergies or intolerances, and always check with them if you’re concerned about any of the ingredients in your medication.

Do not drive a car or ride a bike just after you start taking atomoxetine.

Taking atomoxetine may make you feel tired or dizzy when you first start treatment. This could affect you if you drive a car, ride a bike, or do anything else that needs a lot of focus. It might be best to stop doing these things for the first few days until you know how it affects you.

Most people drive as normal while taking atomoxetine. If you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

You must tell DVLA if your ADHD or your ADHD medication affects your ability to drive safely. This is not necessary if your condition or medication doesn’t affect your ability to drive safely. Ask your doctor if you’re not sure.

Pregnancy

If you become pregnant while you are on atomoxetine, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing atomoxetine and help you to make a decision that is best for you and your baby. They may refer you to a specialist perinatal mental health team to support you with this decision.

You can find out more information about taking atomoxetine during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with atomoxetine.

Breastfeeding

We know that atomoxetine passes into breastmilk. It is unlikely that a significant amount passes into breastmilk but the exact amounts are not clear. Currently, we don’t have much information about taking atomoxetine whilst breastfeeding.

If your baby was born early or has health problems, then breastfeeding while you are taking atomoxetine may not be recommended.
If you breastfeed while taking atomoxetine, seek urgent medical advice if your baby becomes restless, very sleepy, or develops feeding problems.

If your medication makes you sleepy, do not to sleep with your baby in the same bed, and be cautious when handling your baby (especially if waking during the night for feeds).

Talk to your midwife, doctor or pharmacist if you want to breastfeed while taking atomoxetine. They will help you to weigh up the benefits and possible risks based on what we currently know so you can make a decision that is best for you and your baby.

Sex

Atomoxetine can have side effects that may affect your sex life, including:

• problems with getting an erection (getting hard) and ejaculating (coming)
• difficulty reaching orgasm (coming) the same way as before or not being able to have an orgasm at all
• feeling too tired to have sex
• pain in the penis and/or testicles

Another rare side effect that has been reported is a long-lasting and painful erection (called priapism). If this happens, you will need to be treated in hospital.

Most side effects occur when you first start medication and improve over time. If they do not, and this is a problem for you, make an appointment to discuss this with your doctor.

If it works for you, atomoxetine may have a positive effect on your sex life as your symptoms settle, and you can concentrate on your relationships.

Fertility

We do not have enough information to know if there are effects on fertility, but it is thought to be unlikely.

An uncommonly reported side effect of atomoxetine is irregular periods. This may make it harder if you are planning a pregnancy. Talk to your doctor about your atomoxetine if you are trying to get pregnant.

Atomoxetine is not a banned substance in sport.

Most people play sports as normal while taking atomoxetine. However, you may feel tired or dizzy at first which may cause a problem in sports where you need a lot of focus. It might be best to stop doing those sports for a short time until you know how the medicine affects you.

If you are worried that taking atomoxetine might make doing the sports you enjoy more difficult, discuss this with your doctor.

Ideally it is best not to take atomoxetine for the first time just before your exams.

It is not possible to predict how the medication will make you feel, and if you do get any side effects, like feeling dizzy or tired, these are more likely to occur when you first start taking it.

You should talk to your doctor about any future exams if you are starting atomoxetine. You might decide together to delay starting it until you have done them. If they are more than a month away, however, you might find that it is better to start atomoxetine to improve your motivation and ability to study.

If it works for you, atomoxetine should improve your concentration and ability to focus, so you may find it will help you to study. If you are worried that taking atomoxetine might make studying for or taking your exams harder, discuss this with your doctor.