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Atomoxetine Disease Interactions

There are 11 disease interactions with atomoxetine:

Major

Atomoxetine (applies to atomoxetine) narrow angle glaucoma

Major Potential Hazard, High plausibility. Applicable conditions: Glaucoma (Narrow Angle)

The use of atomoxetine is contraindicated in patients with narrow angle glaucoma. In clinical trials, atomoxetine use was associated with an increased risk of mydriasis.

References

  1. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company, Indianapolis, IN.
Major

CNS stimulants (applies to atomoxetine) cardiac disease

Major Potential Hazard, Moderate plausibility. Applicable conditions: Heart Disease, Pheochromocytoma, Hyperthyroidism, Peripheral Arterial Disease

The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

CNS stimulants (applies to atomoxetine) glaucoma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension

The use of most CNS stimulants is contraindicated in patients with glaucoma, as these agents exhibit sympathomimetic activity and may induce mydriasis provoking an increase in intraocular pressure.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
Major

CNS stimulants (applies to atomoxetine) hypertension

Major Potential Hazard, Moderate plausibility.

CNS stimulant medications have shown to increase blood pressure, and their use might be contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

References

  1. "Product Information. Dopram (doxapram)." West-Ward Pharmaceutical Corporation, Eatontown, NJ.
Major

CNS stimulants (applies to atomoxetine) liver disease

Major Potential Hazard, Moderate plausibility.

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

CNS stimulants (applies to atomoxetine) bipolar disorders

Moderate Potential Hazard, Moderate plausibility.

Central nervous system (CNS) stimulants may induce a mixed/manic episode in patients with bipolar disorder. Prior to initiating treatment, screen patients for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or a family history of suicide, bipolar disorder, and depression). Close monitoring is recommended when using these agents in patients with bipolar disorders.

Moderate

CNS stimulants (applies to atomoxetine) psychiatric disorders

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis, Depression

The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

CNS stimulants (applies to atomoxetine) psychotic disorders

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Psychosis

Central nervous system (CNS) stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Close monitoring is recommended when using these agents in patients with psychotic disorders.

Moderate

CNS stimulants (applies to atomoxetine) renal dysfunction

Moderate Potential Hazard, Moderate plausibility.

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

CNS stimulants (applies to atomoxetine) seizure disorders

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Seizures

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
Minor

Atomoxetine (applies to atomoxetine) urinary retention

Minor Potential Hazard, Moderate plausibility.

There have been reports of urinary retention and urinary hesitation in ADHD patients using atomoxetine. Caution should be used if any urinary symptoms appear, especially in patients with history of urinary disorders.

Atomoxetine drug interactions

There are 307 drug interactions with atomoxetine

Atomoxetine alcohol/food interactions

There is 1 alcohol/food interaction with atomoxetine

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.