Strattera (atomoxetine)

Strattera generic

Strattera is a brand-name drug that contains the active drug atomoxetine. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in using the generic form of Strattera, talk with your doctor. They can tell you if it comes in forms and strengths that can be used for your condition.

Strattera side effects

Strattera can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Strattera. These lists do not include all possible side effects.

For more information about the possible side effects of Strattera, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you’d like to notify the FDA about a side effect you’ve had with Strattera, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Strattera. To learn about other mild side effects, talk with your doctor or pharmacist, or view Strattera’s prescribing information.

Mild side effects of Strattera may include:

• constipation
• dry mouth
• nausea
• reduced appetite
• dizziness
• sexual side effects, such as erectile dysfunction
• mood changes
• insomnia
• headache
• fatigue
• mild anxiety*
• mild allergic reaction†

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* In rare cases, anxiety could occur along with suicidal thoughts. In fact, Strattera has a boxed warning for the risk of suicidal thoughts. This is a serious warning from the FDA. To learn more, see the “Strattera precautions” section below.
† For more information about allergic reaction and Strattera, see “Allergic reaction” below.

Serious side effects

Serious side effects from Strattera aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Liver problems. Symptoms can include:
  • pain in the right upper area of your abdomen
  • dark urine
  • jaundice
  • itchiness
• Changes in blood pressure and heart rate. Symptoms may include:
  • rapid heart rate
  • feeling like your heart is pounding or racing
  • dizziness, especially when standing up after sitting or lying down
  • fainting
• Urination problems. Symptoms may include:
  • urinary hesitation (delay in the start of urine flow)
  • urinary retention (not being able to completely empty your bladder when you urinate)
  • decreased urine flow
• Changes in behavior or mental health. Symptoms may include:
  • behavior that’s unexpectedly hostile or threatens the safety of others
  • having less patience than usual
  • having an outburst of anger or aggression without a clear reason
  • mania (episode of extremely high energy that affects your moods and behavior)
  • hallucinations (seeing or hearing things that aren’t there)
• Severe drowsiness.
• Priapism (a prolonged and often painful penile erection).* Symptoms can include:
  • erection that doesn’t go away
  • penile pain that worsens with time
• Suicidal thoughts in children and adolescents.†
• Severe allergic reaction.‡

In addition to the information above and below, you can refer to this article for more details about Strattera’s side effects.

* This side effect did not occur in clinical trials of Strattera. It was reported after the drug was released onto the market.
† Strattera has a boxed warning for this side effect. This is a serious warning from the FDA. To learn more, see the “Strattera precautions” section below.
‡ For details about allergic reaction and Strattera, see “Allergic reaction” below.

Side effects in children

Strattera side effects are expected to be similar in children, adolescents, and adults. It’s important to note that the drug has been shown to increase the risk of suicidal thoughts in children and adolescents. In fact, Strattera has a boxed warning for this side effect. This is a serious warning from the FDA. To learn more, see the “Strattera precautions” section below.

Side effects of Strattera that were more common in the drug’s clinical trials of children and adolescents include:

• nausea
• vomiting
• fatigue
• reduced appetite
• abdominal pain
• drowsiness
• headache

Strattera may also cause weight loss or slowed growth in children and adolescents, especially in the first year of treatment. To watch for this side effect, your child’s doctor will monitor their height and weight regularly during Strattera treatment.

Certain side effects of Strattera, such as reduced appetite and nausea, may cause your child or teen to eat less food than usual. This may contribute to slowed growth. (Not eating enough calories can prevent a child’s or teen’s body from growing at the usual rate.) If your child isn’t eating much during treatment with Strattera, talk with your child’s doctor.

If you have questions about other possible side effects of Strattera and how to manage them, talk with your child’s doctor.

Note: A side effect called priapism (a prolonged and often painful penile erection) was reported after Strattera was released onto the market. Priapism didn’t occur in clinical trials of the drug. For symptoms, see “Serious side effects” above.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Strattera. This side effect wasn’t reported in Strattera’s clinical trials but has occurred since the drug was approved.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Strattera, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Alternatives to Strattera

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Strattera, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is prescribed for a purpose other than what it’s approved for.

Alternatives for attention deficit hyperactivity disorder

Examples of other drugs that may be prescribed to treat attention deficit hyperactivity disorder (ADHD) include:

• viloxazine (Qelbree)
• serdexmethylphenidate/dexmethylphenidate (Azstarys)
• methylphenidate (Concerta, Daytrana, Quillivant XR, Ritalin, others)
• lisdexamfetamine (Vyvanse)
• guanfacine (Intuniv)
• dextroamphetamine (Dexedrine, Zenzedi)
• dexmethylphenidate (Focalin, Focalin XR)
• clonidine (Kapvay)
• bupropion (Wellbutrin XL)
• amphetamine/dextroamphetamine (Adderall, Adderall XR, Mydayis)
• amphetamine (Evekeo, Dyanavel XR)

Strattera dosage

The Strattera dosage your doctor prescribes will depend on several factors. These include:

• the severity of the condition you’re taking Strattera to treat
• your age
• body weight (in children)
• other medical conditions you may have, such as liver problems
• other medications you may take

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage schedule to fit your needs.

Drug forms

Strattera comes as an oral capsule.

Drug strengths (10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg)

Strattera comes in seven strengths: 10 milligrams (mg), 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, and 100 mg.

Dosage for attention deficit hyperactivity disorder

For treating attention deficit hyperactivity disorder (ADHD) in adults, Strattera’s typical starting dosage is 40 milligrams (mg) taken once daily in the morning.

After at least 3 days, your doctor will likely increase this to the recommended dosage of 80 mg per day. You’ll either take the drug as a single dose in the morning or as two divided doses. This would be one 40-mg dose in the morning and one 40-mg dose in the late afternoon or early evening. Your doctor will recommend the dosage schedule that’s best for you.

After 2 to 4 more weeks, depending on your body’s response to Strattera, your doctor may further increase your dosage to 100 mg per day. This dose of 100 mg is the maximum dose.

The dosage chart below summarizes the usual dosages of Strattera in adults.

Your doctor may prescribe a different dosage of Strattera depending on several factors, such as whether you have liver problems. If you have questions about the dosage that’s right for you, talk with your doctor. They can also tell you more about how they’ll monitor your response to Strattera treatment. This may include how they’ll determine whether your dose is too high or too low.

Children’s dosage

Strattera is approved to treat ADHD in children ages 6 years and older as well as in adults. In children, the dosage of Strattera depends on the child’s body weight in kilograms (kg). One kg is about 2.2 pounds (lb).

The starting dose of Strattera for children who weigh 70 kg or less is 0.5 mg per kg of body weight (mg/kg). This starting dose is taken once daily in the morning.

After at least 3 days, the doctor will likely increase the dose to the recommended dosage of 1.2 mg/kg per day. Your child will take the drug either as a single dose in the morning or as two divided doses. (A divided dose is one dose in the morning and one in the late afternoon or early evening.) Your child’s doctor will recommend the dosage schedule that’s right for them.

In some cases, a doctor may further increase the dosage. The maximum daily dosage of Strattera in children who weigh up to 70 kg is 1.4 mg/kg per day or 100 mg per day, whichever is less.

Here’s an example of the usual dosing of Strattera for a child age 8 years who weighs 35 kg (about 77 lb):

• a starting dose of 0.5 mg/kg: 18 mg once daily in the morning
• after at least 3 days, the child’s dosage increases to the recommended dose of 1.2 mg/kg: 40 mg once daily in the morning

The dosage for children who weigh more than 70 kg is the same as the adult dosage. For details, see “Dosage for attention deficit hyperactivity disorder” just above.

What if I miss a dose?

If you miss a dose of Strattera, your next step depends on how soon your next scheduled dose is. For example, if it’s almost time for your next dose, you should skip the missed dose. This is because you should not take more than your prescribed dose in a 24-hour period.

Your doctor and pharmacist can help clarify when to take a missed dose.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to use this drug long term?

Strattera is meant to be used as a long-term treatment. If you and your doctor determine that Strattera is safe and effective for you, you’ll likely take it long term. From time to time during treatment, your doctor may have you stop taking the drug to check whether your ADHD symptoms return. You and your doctor will determine how long you’ll take the drug to treat your condition.

For more details about Strattera’s dosage, you can refer to this article.

Strattera uses

The Food and Drug Administration (FDA) approves prescription drugs such as Strattera to treat certain conditions.

Strattera for attention deficit hyperactivity disorder (ADHD)

Strattera is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) in adults as well as children ages 6 years and older.

ADHD explained

ADHD is a mental health condition that typically starts in childhood. ADHD symptoms may lead to problems at school or work and in relationships. Symptoms can include:

• difficulty focusing on a task
• difficulty staying still or seated
• being overly active
• difficulty with having to wait or take turns
• acting without thinking about what might happen as a result
• difficulty getting organized and completing tasks
• being easily distracted

The cause of ADHD isn’t known, but experts think genetics play a role.

Some people “outgrow” ADHD, while others are affected by it into adulthood. And some adults may have ADHD but weren’t diagnosed with the condition as a child.

You can learn more about this condition at our mental health hub.

Effectiveness for ADHD

Strattera has been shown to be effective in treating ADHD. Atomoxetine (the active drug in Strattera) is included as a treatment option in American Academy of Pediatrics guidelines for ADHD in children and adolescents. Atomoxetine is also recommended as a first treatment option for ADHD in adults in American Academy of Family Physicians guidelines.

For details on how the drug performed in clinical trials, see Strattera’s prescribing information.

Strattera and children

Strattera is FDA-approved to treat ADHD in children and adolescents ages 6 years and older. For details, see “Strattera for attention deficit hyperactivity disorder (ADHD)” above.

Common questions about Strattera

Here are answers to some frequently asked questions about Strattera.

Are there benefits of taking Strattera at night?

Possibly. Strattera is taken as:

• a single dose in the morning, or
• two evenly divided doses, one in the morning and one in the late afternoon or early evening

In a clinical trial, researchers compared Strattera’s effects when it was taken once daily in the morning versus once daily in the evening. They found that both dosing schedules significantly decreased ADHD symptoms for up to 24 hours. Morning dosing was more effective than evening dosing. However, evening dosing was associated with fewer side effects than morning dosing.

Some people may experience insomnia with Strattera. If you have trouble sleeping while taking the drug, talk with your doctor. They may change your dosing schedule. Or your doctor may suggest taking an over-the-counter sleep aid as needed. Examples include melatonin and diphenhydramine (Benadryl, Simply Sleep).

Your doctor can advise you on when to take Strattera.

Is Strattera prescribed for depression?

No. Strattera is prescribed to treat attention deficit hyperactivity disorder (ADHD).

After Strattera was put on the market, some people reported depression while taking the drug. But it isn’t known how often this has happened or whether the drug was the cause. Depression wasn’t a side effect in Strattera’s clinical trials in adults. In rare cases, depression and suicidal thoughts have occurred in children and adolescents taking Strattera.*

It’s common for people with ADHD to also have depression.

Your doctor can help answer any questions you have about treatments for depression.

* Strattera has a boxed warning for the risk of suicidal thoughts. This is a serious warning from the FDA. To learn more, see the “Strattera precautions” section below.

Is weight loss a side effect of Strattera?

Weight loss wasn’t specifically reported as a side effect in adults in Strattera’s clinical trials. However, some of the drug’s common side effects, such as reduced appetite and nausea, may lead to weight loss. These side effects may cause some people to eat less food than usual and contribute to losing weight.

Strattera may cause weight loss or slowed growth in some children and adolescents. These side effects are more likely to occur in the first year of treatment. To watch for these side effects, your child’s doctor will monitor their height and weight regularly while they’re taking Strattera.

If you’re concerned about weight loss or related side effects of Strattera, talk with your doctor.

Does Strattera cause any long-term side effects?

Strattera isn’t known to cause long-term side effects. The drug’s side effects should go away soon after your last dose.

For details about what side effects Strattera may cause, see the “Strattera side effects” section above. You can also talk with your doctor.

Is Strattera a controlled substance?

No, Strattera isn’t a controlled substance. Controlled substances are regulated by the government because of their potential for misuse or drug dependence.* Strattera doesn’t carry these risks.

Other drugs often prescribed for ADHD include stimulants, which are controlled substances. Some examples of stimulants used to treat ADHD include the following:

• amphetamine (Evekeo, Dyanavel XR)
• amphetamine/dextroamphetamine (Adderall, Adderall XR, Mydayis)
• dexmethylphenidate (Focalin, Focalin XR)
• lisdexamfetamine (Vyvanse)
• methylphenidate (Concerta, Daytrana, Quillivant XR, Ritalin, others)

Strattera is considered a nonstimulant treatment for ADHD.

If you have additional questions about Strattera, ask your doctor or pharmacist.

* With misuse, a drug is taken in a way or for a use not prescribed by a doctor. With dependence, your body needs the drug to function like usual.

Strattera interactions

Strattera can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Drug-condition interactions can also cause certain effects. For information about these interactions, see the “Strattera precautions” section below.

Strattera and other medications

Below is a list of medications that can interact with Strattera. This list does not contain all drugs that may interact with Strattera.

Before taking Strattera, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

MAOIs. Monoamine oxidase inhibitors (MAOIs) are a class of drugs traditionally used to treat depression, but are also used for certain other conditions. Taking Strattera with an MAOI can cause serious side effects that may, in rare cases, be fatal. Possible side effects can include an extremely high body temperature and stiff muscles. Other side effects may include sudden jerking of muscles and changes in mental status, such as extreme agitation.

Due to this risk, doctors typically will not prescribe Strattera with an MAOI. Doctors also won’t usually prescribe Strattera if you’ve taken an MAOI in the past 14 days.

Examples of MAOIs include:

• tranylcypromine (Parnate)
• selegiline (Emsam, Zelapar)
• phenelzine (Nardil)
• linezolid (Zyvox)
• isocarboxazid (Marplan)

CYP2D6 inhibitors. Drugs called CYP2D6 inhibitors slow or block the action of an enzyme in the liver called CYP2D6. Taking Strattera with a CYP2D6 inhibitor could increase the risk and severity of Strattera’s side effects. (To learn more, see the “Strattera side effects” section above.)

Examples of CYP2D6 inhibitors include:

• paroxetine (Paxil)
• fluoxetine (Prozac)
• quinidine

Drugs known to affect blood pressure or heart rate. Taking Strattera with a drug known to affect blood pressure or heart rate could lower the effectiveness of the drug. Strattera could also worsen the side effects of the drug.

Examples of medications known to affect blood pressure or heart rate include:

• angiotensin converting enzyme (ACE) inhibitors, such as lisinopril (Zestril)
• angiotensin II receptor blockers (ARBs), such as valsartan (Diovan)
• beta-blockers, such as atenolol (Tenormin)
• calcium channel blockers
• albuterol
• stimulant drugs, such as Adderall

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Strattera and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Strattera. However, you should still check with your doctor or pharmacist before using any of these products while taking Strattera.

Strattera and foods to avoid

There aren’t any foods that have been specifically reported to interact with Strattera. If you have any questions about eating certain foods with Strattera, talk with your doctor.

Strattera withdrawal and dependence

Strattera doesn’t cause drug dependence. (Drug dependence occurs when your body needs a drug to function like usual.)

In addition, stopping Strattera treatment shouldn’t cause withdrawal symptoms. (Withdrawal symptoms are uncomfortable effects that occur when you stop taking a drug or substance that your body is used to.)

Certain drugs require you to slowly decrease your dose before stopping it, but Strattera isn’t one of them. There are no special instructions for “coming off” Strattera.

Strattera and alcohol

Strattera isn’t known to interact with alcohol.

If you drink alcohol and you have questions about consuming it during Strattera treatment, talk with your doctor. You can also refer to this article for details about consuming alcohol with Strattera.

Strattera cost

As with all medications, the cost of Strattera can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Strattera. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Strattera, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide whether the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Strattera, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Strattera, or if you need help understanding your insurance coverage, help is available.

Medicine Assistance Tool and NeedyMeds are two websites offering resources that may help decrease the price you pay for Strattera. They also offer tools to help you find low cost healthcare, as well as educational resources. To learn more, visit their sites.

To learn more about saving money on prescriptions with or without insurance, check out this article.

Mail-order pharmacies

Strattera may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Strattera, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Strattera is available in a generic form called atomoxetine. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

If your doctor has prescribed Strattera and you’re interested in using atomoxetine instead, talk with them. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Strattera and pregnancy

It’s not known whether Strattera is safe to take during pregnancy. The drug’s clinical trials didn’t include pregnant people.

In animal studies, atomoxetine (the active drug in Strattera) caused harmful effects in pregnant animals and their fetuses. However, the results of animal studies don’t always reflect what may happen in humans.

Be sure to tell your doctor if you’re pregnant or trying to conceive before they prescribe Strattera. In these situations, your doctor may suggest a different treatment for your condition. If you become pregnant while taking Strattera, they may suggest that you stop taking the drug.

Pregnancy registry

There’s a pregnancy registry that monitors the outcomes of people who took Strattera at some point while pregnant. This registry helps people learn more about possible drug effects during pregnancy. If you become pregnant while taking the drug, your doctor may suggest visiting the website or calling 866-961-2388 to register.

Strattera and birth control

It’s not known whether Strattera is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Strattera.

For more information about taking Strattera during pregnancy, see the “Strattera and pregnancy” section above.

Strattera and breastfeeding

It’s not known whether Strattera is safe to take while breastfeeding. Researchers haven’t studied the drug’s potential effects on breast milk or children who are breastfed.

In animal studies, the drug passed into the milk of lactating animals. However, animal studies don’t always reflect what may occur in humans.

Before starting Strattera treatment, talk with your doctor if you’re breastfeeding or planning to breastfeed. They’ll help you determine how to feed your child while taking the medication.

Strattera vs. Vyvanse

You may wonder how Strattera compares with other medications that are prescribed for similar uses. To find out how Strattera and Vyvanse are alike and different, see this article.

How to take Strattera

You should take Strattera according to the instructions your doctor gives you.

Strattera comes as an oral capsule that you swallow.

When to take

The dosing schedule for Strattera depends on your doctor’s instructions. If they want you to take the drug once per day, you’ll likely take it in the morning. If they want you to take Strattera twice daily, you’ll likely take one dose in the morning and one dose in the afternoon or early evening. Your doctor will recommend the schedule that’s best for you.

Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Strattera work effectively.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Strattera in an easy-open container. They may also be able to recommend tools that can make it simpler to open lids.

Taking Strattera with food

You can take Strattera with food or without it. This drug isn’t affected by the timing of food.

Can Strattera be opened, crushed, split, or chewed?

No, you should swallow Strattera capsules whole.

You should not open the capsules because the contents can irritate your eyes. If capsule contents accidentally come in contact with your eyes, rinse your eyes with water and seek medical advice right away.

How Strattera works

Strattera is approved to treat attention deficit hyperactivity disorder (ADHD) in adults and children ages 6 years and older. ADHD is a mental health condition in which it’s difficult to pay attention and focus on tasks. The cause isn’t known, but experts think genetics play a role.

It isn’t fully understood how Strattera works to treat ADHD. Strattera belongs to a class of drugs called selective norepinephrine reuptake inhibitors.

Strattera is thought to work by increasing the level of a neurotransmitter (chemical messenger) in the brain called norepinephrine. Having more norepinephrine available in the brain may help improve attention and focus in people with ADHD.

How long does it take to work?

Strattera starts working right away after you take your first dose. However, it may take at least 2 to 4 weeks before your ADHD symptoms become less noticeable.

Strattera precautions

This drug comes with several precautions. These are considered drug-condition interactions.

FDA warning: Risk of suicidal thoughts in children and adolescents

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

In short-term clinical trials, higher rates of suicidal thoughts were reported in children and adolescents who took Strattera. This was compared with children and adolescents who took a placebo (a treatment that contains no active ingredients). No suicides occurred in these trials.

Because of this risk, your doctor will encourage you and your family members to watch for certain symptoms during Strattera treatment. Symptoms sometimes occur before or when someone develops suicidal thoughts. Examples of these symptoms, which may start suddenly, include:

• anxiety
• panic attacks
• feelings of irritation
• restlessness
• depression
• engaging in risky behavior
• hostile behavior
• insomnia
• mania (episode of extremely high energy that affects your mood and behavior)

The risk of suicidal thoughts may be higher early in treatment and when the dose is adjusted.

If you (or others around you) notice any of the above symptoms while you take Strattera, your doctor should be told right away. They can recommend ways to help. This will likely include having you stop Strattera treatment. You may also be switched to a different ADHD medication.

Other precautions

Before taking Strattera, talk with your doctor about your health history. Strattera may not be right for you if you have certain medical conditions or other factors affecting your health. These include the following.

Note: For more information about the potential negative effects of Strattera, see the “Strattera side effects” section above.

Narrow-angle glaucoma. If you have an eye condition called narrow-angle glaucoma, symptoms may be more likely to occur when your pupils are dilated. Strattera can cause your pupils to dilate more than usual. Taking the drug when you have narrow-angle glaucoma could worsen the condition.

Due to the risk of harm, doctors typically won’t prescribe Strattera if you have narrow-angle glaucoma. Be sure to tell your doctor if you have this condition. They’ll likely suggest a different treatment option.

Tumor in the adrenal glands. Strattera can cause changes in blood pressure and heart rate. A tumor in the adrenal glands called pheochromocytoma can also cause these symptoms. If you take Strattera and have a tumor, the symptoms could become severe.

Due to the risk of harm, doctors typically won’t prescribe Strattera if you have or have had pheochromocytoma. It’s important to tell your doctor if you have a history of this condition. They’ll usually recommend a treatment other than Strattera.

Cardiovascular problems. Strattera may cause increases in blood pressure and heart rate. If you have a cardiovascular condition that affects either of these, such as heart failure or an irregular heartbeat, taking Strattera may worsen it. (Cardiovascular refers to the heart and blood vessels.)

Due to the risk of harm, doctors typically won’t prescribe Strattera:

• if your heart problem is considered severe, and
• the condition could rapidly worsen if you were to experience small increases in your blood pressure or heart rate

Be sure to tell your doctor if you have any cardiovascular problems. They can determine whether Strattera is safe for you.

Mental health conditions. Strattera may cause changes in mental health and behavior. Your risk may increase if you or someone in your family has a mental health condition, such as bipolar disorder, depression, or mania.

Be sure to talk with your doctor about your personal and family health history. They’ll help determine whether or not Strattera is right for you. If your doctor prescribes this drug, they’ll likely monitor you closely for changes in your behavior.

Liver problems. The liver plays an important role in metabolizing (processing) many types of drugs, including Strattera. If you have a liver problem, Strattera could build up in your system, which could increase the risk for side effects. An example of a liver problem is alcohol-related liver disease.

It’s important to tell your doctor if you have a liver problem before starting Strattera treatment. Doctors typically prescribe a lower dose of this medication for people with liver problems. Your doctor will check your liver function to determine the correct dose for you.

Drug metabolism problems. A specific liver enzyme called CYP2D6 plays an important role in processing Strattera in your body. Due to genetic differences, some people have a lower rate of metabolism involving this enzyme. Doctors may refer to this as having “poor CYP2D6 metabolism.” If you’ve been told you have this condition, it’s important to tell your doctor before starting Strattera treatment. They’ll likely give you a lower dose of the drug.

Allergic reaction. If you’ve had an allergic reaction to Strattera or any of its ingredients, your doctor will likely not prescribe the medication. Ask them about other medications that may be better options for you.

Pregnancy. It’s not known whether Strattera is safe to take during pregnancy. For more information, see the “Strattera and pregnancy” section above.

Breastfeeding. It’s not known whether Strattera is safe to take while breastfeeding. For more information, see the “Strattera and breastfeeding” section above.

Strattera overdose

Taking more than the recommended dosage of Strattera can lead to serious side effects. Do not take more Strattera than your doctor recommends. (For information on the recommended dosages of Strattera, see the “Strattera dosage” section above.)

Overdose symptoms

Symptoms of an overdose can include:

• digestive symptoms
• sleepiness
• dizziness
• tremors
• agitation or hyperactivity
• symptoms related to overstimulation of the nervous system, such as:
  • rapid heart rate
  • increased blood pressure
  • dilated pupils
  • dry mouth

In rare cases, long QT syndrome and changes in mental status, including confusion and hallucinations, have been reported with overdoses of Strattera. (Long QT syndrome is a condition in which the heart’s electrical activity is affected.)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.