Atomoxetine drug interactions

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Drug-drug interactions

Severity levelClick here to see Severity Level Legend Drug and description of interaction
4 Phenelzine, selegiline, tranylcypromine, isocarboxazide: Atomoxetine should not be used within 14 days of MAO inhibitors due to the risk for serious central nervous system side effects (hyperthermia, rigidity, myoclonus, autonomic instability, and mental status changes).[1][2]
3 Amiodarone, paroxetine, fluoxetine, quinidine: CYP2D6 inhibitors may increase concentrations of atomoxetine in extensive metabolizers (EMs). Consequently, the dose of atomoxetine may need adjustment. For poor metabolizers (PMs), no dose adjustment is necessary since in vitro studies have not demonstrated increased concentrations of atomoxetine when coadministered with CYP2D6 inhibitors.[1]


Albuterol: Atomoxetine may potentiate the cardiovascular effects (elevations in heart rate and blood pressure) of systemic beta agonists (oral and intravenous), such as albuterol. Use caution if administered concomitantly.[1]

Dopamine, epinephrine, norepinephrine, phenylephrine: Pressor agents may further potentiate blood pressure and heart rate if coadministered with atomoxetine. Use caution if used concomitantly.[1]

Pseudoephedrine, amphetamine, dextroamphetamine, dobutamine: Sympathomimetics may further potentiate blood pressure and heart rate if coadministered with atomoxetine. Use caution if used concomitantly.[1][2]

2 Midazolam: Coadministration of a single dose of midazolam 5 mg with atomoxetine (60 mg BID for 12 days) caused an increase in the midazolam's AUC by 15%. However, no dose adjustment is recommended for midazolam or other drugs metabolized by CYP3A4.
1 Methylphenidate: Concomitant use of methylphenidate with atomoxetine did not lead to increased cardiovascular effects compared with methylphenidate use alone.
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Drug-food/drug-herb interactions

Severity levelClick here to see Severity Level Legend Drug and description of interaction
4 None reported.
3 Ma Huang: Vasopressor effects, including elevations in heart rate and blood pressure may occur if used with atomoxetine. Avoid concomitant use with atomxetine.[2]
2 Alcohol: Although atomoxetine and alcohol use did not change the intoxicating effects of alcohol, use of alcohol should be avoided.[1][3]
1 None reported.
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References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Strattera (atomoxetine HCl) package insert. Indianapolis, IN; Eli Lilly and Company; 2007 Apr.
  2. ↑ 2.0 2.1 2.2 Clinical Pharmacology Website. Available at: http://www.clinicalpharmacology.com/. Accessed October 2, 2007.
  3. ↑ Lexi Comp. Available at: http://online.lexi.com/crlonline. Accessed October 3, 2007.
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