Can i cut strattera in half

Ibutilide: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include ibutilide. Iloperidone: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include iloperidone.

Because atomoxetine is primarily metabolized by CYP2D6, concurrent use of strong CYP2D6 inhibitors such as imatinib may theoretically increase the risk of atomoxetine-induced adverse effects. Imipramine: Minor Atomoxetine should be used cautiously with tricyclic antidepressants TCAs such as imipramine as concurrent use may increase the risk of QT prolongation. Inotuzumab Ozogamicin: Major Avoid coadministration of inotuzumab ozogamicin with atomoxetine due to the potential for additive QT prolongation and risk of torsade de pointes TdP.

If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment, after treatment initiation, and periodically during treatment. Inotuzumab has been associated with QT interval prolongation. Iobenguane I Major Discontinue selective norepinephrine reuptake inhibitors for at least 5 half-lives before the administration of the dosimetry dose or a therapeutic dose of iobenguane I Do not restart selective norepinephrine reuptake inhibitors until at least 7 days after each iobenguane I dose.

Drugs that reduce catecholamine uptake or deplete catecholamine stores, such as selective norepinephrine reuptake inhibitors, may interfere with iobenguane I uptake into cells and interfere with dosimetry calculations resulting in altered iobenguane I efficacy.

Isocarboxazid: Severe The use of selective norepinephrine reuptake inhibitors with monoamine oxidase inhibitors is contraindicated. At least 2 weeks should elapse between the discontinuation of a drug with MAO inhibiting activity and the start of selective norepinephrine reuptake inhibitors, or vice-versa.

Selective norepinephrine reuptake inhibitors potentiate certain catecholamines by inhibiting neuronal reuptake. Since some of these catecholamines are deaminated by monoamine oxidase, the administration of drugs that inhibit this enzyme concurrently with an atomoxetine can lead to serious reactions, such as those seen with other reuptake inhibitors. These reactions may include confusion, seizures, and severe hypertension as well as less severe symptoms.

Isoflurane: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Atomoxetine is one of the selective norepinephrine reuptake inhibitors.

Since norepinephrine is deaminated by monoamine oxidase, administration of drugs that inhibit this enzyme concurrently with atomoxetine can lead to serious reactions. Itraconazole: Moderate Use itraconazole with caution in combination with atomoxetine as concurrent use may increase the risk of QT prolongation.

Itraconazole has been associated with prolongation of the QT interval. Ivosidenib: Major Avoid coadministration of ivosidenib with atomoxetine due to an increased risk of QT prolongation.

If concomitant use is unavoidable, monitor ECGs for QTc prolongation and monitor electrolytes; correct any electrolyte abnormalities as clinically appropriate.

An interruption of therapy and dose reduction of ivosidenib may be necessary if QT prolongation occurs. Prolongation of the QTc interval and ventricular arrhythmias have been reported in patients treated with ivosidenib.

Ketoconazole: Moderate Use ketoconazole with caution in combination with atomoxetine as concurrent use may increase the risk of QT prolongation. Ketoconazole has been associated with prolongation of the QT interval. Lapatinib: Moderate Monitor for evidence of QT prolongation if lapatinib is administered with atomoxetine.

Lapatinib has been associated with concentration-dependent QT prolongation; ventricular arrhythmias and torsade de pointes TdP have been reported in postmarketing experience with lapatinib. Lefamulin: Major Avoid coadministration of lefamulin with atomoxetine as concurrent use may increase the risk of QT prolongation. If coadministration cannot be avoided, monitor ECG during treatment.

Lefamulin has a concentration dependent QTc prolongation effect. The pharmacodynamic interaction potential to prolong the QT interval of the electrocardiogram between lefamulin and other drugs that effect cardiac conduction is unknown. Lenvatinib: Major Avoid coadministration of lenvatinib with atomoxetine due to the risk of QT prolongation. Prolongation of the QT interval has been reported with lenvatinib therapy. Leuprolide: Moderate Consider whether the benefits of androgen deprivation therapy i.

Leuprolide; Norethindrone: Moderate Consider whether the benefits of androgen deprivation therapy i. Levofloxacin: Moderate Levofloxacin should be used cautiously with other agents that may prolong the QT interval or increase the risk of torsade de pointes TdP , such as atomoxetine.

Levofloxacin has been associated with a risk of QT prolongation and TdP. Although extremely rare, TdP has been reported during postmarketing surveillance of levofloxacin. Levomilnacipran: Moderate Levomilnacipran is a serotonin norepinephrine reuptake inhibitor SNRI and atomoxetine selectively inhibits norepinephrine reuptake; the drugs have some additive pharmacology that may lead to increases in blood pressure or heart rate.

Atomoxetine, a selective norepinephrine reuptake inhibitor, is contraindicated with the use of any MAOI due to the potential for serious reactions. Clinically, the potential for interaction between linezolid and atomoxetine has not been studied. Lisdexamfetamine: Moderate Consider monitoring heart rate and blood pressure at baseline and regularly throughout treatment if these agents must be used together. Amphetamines increase both systolic and diastolic blood pressure; atomoxetine has been reported to also increase blood pressure and heart rate.

Due to an additive pharmacodynamic effect, lisdexamfetamine and atomoxetine should be used together cautiously, particularly in patients with a history of cardiac disease.

Lithium: Moderate Lithium should be used cautiously with atomoxetine as concurrent use may increase the risk of QT prolongation. Lithium has been associated with QT prolongation. Lofexidine prolongs the QT interval. In addition, there are postmarketing reports of torsade de pointes. Long-acting beta-agonists: Moderate Use caution if atomoxetine is administered with long-acting beta-agonists as concurrent use may increase the risk of QT prolongation. Beta-agonists may be associated with adverse cardiovascular effects including QT interval prolongation, usually at higher doses, when associated with hypokalemia, or when used with other drugs known to prolong the QT interval.

This risk may be more clinically significant with long-acting beta-agonistsas compared to short-acting beta-agonists. Loperamide: Moderate Atomoxetine should be used cautiously with loperamide as concurrent use may increase the risk of QT prolongation. At high doses, loperamide has been associated with serious cardiac toxicities, including syncope, ventricular tachycardia, QT prolongation, torsade de pointes TdP , and cardiac arrest.

Coadministration may further increase the risk of QT prolongation and TdP. Loperamide; Simethicone: Moderate Atomoxetine should be used cautiously with loperamide as concurrent use may increase the risk of QT prolongation. Loratadine; Pseudoephedrine: Moderate Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as pseudoephedrine.

Macimorelin: Major Avoid concurrent administration of macimorelin with drugs that prolong the QT interval, such as atomoxetine. Use of these drugs together may increase the risk of developing torsade de pointes-type ventricular tachycardia.

Sufficient washout time of drugs that are known to prolong the QT interval prior to administration of macimorelin is recommended. Treatment with macimorelin has been associated with an increase in the corrected QT QTc interval. Maprotiline: Minor Use caution when administering atomoxetine with maprotiline as concurrent use may increase the risk of QT prolongation. Maprotiline has been reported to prolong the QT interval, particularly in overdose or with higher-dose prescription therapy elevated serum concentrations.

Cases of long QT syndrome and torsade de pointes TdP tachycardia have been described with maprotiline use, but rarely occur when the drug is used alone in normal prescribed doses and in the absence of other known risk factors for QT prolongation. Limited data are available regarding the safety of maprotiline in combination with other QT-prolonging drugs. Mefloquine: Moderate Mefloquine should be used with caution in patients receiving atomoxetine as concurrent use may increase the risk of QT prolongation.

There is evidence that the use of halofantrine after mefloquine causes a significant lengthening of the QTc interval. Mefloquine alone has not been reported to cause QT prolongation. Mepenzolate: Moderate Mepenzolate and atomoxetine should be combined cautiously in patients with known cardiac disease.

Mepenzolate may alter the heart rate; the predominant clinical effect is sinus tachycardia. Meperidine; Promethazine: Moderate Use atomoxetine and promethazine together with caution as concurrent use may increase the risk of QT prolongation.

Methadone: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include methadone.

Methamphetamine: Major Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as methamphetamine. Methscopolamine: Moderate Methscopolamine and atomoxetine should be combined cautiously in patients with known cardiac disease.

Methscopolamine may alter the heart rate; the predominant clinical effect is sinus tachycardia. Methylphenidate: Moderate Use atomoxetine and methylphenidate together with caution and monitor for additive effects. Monitor heart rate and blood pressure, as well as for any changes in moods or behavior.

Pulse and blood pressure should be measured at baseline, following any dose increases, and periodically while on therapy to detect possible clinically important increases. Coadministration of methylphenidate and atomoxetine did not increase the cardiovascular effects seen with administration of methylphenidate alone during clinical trials of atomoxetine.

However, methylphenidate has sympathomimetic effects and atomoxetine may increase the blood pressure and heart rate. Metronidazole: Moderate Use caution when using metronidazole in combination with atomoxetine as concurrent use may increase the risk of QT prolongation.

Midodrine: Major Due to the potential for additive increases in blood pressure and heart rate, atomoxetine should be used cautiously with vasopressors such as midodrine. Midostaurin: Major The concomitant use of midostaurin and atomoxetine may lead to additive QT interval prolongation. If these drugs are used together, consider obtaining electrocardiograms to monitor the QT interval.

In clinical trials, QT prolongation was reported in patients who received midostaurin as single-agent therapy or in combination with cytarabine and daunorubicin. Mifepristone: Moderate Mifepristone has been associated with dose-dependent prolongation of the QT interval.

There is no experience with high exposure or concomitant use with other QT prolonging drugs. To minimize the risk of QT prolongation, the lowest effective dose should always be used.

Drugs with a possible risk for QT prolongation and torsades de pointes that should be used cautiously with mifepristone include atomoxetine. Mirabegron: Moderate Because atomoxetine is primarily metabolized by CYP2D6, concurrent use of CYP2D6 inhibitors such as mirabegron may theoretically increase the risk of atomoxetine-induced adverse effects. Mirtazapine: Moderate Use caution when using mirtazapine in combination with atomoxetine as concurrent use may increase the risk of QT prolongation.

Mirtazapine has been associated with dose-dependent prolongation of the QT interval. Torsade de pointes TdP has been reported postmarketing, primarily in overdose or in patients with other risk factors for QT prolongation.

Monoamine oxidase inhibitors: Severe The use of selective norepinephrine reuptake inhibitors with monoamine oxidase inhibitors is contraindicated. Moxifloxacin: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include moxifloxacin. Naproxen; Pseudoephedrine: Moderate Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as pseudoephedrine.

Nicardipine: Moderate Monitor for adverse effects, such as dizziness, drowsiness, nervousness, insomnia, and cardiac effects e. Because atomoxetine is primarily metabolized by CYP2D6, concurrent use of CYP2D6 inhibitors such as nicardipine may theoretically increase the risk of atomoxetine-induced adverse effects. Nilotinib: Major Avoid the concomitant use of nilotinib with atomoxetine as significant prolongation of the QT interval may occur.

Sudden deaths and QT prolongation have been reported with nilotinib therapy. Nitroglycerin: Minor Nitroglycerin can cause hypotension. This action may be additive with other agents that can cause hypotension such as antidepressants. Patients should be monitored more closely for hypotension if nitroglycerin is used concurrently with antidepressants. Norepinephrine: Moderate Due to the potential for additive increases in blood pressure and heart rate, atomoxetine should be used cautiously with vasopressors such as norepinephrine.

Consider monitoring blood pressure and heart rate at baseline and regularly if vasopressors are coadministered with atomoxetine. Norfloxacin: Moderate Use caution if atomoxetine is administered with norfloxacin as concurrent use may increase the risk of QT prolongation. Quinolones have been associated with a risk of QT prolongation and torsade de pointes TdP.

Although extremely rare, TdP has been reported during postmarketing surveillance of norfloxacin. These reports generally involved patients with concurrent medical conditions or concomitant medications that may have been contributory.

Nortriptyline: Minor Atomoxetine should be used cautiously with tricyclic antidepressants TCAs such as nortriptyline as concurrent use may increase the risk of QT prolongation. Octreotide: Minor Use octreotide with caution in combination with atomoxetine as concurrent use may increase the risk of QT prolongation.

Arrhythmias, sinus bradycardia, and conduction disturbances have occurred during octreotide therapy. Since bradycardia is a risk factor for development of torsade de pointes TdP , the potential occurrence of bradycardia during octreotide administration could theoretically increase the risk of TdP in patients receiving drugs that prolong the QT interval. Ofloxacin: Moderate Ofloxacin should be used cautiously with other agents, such as atomoxetine, that may prolong the QT interval or increase the risk of torsade de pointes TdP.

Quinolones have been associated with a risk of QT prolongation and TdP. Although extremely rare, TdP has been reported during postmarketing surveillance of ofloxacin. Olanzapine: Moderate Caution is advised when administering olanzapine with atomoxetine as concurrent use may increase the risk of QT prolongation. Ondansetron: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include ondansetron. Plasma concentrations and efficacy of atomoxetine may be reduced if these drugs are administered concurrently.

Osimertinib: Major Avoid coadministration of atomoxetine with osimertinib if possible due to the risk of QT prolongation and torsade de pointes TdP. If concomitant use is unavoidable, periodically monitor ECGs for QT prolongation and monitor electrolytes; an interruption of osimertinib therapy with dose reduction or discontinuation of therapy may be necessary if QT prolongation occurs.

Concentration-dependent QTc prolongation occurred during clinical trials of osimertinib. Oxaliplatin: Major Monitor ECGs and electrolytes in patients receiving oxaliplatin and atomoxetine concomitantly; correct electrolyte abnormalities prior to administration of oxaliplatin.

QT prolongation and ventricular arrhythmias including fatal torsade de pointes have been reported with oxaliplatin use in post-marketing experience. Oxycodone: Major Serotonin syndrome can occur during concomitant use of opiate agonists with serotonergic drugs, such as serotonin norepinephrine reuptake inhibitors SNRIs. Paliperidone: Major Paliperidone has been associated with QT prolongation; torsade de pointes TdP and ventricular fibrillation have been reported in the setting of overdose.

According to the manufacturer, since paliperidone may prolong the QT interval, it should be avoided in combination with other agents also known to have this effect. If coadministration is considered necessary and the patient has known risk factors for cardiac disease or arrhythmias, close monitoring is essential. Panobinostat: Major The co-administration of panobinostat and atomoxetine is not recommended. If concomitant use cannot be avoided, closely monitor patients for signs and symptoms of atomoxetine toxicity.

In extensive metabolizers EMs taking atomoxetine who are treated concurrently with paroxetine, the atomoxetine AUC is roughly 6 to 8-fold and Cmax 3 to 4-fold greater than if atomoxetine is given alone. If concurrent use is necessary, monitor for adverse effects, such as dizziness, nervousness, insomnia, and cardiac effects e.

Because atomoxetine has a possible risk of QT prolongation and torsade de pointes, concurrent use of a potent CYP2D6 inhibitor such as paroxetine may increase the risk of such events. Pasireotide: Moderate Use caution when using pasireotide in combination with atomoxetine as concurrent use may increase the risk of QT prolongation. QT prolongation has also occurred with pasireotide at therapeutic and supra-therapeutic doses.

Pazopanib: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include pazopanib.

Peginterferon Alfa-2b: Moderate Monitor for adverse effects associated with increased exposure to atomoxetine if peginterferon alfa-2b is coadministered.

Pentamidine: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include pentamidine. Perphenazine: Minor Use caution when administering atomoxetine with perphenazine as concurrent use may increase the risk of QT prolongation.

Additionally, perphenazine is associated with a possible risk for QT prolongation. Perphenazine; Amitriptyline: Minor Atomoxetine should be used cautiously with tricyclic antidepressants TCAs such as amitriptyline as concurrent use may increase the risk of QT prolongation. Minor Use caution when administering atomoxetine with perphenazine as concurrent use may increase the risk of QT prolongation.

Phendimetrazine: Major Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as phendimetrazine. Phenelzine: Severe The use of selective norepinephrine reuptake inhibitors with monoamine oxidase inhibitors is contraindicated. Phentermine: Major Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as phentermine.

Phentermine; Topiramate: Major Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as phentermine. Phenylephrine: Moderate Due to the potential for additive increases in blood pressure and heart rate, atomoxetine should be used cautiously with vasopressors such as phenylephrine.

Phenylephrine; Promethazine: Moderate Due to the potential for additive increases in blood pressure and heart rate, atomoxetine should be used cautiously with vasopressors such as phenylephrine.

Pimavanserin: Major Pimavanserin may cause QT prolongation and should generally be avoided in patients receiving other medications known to prolong the QT interval, such as atomoxetine. Coadministration may increase the risk for QT prolongation. Pimozide: Severe QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Pimozide is associated with a well-established risk of QT prolongation and torsade de pointes TdP. Because of the potential for TdP, use of atomoxetine with pimozide is contraindicated.

Pitolisant: Major Avoid coadministration of pitolisant with atomoxetine as concurrent use may increase the risk of QT prolongation. Pitolisant prolongs the QT interval. Posaconazole: Moderate Use posaconazole with caution in combination with atomoxetine as concurrent use may increase the risk of QT prolongation. Posaconazole has been associated with prolongation of the QT interval as well as rare cases of torsade de pointes. Prilocaine; Epinephrine: Major Due to the potential for additive increases in blood pressure and heart rate, atomoxetine should be used cautiously with vasopressors such as epinephrine.

Primaquine: Moderate Use atomoxetine with caution in combination with primaquine as concurrent use may increase the risk of QT prolongation. Primaquine also has the potential to prolong the QT interval. Procainamide: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include procainamide. The use of atomoxetine with monoamine oxidase inhibitors MAOIs is contraindicated. Atomoxetine is one of the selective norepinephrine reuptake inhibitors SNRIs. Prochlorperazine: Minor Use atomoxetine with caution in combination with prochlorperazine as concurrent use may increase the risk of QT prolongation.

Prochlorperazine is also associated with a possible risk for QT prolongation. Promethazine: Moderate Use atomoxetine and promethazine together with caution as concurrent use may increase the risk of QT prolongation.

Propafenone: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose. Both atomoxetine and propafenone are considered drugs with a possible risk of torsade de pointes TdP ; therefore, the combination should be used cautiously and with close monitoring. In addition, because atomoxetine is primarily metabolized by CYP2D6, concurrent use of CYP2D6 inhibitors such as propafenone may theoretically increase the risk of atomoxetine-induced adverse effects.

Protriptyline: Minor Atomoxetine should be used cautiously with tricyclic antidepressants TCAs such as protriptyline as concurrent use may increase the risk of QT prolongation. Pseudoephedrine: Moderate Due to the potential for increases in blood pressure and heart rate, atomoxetine should be used cautiously with drugs with sympathomimetic activity such as pseudoephedrine. Quetiapine: Major QT prolongation has occurred during therapeutic use of atomoxetine and following overdose.

Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with atomoxetine include quetiapine. Quinidine: Major If possible, quinidine should be avoided in patients receiving medications that both prolong the QT interval and are CYP2D6 substrates such as atomoxetine. Work with your family physician and let the clinical benefits noted with your child guide you.

Larry Silver, M. Strattera is manufactured by Eli Lilly and Company. For more information, visit the patient and healthcare professional website. You must be logged in to post a comment. It appears JavaScript is disabled in your browser.

Please enable JavaScript and refresh the page in order to complete this form. By Larry Silver, M. Verified Medically reviewed by William Dodson, M. Less likely to be abused intranasal or IV than short acting. Must use whole capsule. TENEX guanfacine guanfacine tablets. Treatment of ADHD usually includes medical management, behavior modification.

The medications charted above include: 1 the stimulants, 2 the non-stimulant Strattera atomoxetine with effects similar to stimulants, 3 the antidepressant Wellbutrin bupropion and 4 two antihypertensives Catapres clonidine and Tenex guanfacine. Stimulants include all formulations of methyphenidate Ritalin, Focalin, Metadate and Methylin and all forms of amphetamines Dexedrine, Dextrostat and Adderall. Individuals respond in their own unique way to medication depending upon their physical make-up, severity of symptoms.

Careful monitoring should be done by a physician in collaboration with the teacher, therapist. Medications to treat ADHD and related conditions should only be prescribed by a physician.

Information presented here is not intended to replace the advice of a physician. This chart may be reproduced without permission. Thanks go to Dorothy Johnson, M. Parker, Ph. All rights reserved. Books, assessment products and training programs for ADHD and related problems.

Sign In. My Account. Overcoming Underachieving. Avoiding the Back to School Homework Blues. Assessment Products. ADHD Articles. About Us. Click here to Register. I forgot my password. Short Acting Tablet 5 mg 10 mg 20 mg.

Starting dose for children is 5 mg twice daily, hours apart. Add third dose about 4 hours after second. Adjust timing based on duration of action. Increase by mg increments.

Daily dosage above 60 mg not recommended. Estimated dose range. Insomnia, decreased appetite, weight loss, headache, irritability, stomachache, and rebound agitation or exaggeration of pre-medication symptoms as it is wearing off. About hours. Most helpful when need rapid onset and short duration.

Works quickly within minutes. Use cautiously in patients with marked anxiety, motor tics or with family history of Tourette syndrome, or history of substance abuse. Mucous membrane irritant; Note: women who are, or may become, pregnant, should not handle crushed or broken tablets l.

Slow-release a Note: do not give via NG tubes; crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose. Slow-release b ; Note: crushing, chewing or dissolving tablets can cause rapid release and absorption of a potentially fatal dose.

Film-coated Note: active ingredients are surrounded by wax matrix to prevent healthcare exposure; women who are, or may become, pregnant should not handle crushed or broken tablet. Empty contents into a spoon for administration.

Do not swallow the capsule. Do not chew or crush the contents of the capsule. Mucous membrane irritant; Note: accidentally opened or damaged capsules require rigorous precautions to avoid inhalation or contact with the skin or mucous membranes i.

Slow-release; Note: crushing, chewing, or dissolving capsules can cause rapid release and absorption of a potentially fatal dose. Note: irritant; avoid contact with skin or mucous membranes; avoid contact with crushed or broken tablets. Add to cart.