Consumer medicine information

Strattera 100 mg Capsules

Atomoxetine

BRAND INFORMATION

Brand name

Strattera

Active ingredient

Atomoxetine

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Strattera 100 mg Capsules.

What is in this leaflet


This leaflet answers some common questions about STRATTERA. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you taking STRATTERA against the benefits it may have for you.
If you have any concerns about taking this medicine, ask your doctor or pharmacist.

What STRATTERA is used for


STRATTERA is used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children 6 years and older, adolescents and adults. ADHD is a behavioural disorder that causes lack of focus and/or hyperactivity that is much more frequent or severe than others who are close in age or development.
STRATTERA works by acting on brain chemicals called amines which are involved in controlling behaviour.
Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.
Available evidence suggests that STRATTERA does not have a significant potential for abuse.
This medicine is available only with a doctor's prescription.

Before you take STRATTERA

When you must not take it


Do not take STRATTERA if you have an allergy to:
  • any medicine containing atomoxetine hydrochloride (the active ingredient in STRATTERA)
  • any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Do not take STRATTERA if you have any of the following conditions:
  • certain heart diseases such as moderate to severe raised blood pressure (hypertension), abnormal or dangerously fast heart beat, thickening and hardening of the walls of the arteries due to cholesterol deposits
  • an uncontrolled overactive thyroid gland which causes increased appetite, weight loss, intolerance to heat, increased sweating, tremors, and rapid heart rate
  • a tumour of the adrenal gland, which sits near the kidney. The symptoms are bouts of anxiety and headaches, palpitations, dizziness, a feeling of weakness, nausea, vomiting, diarrhoea, dilated pupils and blurring vision, stomach pains, and raised blood pressure.

Do not take STRATTERA if you are taking medicine called a monoamine oxidase inhibitor (MAOI) for the treatment of depression or have been taking a MAOI within the last 14 days.
Check with your doctor or pharmacist if you are unsure as to whether or not you are taking a MAOI.
If you do take STRATTERA while you are taking a MAOI, you may experience elevated body temperature, muscle stiffness, involuntary muscle jerking, fluctuations of vital signs (blood pressure, heart rate, breathing rate) and mental state from extreme agitation progressing to confusion and coma (a condition resembling neuroleptic malignant syndrome).

Do not take STRATTERA if you have high pressure in the eye (glaucoma), or have a family history of glaucoma.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
If it has expired or is damaged, return it to your pharmacist for disposal.
If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it


Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.
Tell your doctor if you have or have had any of the following medical conditions:
  • high blood pressure
  • low blood pressure
  • fast heart beat
  • heart disease
  • conditions affecting blood flow in the brain, such as stroke
  • liver disease
  • kidney disease
  • an overactive thyroid gland
  • enlargement or disease of the prostate
  • difficulty passing urine
  • seizures, fits or convulsions
  • any psychiatric disorder, including depression or bipolar disorder.

Tell your doctor if you or your child have or have had:
  • thoughts or talk of death or suicide
  • thoughts or talk of self-harm or harm to others
  • any recent attempts at self-harm.

You may wish to see a paediatric psychiatrist for further assessment and supervision of your child.
Tell your doctor if you:
  • are involved in strenuous exercise or activities
  • are using a group of medicines called stimulants
  • have a family history of sudden/cardiac death.

STRATTERA generally should not be used in children, adolescents or adults with known structural heart abnormalities due to increased risks of sudden death/stroke.
Tell your doctor if you are pregnant or plan to become pregnant or are breast-feeding.
Your doctor can discuss with you the risks and benefits involved.
Safety and effectiveness in elderly patients older than 65 years and children younger than 6 years have not been established.
If you have not told your doctor about any of the above, tell him/her before you start taking STRATTERA.

Taking other medicines


Tell your doctor or pharmacist if you are taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.
Some medicines may be affected by STRATTERA or may affect how it works. You may need different amounts of your medicines or you may need to take different medicines.
These include:
  • monoamine oxidase inhibitors (MAOIs), medicines used to treat some types of depression.
    You should stop taking MAOIs at least two weeks before starting STRATTERA
  • certain medicines used to treat depression such as fluoxetine, paroxetine, desipramine, imipramine, venlafaxine and mirtazapine
  • certain medicines used to treat irregular heart beat such as quinidine
  • medicines used to treat low blood pressure or to raise blood pressure (anti-hypertensive medicines and pressor agents)
  • medicines containing the decongestants pseudoephedrine or phenylephrine
  • asthma reliever medicines such as salbutamol, when taken orally as a syrup or as an injection
  • certain medicines taken for anxiety such as diazepam or to treat epilepsy such as phenytoin.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking STRATTERA.

How to take STRATTERA


Carefully follow all directions given to you by your doctor or pharmacist.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the box, ask your doctor or pharmacist for help.

How much to take


For children and adolescents up to 70 kg body weight, the usual starting dose is approximately 0.5 mg/kg once a day.
After a minimum of 3 days, if necessary, the dose may be increased to approximately 1.2 mg/kg once daily in the morning or as evenly divided doses in the morning and late afternoon/early evening. After 2 to 4 additional weeks, if necessary, the dose may be increased to a maximum of 1.4 mg/kg once daily or 100 mg.
For children and adolescents greater than 70 kg body weight and adults, the usual starting dose is 40 mg once a day.
After a minimum of 3 days, if necessary, the dose may be increased to approximately 80 mg once daily in the morning or as evenly divided doses in the morning and late afternoon/early evening. After 2 to 4 additional weeks, the dose may be increased to a maximum of 100 mg.
If therapy is interrupted for more than 1 week, treatment should be started at the lowest recommended dose.
Your doctor will tell you how much STRATTERA you need to take each day.
Your doctor may increase or decrease your dose depending on your condition and any other illness that you may have.

How to take it


Swallow the capsules whole with a full glass of water.
STRATTERA can be taken with or without food.

When to take it


STRATTERA is usually taken one or two times a day (early morning and late afternoon/early evening).
If you find that you are sleepy during the day or have trouble sleeping at night, talk to your doctor about the best time to take your medicine.
Take your medicine at about the same time each day.
Taking it at the same time each day will have the best effect. It will also help you remember when to take it.
It does not matter if you take this medicine before or after food.

How long to take it


Continue taking your medicine for as long as your doctor tells you.
This medicine helps to control your condition, but does not cure it. It is important to keep taking your medicine even if you feel well.

If you forget to take it


If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take it as soon as you remember, and then go back to taking your medicine as you would normally. Do not take more than your total daily dose in a 24-hour period.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)


If you think that you or anyone else may have taken too much STRATTERA, immediately telephone your doctor or the Poisons Information Centre (telephone Australia: 13 11 26, NZ: 0800 POISON or 0800 764 766) for advice, or go to Emergency Department at the nearest hospital. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
If you have taken too much STRATTERA, the most common signs are sleepiness, dizziness, tremor, agitation, hyperactivity, unusual behaviour and an upset stomach. In some cases of overdose, seizures and changes to the way that the heart beats (a condition called QT prolongation) have been reported.

While you are taking STRATTERA

Things you must do


Contact your doctor or a paediatric psychiatrist straight away or go to the nearest hospital for treatment if you notice any sudden change in your child's behaviour, if your child is demonstrating any of the following warning signs, if you notice any of the following or if they seem worse.
Signs to watch for:
  • thoughts or talk of death or suicide
  • thoughts or talk of self-harm or harm to others
  • attempts to commit suicide
  • new or worse depression
  • new or worse anxiety
  • feeling very agitated or restless
  • panic attacks
  • difficulty sleeping (insomnia)
  • new or worse irritability
  • acting on dangerous impulses
  • an extreme increase in activity and talking
  • appearance or worsening of aggressive behaviour or hostility
  • other unusual changes in behaviour.

Preventing suicidal thoughts or action:


To try and prevent suicidal thoughts or actions in your child, talk with and listen to your child about his or her thoughts and feelings and pay close attention to changes in his or her moods or action, especially if the changes occur suddenly. Other important people in your child's life can help by paying attention as well (e.g. brothers and sisters, teachers, caregivers and other important people). Pay close attention to your child whenever STRATTERA is started or its dose is changed (see Side Effects).
If you notice an increase in aggression or hostility since taking this medication, you should call your doctor as soon as possible.
Tell your doctor if you experience a seizure, fit or convulsion. If you already suffer from seizures, fits or convulsions, tell your doctor if they seem to increase in frequency.
Tell your doctor if you notice changes in your sexual function while you are taking this medicine.
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking STRATTERA.
Tell any other doctors, dentists and pharmacists who treat you that you are taking this medicine.
If you are going to have surgery, tell the surgeon or anaesthetist that you are taking this medicine.
It may affect other medicines used during surgery.
If you become pregnant while taking this medicine, tell your doctor immediately.
Keep all of your doctor's appointments so that your progress can be checked.
Your doctor may do some tests (blood pressure and heart rate) from time to time while on therapy. After starting STRATTERA children may have a reduced rate of growth so your doctor may also monitor your height and weight from time to time when on long term therapy.

Things you must not do


Do not take STRATTERA to treat any other complaints unless your doctor tells you to.
Do not give your medicine to anyone else, even if they have the same condition as you.
Do not open your STRATERRA capsules as the content is an eye irritant.
In the event of capsule content coming in contact with the eye, flush the affected eye immediately with water and seek medical advice. Hands and any potentially contaminated surfaces should be washed as soon as possible.

Things to be careful of


Be careful driving or operating machinery until you know how STRATTERA affects you.
This medicine may cause dizziness, tiredness or drowsiness in some people. If you have any of these symptoms, do not drive, operate machinery or do anything else that could be dangerous.
If you feel light-headed, dizzy or faint when getting out of bed or standing up, get up slowly.
Standing up slowly, especially when you get up from bed or chairs, will help your body get used to the change in position and blood pressure. If this problem continues or gets worse, talk to your doctor.
If your doctor advises you to stop taking STRATTERA, do not take monoamine oxidase inhibitors (MAOIs) within the first two weeks after stopping STRATTERA.

Side effects


Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking STRATTERA.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.
Do not be alarmed by the following lists of side effects. You may not experience any of them. Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor or pharmacist if you notice any of the following:
Children, adolescents and Adults

  • constipation
  • upset or sore stomach, nausea, vomiting
  • diarrhoea
  • decreased appetite
  • weight loss
  • decreased growth (weight and height)
  • headache
  • drowsiness
  • dizziness
  • constant flu like symptoms such as chills, fever, irritated watery eyes, sore throat
  • feeling cold
  • dilated pupils
  • blurred vision
  • Eye redness
  • mood swings
  • skin rash, redness, itching
  • early morning waking, tiredness
  • unusual weakness
  • lacking energy, feeling tired
  • cough, sore throat, blocked or runny nose, which may be associated with a respiratory infection

Adults
  • dry mouth
  • thirst
  • flatulence
  • difficulty urinating, abnormal, painful and/or frequent urination
  • sexual disturbances including reduced sex drive, erectile dysfunction, abnormal orgasm
  • testicular or genital pain in males
  • painful or irregular menstrual periods
  • hot flushes
  • increased sweating
  • tickling, tingling, burning, pricking, or numbness of skin
  • feeling jittery, tremors
  • persistent abnormal taste

Tell your doctor immediately or go to the Emergency Department of your nearest hospital if you notice any of the following in you/your child while taking STRATTERA:
  • fast or irregular heart beat
  • fainting
  • numbness, tingling and colour change (white, blue then red) in fingers and toes when exposed to cold
  • seizures, fits or convulsions
  • signs of liver injury such as dark urine, yellowing of the skin or eyes, severe cramps of the stomach, or unexplained nausea, fatigue, lethargy, itching or flu-like symptoms
  • episodes of overactivity, restlessness, elation or irritability, hostility or aggressiveness
  • anxiety, agitation, impulsive behaviour and other changes in behaviour
  • difficulty in sleeping
  • panic attacks
  • chest pain
  • depression
  • confusion or hallucinations (seeing or feeling things that are not really there)
  • thoughts of suicide or attempts to harm yourself. (also see Things You Must Do if you notice this behaviour in children or adolescents)

These are serious side effects, which may require medical attention. Serious side effects are rare or very rare. Other side effects not listed above may also occur in some people.
Other changes you may not be aware of:
  • increased blood pressure
  • heart rhythm changes

Tell your doctor or pharmacist if you notice any other effects.

After taking STRATTERA

Storage


Keep your capsules in the pack until it is time to take them.
If you take the capsules out of the pack they may not keep as well.
Keep your capsules in a cool dry place where the temperature stays below 25°C.
Do not store STRATTERA or any other medicine in the bathroom or near a sink. Do not leave it on a windowsill or in the car.
Heat and dampness can destroy some medicines.
Keep it where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal


If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

Product description

What it looks like


STRATTERA 10 mg capsules are coloured opaque white and are marked with "Lilly", "3227" and "10 mg".
STRATTERA 18 mg capsules are coloured gold and opaque white and are marked with "Lilly", "3238" and "18 mg".
STRATTERA 25 mg capsules are coloured opaque blue and opaque white and are marked with "Lilly", "3228" and "25 mg".
STRATTERA 40 mg capsules are coloured opaque blue and are marked with "Lilly", "3229" and "40 mg".
STRATTERA 60 mg capsules are coloured opaque blue and gold and are marked with "Lilly", "3239" and "60 mg".
STRATTERA 80 mg capsules are coloured opaque brown and opaque white and are marked with "Lilly", "3250" and "80 mg".
STRATTERA 100 mg capsules are coloured opaque brown and are marked with "Lilly", "3251" and "100 mg".

Ingredients


STRATTERA contains 10, 18, 25, 40, 60, 80 or 100 mg of atomoxetine hydrochloride as the active ingredient. It also contains:
  • starch (pregelatinised maize)
  • dimeticone 350
  • gelatin
  • sodium lauryl sulfate
  • edible black ink
  • one or more of the following:
    - indigo carmine CI73015
    - iron oxide yellow CI77492
    - iron oxide red CI77491
    - titanium dioxide

This medicine does not contain lactose, sucrose, gluten, tartrazine or any other azo dyes.

Supplier


Supplied in Australia by:
Eli Lilly Australia Pty Ltd
Level 9, 60 Margaret Street,
Sydney, NSW 2000
Australia
Supplied in NZ by:
Eli Lilly and Company (NZ) Ltd.
PO Box 109 197, Newmarket,
AUCKLAND
New Zealand

Australian Registration Number:


STRATTERA 10 mg capsules -
AUST R 90592
STRATTERA 18 mg capsules -
AUST R 90593
STRATTERA 25 mg capsules -
AUST R 90594
STRATTERA 40 mg capsules -
AUST R 90595
STRATTERA 60 mg capsules -
AUST R 90596
STRATTERA 80 mg capsules -
AUST R 146333
STRATTERA 100 mg capsules -
AUST R 146413
This leaflet was revised in January 2024.
® = Registered Trademark
vA8

BRAND INFORMATION

Brand name

Strattera

Active ingredient

Atomoxetine

Schedule

S4

 

Boxed Warnings

Short-term placebo controlled studies evaluated over 2200 children and adolescents with attention deficit hyperactivity disorder (ADHD). Among the 1357 patients on Strattera, there was a positive signal for suicidal thoughts (5 patients) and behaviours (1 patient) in children 12 years of age and younger compared to placebo (0/851). No suicides occurred in these trials. Anyone considering the use of Strattera in children must balance the risk of suicidality (suicidal thoughts or behaviours) against the clinical need. Patients who are started on Strattera should be closely monitored for suicidality (see Section 4.4 Special Warnings and Precautions for Use).

1 Name of Medicine

Strattera (atomoxetine hydrochloride) tablets.

2 Qualitative and Quantitative Composition

Capsules containing 5, 10, 18, 25, 40, 60, 80 and 100 mg of atomoxetine hydrochloride.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Strattera is available as capsules for oral administration.
Each capsule contains 10, 18, 25, 40, 60, 80 or 100 mg of atomoxetine (as the hydrochloride).
The capsule colours and markings are as follows:
*5 mg capsules. Gold and marked with "Lilly 3226" and "5 mg".
10 mg capsules. Opaque white and marked with "Lilly 3227" and "10 mg".
18 mg capsules. Gold and opaque white and marked with "Lilly 3238" and "18 mg".
25 mg capsules. Opaque blue and opaque white and marked with "Lilly 3228" and "25 mg".
40 mg capsules. Opaque blue and marked with "Lilly 3229" and "40 mg".
60 mg capsules. Opaque blue and gold and marked with "Lilly 3239" and "60 mg".
80 mg capsules. Opaque brown and opaque white and marked with "Lilly 3250" and "80 mg".
100 mg capsules. Opaque brown and marked with "Lilly 3251" and "100 mg".
* Not currently available.

4 Clinical Particulars

4.9 Overdose

During postmarketing overseas, there have been no fatalities involving overdose with Strattera alone, including intentional overdoses at amounts up to or exceeding 1500 mg. The most commonly reported symptoms accompanying acute and chronic overdoses were gastrointestinal symptoms, somnolence, dizziness, tremor, and abnormal behaviour. Hyperactivity and agitation have also been reported. Signs and symptoms consistent with mild to moderate sympathetic nervous system activation (e.g. tachycardia, blood pressure increased, mydriasis, dry mouth) were also observed. Most events were mild to moderate. In some cases of overdose involving Strattera, seizures and QT prolongation have been reported. There have also been reports of fatal, acute overdoses involving mixed ingestion of Strattera and at least one other drug. There is limited clinical trial experience with Strattera overdose.
No specific information is available on the treatment of overdose with Strattera. Patients who overdose with atomoxetine should be monitored carefully and receive supportive care. Activated charcoal may be useful in limiting absorption. Activated charcoal may reduce absorption of the medicine if given within one or two hours after ingestion. In patients who are not fully conscious or have impaired gag reflex, consideration should be given to administering activated charcoal via a nasogastric tube, once the airway is protected.
Dialysis is not likely to be useful in the treatment of overdose because Strattera is highly protein bound.
For information on the management of overdose, contact the Poison Information Centre on 131126 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. Atomoxetine hydrochloride was not genotoxic in a battery of tests including bacterial reverse mutation assays, a mouse lymphoma assay, a chromosomal aberration test in Chinese hamster ovary cells, in vivo micronucleus test in mice, unscheduled DNA synthesis test in rat hepatocytes and in vivo sister chromatid exchange test in bone marrow of Chinese hamsters. However, there was a slight increase in the percentage of Chinese hamster ovary cells with diplochromosomes, suggesting endoreduplication (numerical aberration). The metabolite N-desmethylatomoxetine hydrochloride was negative in the Ames test, mouse lymphoma assay and unscheduled DNA synthesis test.
Carcinogenicity. Atomoxetine hydrochloride was not carcinogenic in rats and mice when given in the diet for 2 years. The time-weighted average doses of up to 47 and 458 mg/kg/day were approximately 6 (rat) and 30 (mouse) times the maximum recommended daily oral dose in children and approximately 4 (rat) and 17 (mouse) times the maximum recommended daily oral dose in adults, on a mg/m2 basis. Systemic exposure (plasma AUC) to active moiety (atomoxetine + 4-hydroxyatomoxetine) in rats was estimated to be less than that in extensive or poor metabolisers receiving the maximum dose, and exposure in mice was estimated to be 1 to 3 times that in extensive metabolisers but less than that in poor metabolisers.

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

Chemical structure. The active ingredient in Strattera capsules is atomoxetine hydrochloride.
Atomoxetine hydrochloride is a white to practically white solid which has a solubility of 27.8 mg/mL in water.
Chemically, Strattera is (R)-(-)-N-methyl-γ-(2-methylphenoxy)-benzenepropanamine hydrochloride. The empirical formula is C17H21NO.HCl which corresponds to a molecular weight of 291.82 daltons.
The chemical structure is:
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSATOMHC.gif CAS number. The CAS number for atomoxetine hydrochloride is 82248-59-7.

7 Medicine Schedule (Poisons Standard)

S4 - Prescription Only Medicine.

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/STRATTST.gif