On this page

atomoxetine hydrochloride

Prescription ANDA TE AB Official labelling
Informational index, not medical advice. Content is reproduced from public FDA and NLM data. Always confirm against the manufacturer's current prescribing information. Report adverse events to FDA MedWatch.

Overview

Brand name
Atomoxetine Hydrochloride
Generic name
atomoxetine hydrochloride
Dosage form
Capsule
Route
Oral
Marketing category
ANDA · ANDA
Labeler
Golden State Medical Supply, Inc.
Product type
Human Prescription Drug
DEA schedule
Not scheduled
Active ingredients
7
NDC product codes
26
Packages
26
Data completeness
82% of corroborating sources present

Active ingredients

Source: NDC Directory
Active ingredients and strengths as listed in the NDC Directory.
Ingredient Strength RxCUI Monograph
Atomoxetine Hydrochloride 10 mg/1 349593 View
Atomoxetine Hydrochloride 100 mg/1 349593 View
Atomoxetine Hydrochloride 18 mg/1 349593 View
Atomoxetine Hydrochloride 25 mg/1 349593 View
Atomoxetine Hydrochloride 40 mg/1 349593 View
Atomoxetine Hydrochloride 60 mg/1 349593 View
Atomoxetine Hydrochloride 80 mg/1 349593 View

Forms, strengths and routes

Source: NDC Directory
Dosage form
Capsule
Route of administration
Oral
Presentations
52

Pharmacologic classes are listed in the class section below.

Pharmacologic class

Source: NDC Directory
Established pharmacologic classes (EPC), mechanisms of action (MoA), chemical structures (CS) and physiologic effects (PE).
Class Type Browse
Norepinephrine Reuptake Inhibitor [EPC] EPC 4 members — no class page
Norepinephrine Uptake Inhibitors [MoA] MoA All 44 members

Regulatory status

Source: Drugs@FDANDC Directory
Application number
078983
Application type
ANDA · Abbreviated New Drug Application
Approval date
May 30, 2017
Sponsor
APOTEX
Products on application
7
Submissions recorded
3
Products approved under application 078983.
Product Trade name Form Strength Ingredient Status TE Flags
078983-001 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-002 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-003 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-004 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-005 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-006 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB
078983-007 ATOMOXETINE HYDROCHLORIDE CAPSULE ATOMOXETINE HYDROCHLORIDE Prescription AB

Therapeutic equivalence

Source: Orange Book
TE code
AB
Reference Listed Drug
No
Reference Standard
No

What this rating means: Therapeutically equivalent — bioequivalence demonstrated by in vivo or in vitro testing

Codes beginning with “A” indicate products the FDA considers therapeutically equivalent. Codes beginning with “B” indicate bioequivalence has not been established. See methodology.

Approval history

Source: Drugs@FDA
Most recent submissions on application 078983.
Type No. Action Status Date Review
Supplement 5 Labeling Approved January 19, 2023 Standard
Supplement 2 Labeling Approved March 9, 2021 Standard
Original application 1 Approved May 30, 2017 —

Review documents

  • 0 · Original application · June 2, 2017

Prescribing information

Source: openFDA Drug Labeling

Reproduced verbatim from the Structured Product Labeling submitted to the FDA (effective 20260904). This is the manufacturer's labelling text, not a summary and not advice.

HUMAN PRESCRIPTION DRUG · 20260904 HUMAN PRESCRIPTION DRUG · 20260811 HUMAN PRESCRIPTION DRUG · 20260108 HUMAN PRESCRIPTION DRUG · 20251209

Boxed Warning

openFDA Drug Labeling

WARNING: SUICIDAL IDEATION IN CHILDREN AND ADOLESCENTS Atomoxetine increased the risk of suicidal ideation in short-term studies in children or adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Anyone considering the use of atomoxetine in a child or adolescent must balance this risk with the clinical need. Co-morbidities occurring with ADHD may be associated with an increase in the risk of suicidal ideation and/or behavior. Patients who are started on therapy should be monitored closely for suicidality (suicidal thinking and behavior), clinical worsening, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Atomoxetine is approved for ADHD in pediatric and adult patients. Atomoxetine is not approved for major depressive disorder. Pooled analyses of short-term (6 to 18 weeks) placebo-controlled trials of atomoxetine in children and adolescents (a total of 12 trials involving over 2200 patients, including 11 trials in ADHD and 1 trial in enuresis) have revealed a greater risk of suicidal ideation early during treatment in those receiving atomoxetine compared to placebo. The average risk of suicidal ideation in patients receiving atomoxetine was 0.4% (5/1357 patients), compared to none in placebo-treated patients (851 patients). No suicides occurred in these trials [see Warnings and Precautions ( 5.1 )] . WARNING: SUICIDAL IDEATION IN CHILDREN AND ADOLESCENTS See full prescribing information for complete boxed warning. Increased risk of suicidal ideation in children or adolescents (5.1) No suicides occurred in clinical trials (5.1) Patients started on therapy should be monitored closely (5.1)

Recent Major Changes

openFDA Drug Labeling

RECENT MAJOR CHANGES SECTION Dosage and Administration, Screen for Bipolar Disorder Prior to Starting Atomoxetine Capsules ( 2.4 ) 1/2022 Warnings and Precautions, Emergence of New Psychotic or Manic Symptoms ( 5.5 ) 1/2022 Warnings and Precautions, Screening Patients for Bipolar Disorder ( 5.6 ) 1/2022 Warnings and Precautions, Aggressive Behavior or Hostility ( 5.7 ) 1/2022

Indications and Usage

openFDA Drug Labeling

1 INDICATIONS AND USAGE Atomoxetine is a selective norepinephrine reuptake inhibitor indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). ( 1.1 ) 1.1 Attention-Deficit/Hyperactivity Disorder (ADHD) Atomoxetine capsules are indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). The efficacy of atomoxetine capsules was established in seven clinical trials in outpatients with ADHD: four 6 to 9-week trials in pediatric patients (ages 6 to 18), two 10-week trial in adults, and one maintenance trial in pediatrics (ages 6 to 15) [see Clinical Studies ( 14 )] . 1.2 Diagnostic Considerations A diagnosis of ADHD (DSM-IV) implies the presence of hyperactive-impulsive or inattentive symptoms that cause impairment and that were present before age 7 years. The symptoms must be persistent, must be more severe than is typically observed in individuals at a comparable level of development, must cause clinically significant impairment, e.g., in social, academic, or occupational functioning, and must be present in 2 or more settings, e.g., school (or work) and at home. The symptoms must not be better accounted for by another mental disorder. The specific etiology of ADHD is unknown, and there is no single diagnostic test. Adequate diagnosis requires the use not only of medical but also of special psychological, educational, and social resources. Learning may or may not be impaired. The diagnosis must be based upon a complete history and evaluation of the patient and not solely on the presence of the required number of DSM-IV characteristics. For the Inattentive Type, at least 6 of the following symptoms must have persisted for at least 6 months: lack of attention to details/careless mistakes, lack of sustained attention, poor listener, failure to follow through on tasks, poor organization, avoids tasks requiring sustained mental effort, loses things, easily distracted, forgetful. For the Hyperactive-Impulsive Type, at least 6 of the following symptoms must have persisted for at least 6 months: fidgeting/squirming, leaving seat, inappropriate running/climbing, difficulty with quiet activities, “on the go,” excessive talking, blurting answers, can’t wait turn, intrusive. For a Combined Type diagnosis, both inattentive and hyperactive-impulsive criteria must be met. 1.3 Need for Comprehensive Treatment Program Atomoxetine is indicated as an integral part of a total treatment program for ADHD that may include other measures (psychological, educational, social) for patients with this syndrome. Drug treatment may not be indicated for all patients with this syndrome. Drug treatment is not intended for use in the patient who exhibits symptoms secondary to environmental factors and/or other primary psychiatric disorders, including psychosis. Appropriate educational placement is essential in children and adolescents with this diagnosis and psychosocial intervention is often helpful. When remedial measures alone are insufficient, the decision to prescribe drug treatment medication will depend upon the physician’s assessment of the chronicity and severity of the patient’s symptoms.

Dosage and Administration

openFDA Drug Labeling

2 DOSAGE AND ADMINISTRATION Prior to initiating treatment with atomoxetine capsules, screen patients for a personal or family history of bipolar disorder, mania, or hypomania. ( 2.1 , 5.6 ) See table below for the recommended atomoxetine capsule dosage. ( 2.3 ) Age and Body Weight Starting Dosage Target Dosage 1 Maximum Total Daily Dose 1 Pediatrics who weigh less than 70 kg 0.5 mg/kg/day 1.2 mg/kg/day 1.4 mg/kg/day or 100 mg/day (whichever is less) Pediatrics who weigh 70 kg or more and adults 40 mg/day 80 mg/day 100 mg/day 1 Administer either as once daily dosage in the morning or as evenly divided twice daily dosage in the morning and late afternoon/early evening. For the recommended dosage in patients with hepatic impairment, see Full Prescribing Information. ( 2.4 ) For the recommended dosage with concomitant use of a strong CYP2D6 inhibitor or in CYP2D6 poor metabolizers, see Full Prescribing Information. ( 2.5 ) 2.1 Recommendations Prior to Initiating Atomoxetine Capsules Treatment Prior to initiating treatment with atomoxetine capsules, screen patients for a personal or family history of bipolar disorder, mania, or hypomania [see Warnings and Precautions ( 5.6 )]. 2.2 Administration Instructions Atomoxetine capsules may be taken with or without food. Take atomoxetine capsules whole; do not open the capsules. 2.3 Recommended Dosage Table 1 includes the recommended atomoxetine capsules dosage in adult patients and pediatric patients 6 years of age and older for acute treatment of ADHD. Table 1: Recommended Dosage of Atomoxetine Capsules for Acute Treatment of ADHD Age and Body Weight Starting Dosage Titration Interval Target Dosage Maximum Dosage Pediatric patients who weigh less than 70 kg 0.5 mg/kg/day Minimum of 3 days 1.2 mg/kg/day a,b 1.4 mg/kg/day or 100 mg/day, whichever is less a Pediatric patients who weigh 70 kg or more and adult patients 40 mg/day Minimum of 3 days 80 mg/day a 100 mg/day a,c a Administer either as once daily dosage in the morning or as evenly divided twice daily dosage in the morning and late afternoon/early evening. b No additional benefit has been demonstrated with atomoxetine capsules dosages higher than 1.2 mg/kg/day [see Clinical Studies ( 14 )]. c If a patient has not achieved an optimal response at 80 mg/day after 2 to 4 additional weeks, may increase the dosage to a maximum of 100 mg/day. There is no data that supports increased effectiveness at a dosage higher than 100 mg/day [see Clinical Studies ( 14 )]. The health care provider who elects to use atomoxetine capsules for extended periods should periodically reevaluate the long-term usefulness of atomoxetine capsules for the individual patient. 2.4 Recommended Dosage in Patients with Hepatic Impairment For patients aged 6 years of age or older with: Severe hepatic impairment (HI) (Child-Pugh Class C), the recommended initial and target atomoxetine capsules dosage is 25% of recommended dosage in patients with normal hepatic function [see Use in Specific Populations ( 8.6 ) and Clinical Pharmacology ( 12.3 )]. Moderate HI (Child-Pugh Class B), the recommended initial and target atomoxetine capsules dosage is 50% of the recommended dosage in patients with normal hepatic function [see Use in Specific Populations ( 8.6 ) and Clinical Pharmacology ( 12.3 )]. Mild HI (Child-Pugh Class A), the recommended initial and target atomoxetine capsules dosage is the same as those with normal hepatic function. 2.5 Recommended Dosage with Concomitant Use of Strong CYP2D6 Inhibitors or in CYP2D6 Poor Metabolizers Consider genetic testing to determine the patient’s CYP2D6 metabolizer status. In patients taking a concomitant strong CYP2D6 inhibitor or who are CYP2D6 poor metabolizers, a longer titration interval of 4 weeks is recommended, if ADHD symptoms fail to improve and the initial atomoxetine capsules dosage is well tolerated. The recommended starting, target, and maximum atomoxetine capsules dosages are the same as outlined in Table 1 [see Dosage …

Dosage Forms and Strengths

openFDA Drug Labeling

3 DOSAGE FORMS AND STRENGTHS Each capsule contains atomoxetine hydrochloride, USP equivalent to: 10 mg of atomoxetine (Opaque White, Opaque White) 18 mg of atomoxetine (Opaque Gold, Opaque White) 25 mg of atomoxetine (Opaque Blue, Opaque White) 40 mg of atomoxetine (Opaque Blue, Opaque Blue) 60 mg of atomoxetine (Opaque Blue, Opaque Gold) 80 mg of atomoxetine (Opaque Orange, Opaque White) 100 mg of atomoxetine (Opaque Orange, Opaque Orange) Capsules: contain 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg, or 100 mg of atomoxetine. ( 3 , 11 , 16 )

Contraindications

openFDA Drug Labeling

4 CONTRAINDICATIONS Hypersensitivity to atomoxetine or other constituents of product. ( 4.1 ) Atomoxetine use within 2 weeks after discontinuing MAOI or other drugs that affect brain monoamine concentrations. ( 4.2 , 7.1 ) Narrow Angle Glaucoma. ( 4.3 ) Pheochromocytoma or history of pheochromocytoma. ( 4.4 ) Severe Cardiovascular Disorders that might deteriorate with clinically important increases in HR and BP. ( 4.5 ) 4.1 Hypersensitivity Atomoxetine capsules are contraindicated in patients known to be hypersensitive to atomoxetine or other constituents of the product [see Warnings and Precautions ( 5.8 )] . 4.2 Monoamine Oxidase Inhibitors (MAOI) Atomoxetine should not be taken with an MAOI, or within 2 weeks after discontinuing an MAOI. Treatment with an MAOI should not be initiated within 2 weeks after discontinuing atomoxetine. With other drugs that affect brain monoamine concentrations, there have been reports of serious, sometimes fatal reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma) when taken in combination with an MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Such reactions may occur when these drugs are given concurrently or in close proximity [see Drug Interactions ( 7.1 )] . 4.3 Narrow Angle Glaucoma In clinical trials, atomoxetine use was associated with an increased risk of mydriasis and therefore its use is not recommended in patients with narrow angle glaucoma. 4.4 Pheochromocytoma Serious reactions, including elevated blood pressure and tachyarrhythmia, have been reported in patients with pheochromocytoma or a history of pheochromocytoma who received atomoxetine. Therefore, atomoxetine should not be taken by patients with pheochromocytoma or a history of pheochromocytoma. 4.5 Severe Cardiovascular Disorders Atomoxetine should not be used in patients with severe cardiac or vascular disorders whose condition would be expected to deteriorate if they experience increases in blood pressure or heart rate that could be clinically important (for example, 15 to 20 mm Hg in blood pressure or 20 beats per minute in heart rate). [See Warnings and Precautions ( 5.4 )] .

Warnings and Cautions

openFDA Drug Labeling

5 WARNINGS AND PRECAUTIONS Suicidal Ideation - Monitor for suicidality, clinical worsening, and unusual changes in behavior. (5.1) Severe Liver Injury- Should be discontinued and not restarted in patients with jaundice or laboratory evidence of liver injury. (5.2) Serious Cardiovascular Events - Sudden death, stroke and myocardial infarction have been reported in association with atomoxetine treatment. Patients should have a careful history and physical exam to assess for presence of cardiovascular disease. Atomoxetine generally should not be used in children or adolescents with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, or other serious cardiac problems that may place them at increased vulnerability to its noradrenergic effects. Consideration should be given to not using atomoxetine in adults with clinically significant cardiac abnormalities. ( 5.3 ) Emergent Cardiovascular Symptoms - Patients should undergo prompt cardiac evaluation. (5.3) Effects on Blood Pressure and Heart Rate - Increase in blood pressure and heart rate; orthostasis and syncope may occur. Use with caution in patients with hypertension, tachycardia, or cardiovascular or cerebrovascular disease. (5.4) Emergent Psychotic or Manic Symptoms - Consider discontinuing treatment if such new symptoms occur. (5.5) Bipolar Disorder - Screen patients to avoid possible induction of a mixed/manic episode. (5.6) Aggressive behavior or hostility should be monitored. (5.7) Possible allergic reactions, including anaphylactic reactions, angioneurotic edema, urticaria, and rash. (5.8) Effects on Urine Outflow - Urinary hesitancy and retention may occur. (5.9) Priapism - Prompt medical attention is required in the event of suspected priapism. (5.10, 17.5) Growth - Height and weight should be monitored in pediatric patients. (5.11) Concomitant Use of Potent CYP2D6 Inhibitors or Use in patients known to be CYP2D6 PMs - Dose adjustment of Atomoxetine Hydrochloride Capsules may be necessary. ( 5.13 ) 5.1 Suicidal Ideation Atomoxetine increased the risk of suicidal ideation in short-term studies in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Pooled analyses of short-term (6 to 18 weeks) placebo-controlled trials of atomoxetine in children and adolescents have revealed a greater risk of suicidal ideation early during treatment in those receiving atomoxetine. There were a total of 12 trials (11 in ADHD and 1 in enuresis) involving over 2200 patients (including 1357 patients receiving atomoxetine and 851 receiving placebo). The average risk of suicidal ideation in patients receiving atomoxetine was 0.4% (5/1357 patients), compared to none in placebo-treated patients. There was 1 suicide attempt among these approximately 2200 patients, occurring in a patient treated with atomoxetine. No suicides occurred in these trials. All reactions occurred in children 12 years of age or younger. All reactions occurred during the first month of treatment. It is unknown whether the risk of suicidal ideation in pediatric patients extends to longer-term use. A similar analysis in adult patients treated with atomoxetine for either ADHD or major depressive disorder (MDD) did not reveal an increased risk of suicidal ideation or behavior in association with the use of atomoxetine. All pediatric patients being treated with atomoxetine should be monitored appropriately and observed closely for clinical worsening, suicidality, and unusual changes in behavior, especially during the initial few months of a course of drug therapy, or at times of dose changes, either increases or decreases. The following symptoms have been reported with atomoxetine: anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania and mania. Although a causal link between the emergence of such symptoms and the emergence of suicidal impulses has not been establ …

Adverse Reactions

openFDA Drug Labeling

6 ADVERSE REACTIONS Most common adverse reactions (≥5% and at least twice the incidence of placebo patients) Child and Adolescent Clinical Trials - Nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence. (6.1) Adult Clinical Trials - Constipation, dry mouth, nausea, decreased appetite, dizziness, erectile dysfunction, and urinary hesitation. (6.1) To report SUSPECTED ADVERSE REACTIONS, contact AvKARE at 855-361-3993 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trials Experience Atomoxetine was administered to 5382 children or adolescent patients with ADHD and 1007 adults with ADHD in clinical studies. During the ADHD clinical trials, 1625 children and adolescent patients were treated for longer than 1 year and 2529 children and adolescent patients were treated for over 6 months. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Child and Adolescent Clinical Trials Reasons for discontinuation of treatment due to adverse reactions in child and adolescent clinical trials — In acute child and adolescent placebo-controlled trials, 3.0% (48/1613) of atomoxetine subjects and 1.4% (13/945) placebo subjects discontinued for adverse reactions. For all studies, (including open-label and long-term studies), 6.3% of extensive metabolizer (EM) patients and 11.2% of poor metabolizer (PM) patients discontinued because of an adverse reaction. Among atomoxetine-treated patients, irritability (0.3%, N=5); somnolence (0.3%, N=5); aggression (0.2%, N=4); nausea (0.2%, N=4); vomiting (0.2%, N=4); abdominal pain (0.2%, N=4); constipation (0.1%, N=2); fatigue (0.1%, N=2); feeling abnormal (0.1%, N=2); and headache (0.1%, N=2) were the reasons for discontinuation reported by more than 1 patient. Seizures — Atomoxetine has not been systematically evaluated in pediatric patients with seizure disorder as these patients were excluded from clinical studies during the product’s premarket testing. In the clinical development program, seizures were reported in 0.2% (12/5073) of children whose average age was 10 years (range 6 to 16 years). In these clinical trials, the seizure risk among poor metabolizers was 0.3% (1/293) compared to 0.2% (11/4741) for extensive metabolizers. Commonly observed adverse reactions in acute child and adolescent, placebo-controlled trials — Commonly observed adverse reactions associated with the use of atomoxetine (incidence of 2% or greater) and not observed at an equivalent incidence among placebo-treated patients (atomoxetine incidence greater than placebo) are listed in Table 2. Results were similar in the BID and the QD trial except as shown in Table 3, which shows both BID and QD results for selected adverse reactions based on statistically significant Breslow-Day tests. The most commonly observed adverse reactions in patients treated with atomoxetine (incidence of 5% or greater and at least twice the incidence in placebo patients, for either BID or QD dosing) were: nausea, vomiting, fatigue, decreased appetite, abdominal pain, and somnolence ( see Tables 2 and 3). Additional data from ADHD clinical trials (controlled and uncontrolled) has shown that approximately 5 to 10% of pediatric patients experienced potentially clinically important changes in heart rate (≥20 beats per min) or blood pressure (≥15 to 20 mm Hg) [see Contraindications ( 4 ) and Warnings and Precautions ( 5 )] . Table 2: Common Treatment-Emergent Adverse Reactions Associated with the Use of Atomoxetine in Acute (up to 18 weeks) Child and Adolescent Trials Adverse Reaction a Percentage of Patients Reporting Reaction Atomoxetine (N=1597) Placebo (N=934) Gastrointestinal Disorders Abdominal pain b 18 10 Vomiting 11 6 Nausea 10 5 General Disorders and Administration Site Conditions Fatigue 8 3 Irritability 6 3 …

Drug Interactions

openFDA Drug Labeling

7 DRUG INTERACTIONS Monoamine Oxidase Inhibitors. (4.2, 7.1) CYP2D6 Inhibitors – Concomitant use may increase atomoxetine steady–state plasma concentrations in EMs. (7.2) Antihypertensive Drugs and Pressor Agents – Possible effects on blood pressure. (7.3) Albuterol (or other beta 2 agonists) – Action of albuterol on cardiovascular system can be potentiated. (7.4) 7.1 Monoamine Oxidase Inhibitors With other drugs that affect brain monoamine concentrations, there have been reports of serious, sometimes fatal reactions (including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma) when taken in combination with an MAOI. Some cases presented with features resembling neuroleptic malignant syndrome. Such reactions may occur when these drugs are given concurrently or in close proximity [see Contraindications ( 4.2 )] . 7.2 Effect of CYP2D6 Inhibitors on Atomoxetine In extensive metabolizers (EMs), inhibitors of CYP2D6 (e.g., paroxetine, fluoxetine, and quinidine) increase atomoxetine steady-state plasma concentrations to exposures similar to those observed in poor metabolizers (PMs). In EM individuals treated with paroxetine or fluoxetine, the AUC of atomoxetine is approximately 6- to 8-fold and C ss, max is about 3- to 4-fold greater than atomoxetine alone. In vitro studies suggest that coadministration of cytochrome P450 inhibitors to PMs will not increase the plasma concentrations of atomoxetine. 7.3 Antihypertensive Drugs and Pressor Agents Because of possible effects on blood pressure, atomoxetine should be used cautiously with antihypertensive drugs and pressor agents (e.g., dopamine, dobutamine) or other drugs that increase blood pressure. 7.4 Albuterol Atomoxetine should be administered with caution to patients being treated with systemically-administered (oral or intravenous) albuterol (or other beta 2 agonists) because the action of albuterol on the cardiovascular system can be potentiated resulting in increases in heart rate and blood pressure. Albuterol (600 mcg iv over 2 hours) induced increases in heart rate and blood pressure. These effects were potentiated by atomoxetine (60 mg BID for 5 days) and were most marked after the initial coadministration of albuterol and atomoxetine. However, these effects on heart rate and blood pressure were not seen in another study after the coadministration with inhaled dose of albuterol (200 to 800 mcg) and atomoxetine (80 mg QD for 5 days) in 21 healthy Asian subjects who were excluded for poor metabolizer status. 7.5 Effect of Atomoxetine on P450 Enzymes Atomoxetine did not cause clinically important inhibition or induction of cytochrome P450 enzymes, including CYP1A2, CYP3A, CYP2D6, and CYP2C9. CYP3A Substrate (e.g., Midazolam) — Coadministration of atomoxetine (60 mg BID for 12 days) with midazolam, a model compound for CYP3A4 metabolized drugs (single dose of 5 mg), resulted in 15% increase in AUC of midazolam. No dose adjustment is recommended for drugs metabolized by CYP3A. CYP2D6 Substrate (e.g., Desipramine) — Coadministration of atomoxetine (40 or 60 mg BID for 13 days) with desipramine, a model compound for CYP2D6 metabolized drugs (single dose of 50 mg), did not alter the pharmacokinetics of desipramine. No dose adjustment is recommended for drugs metabolized by CYP2D6. 7.6 Alcohol Consumption of ethanol with atomoxetine did not change the intoxicating effects of ethanol. 7.7 Methylphenidate Coadministration of methylphenidate with atomoxetine did not increase cardiovascular effects beyond those seen with methylphenidate alone. 7.8 Drugs Highly Bound to Plasma Protein In vitro drug-displacement studies were conducted with atomoxetine and other highly-bound drugs at therapeutic concentrations. Atomoxetine did not affect the binding of warfarin, acetylsalicylic acid, phenytoin, or diazepam to human albumin. Similarly, these compoun …

Use in Specific Populations

openFDA Drug Labeling

8 USE IN SPECIFIC POPULATIONS Hepatic Insufficiency - Increased exposure (AUC) to atomoxetine than with normal subjects in EM subjects with moderate (Child-Pugh Class B) (2-fold increase) and severe (Child-Pugh Class C) (4-fold increase). ( 8.6 ) Renal Insufficiency - Higher systemic exposure to atomoxetine than healthy subjects for EM subjects with end stage renal disease - no difference when exposure corrected for mg/kg dose. ( 8.7 ) Patients with Concomitant Illness – Does not worsen tics in patients with ADHD and comorbid Tourette’s Disorder. ( 8.10 ) Patients with Concomitant Illness – Does not worsen anxiety in patients with ADHD and comorbid Anxiety Disorders. ( 8.10 ) 8.1 Pregnancy Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including atomoxetine, during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for ADHD Medications at 1-866-961-2388 or visiting https://womensmentalhealth.org/adhd-medications/. Risk Summary Available published studies with atomoxetine use in pregnant women are insufficient to establish a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. Some animal reproduction studies of atomoxetine had adverse developmental outcomes. One of 3 studies in pregnant rabbits dosed during organogenesis resulted in decreased live fetuses and an increase in early resorptions, as well as slight increases in the incidences of atypical origin of carotid artery and absent subclavian artery. These effects were observed at plasma levels (AUC) 3 times and 0.4 times the human plasma levels in extensive and poor metabolizers receiving the maximum recommended human dose (MRHD), respectively. In rats dosed prior to mating and during organogenesis a decrease in fetal weight (female only) and an increase in the incidence of incomplete ossification of the vertebral arch in fetuses were observed at a dose approximately 5 times the MRHD on a mg/m 2 basis. In one of 2 studies in which rats were dosed prior to mating through the periods of organogenesis and lactation, decreased pup weight and decreased pup survival were observed at doses corresponding to 5-6 times the MRHD on a mg/m 2 basis. No adverse fetal effects were seen in pregnant rats dosed during the organogenesis period (see Data). The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-­20%, respectively. Data Animal Data Pregnant rabbits were treated with up to 100 mg/kg/day of atomoxetine by gavage throughout the period of organogenesis. At this dose, in 1 of 3 studies, a decrease in live fetuses and an increase in early resorptions was observed. Slight increases in the incidences of atypical origin of carotid artery and absent subclavian artery were observed. These findings were observed at doses that caused slight maternal toxicity. The no-effect dose for these findings was 30 mg/kg/day. The 100 mg/kg dose is approximately 23 times the MRHD on a mg/m 2 basis; plasma levels (AUC) of atomoxetine at this dose in rabbits are estimated to be 3.3 times (extensive metabolizers) or 0.4 times (poor metabolizers) those in humans receiving the MRHD. Rats were treated with up to approximately 50 mg/kg/day of atomoxetine (approximately 6 times the MRHD on a mg/m 2 basis) in the diet from 2 weeks (females) or 10 weeks (males) prior to mating through the periods of organogenesis and lactation. In 1 of 2 studies, decreases in pup weight and pup survival were observed. The decreased pup survival was also seen at 25 mg/kg (but not at 13 mg/kg). In a study in which rats were treated with atomoxetine i …

Mechanism of Action

openFDA Drug Labeling

12.1 Mechanism of Action The precise mechanism by which atomoxetine produces its therapeutic effects in Attention–Deficit/Hyperactivity Disorder (ADHD) is unknown, but is thought to be related to selective inhibition of the pre–synaptic norepinephrine transporter, as determined in ex vivo uptake and neurotransmitter depletion studies.

Description

openFDA Drug Labeling

11 DESCRIPTION Atomoxetine is a selective norepinephrine reuptake inhibitor. Atomoxetine hydrochloride, USP is the R (-) isomer as determined by x-ray diffraction. The chemical designation is (-)- N -Methyl-3-phenyl-3-( o -tolyloxy)- propylamine hydrochloride. The molecular formula is C 17 H 21 NO•HCl, which corresponds to a molecular weight of 291.82. The chemical structure is: Atomoxetine hydrochloride, USP is a white to practically white solid, which has a solubility of 27.8 mg/mL in water. Atomoxetine capsules, USP are intended for oral administration only. Each capsule contains atomoxetine hydrochloride, USP equivalent to 10, 18, 25, 40, 60, 80, or 100 mg of atomoxetine. The capsules also contain pregelatinized starch. The capsule shells contain gelatin and titanium dioxide. The capsule shells may also contain one or more of the following: FD&C Blue No. 2 (25 mg, 40 mg, and 60 mg), iron oxide red (80 mg and 100 mg), and iron oxide yellow (18 mg, 25 mg, 40 mg, 60 mg, 80 mg and 100 mg). The capsules are imprinted with edible black ink (comprised of ammonia solution, iron oxide black, potassium hydroxide, propylene glycol, and shellac.). atomstructure

10 OVERDOSAGE During postmarketing use, there have been fatalities reported involving a mixed ingestion overdose of atomoxetine and at least one other drug. There have been no reports of death involving overdose of atomoxetine alone, including intentional overdoses at amounts up to 1,400 mg (14 times the maximum recommended dosage). The most commonly reported symptoms with acute and chronic overdoses of atomoxetine were gastrointestinal symptoms, somnolence, dizziness, tremor, and abnormal behavior. 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) have also been observed. Most events were mild to moderate. In some cases of overdose involving atomoxetine, seizures have been reported. Less commonly, there have been reports of QT prolongation and mental changes, including disorientation and hallucinations [see Clinical Pharmacology ( 12.2 )]. If an overdose occurs, consider contacting the Poison Help line (1-800-222-1222) or a medical toxicologist for additional overdose management recommendations. Because atomoxetine is highly protein-bound, dialysis is not likely to be useful in the treatment of atomoxetine overdose.

How Supplied / Storage and Handling

openFDA Drug Labeling

16 HOW SUPPLIED/STORAGE AND HANDLING 16.1 How Supplied Atomoxetine capsules, USP 10 mg are available for oral administration as hard gelatin capsules with a white opaque body and a white opaque cap, imprinted “APO AM10” in black ink. They are supplied as follows: NDC Number Size 51407-100-30 Bottles of 30 Atomoxetine capsules, USP 18 mg are available for oral administration as hard gelatin capsules with a white opaque body and a gold opaque cap, imprinted “APO AM18” in black ink. They are supplied as follows: NDC Number Size 51407-101-30 Bottles of 30 Atomoxetine capsules, USP 25 mg are available for oral administration as hard gelatin capsules with a white opaque body and a blue opaque cap, imprinted “APO AM25” in black ink. They are supplied as follows: NDC Number Size 51407-102-30 Bottles of 30 Atomoxetine capsules, USP 40 mg are available for oral administration as hard gelatin capsules with a blue opaque body and a blue opaque cap, imprinted “APO AM40” in black ink. They are supplied as follows: NDC Number Size 51407-103-30 Bottles of 30 Atomoxetine capsules, USP 60 mg are available for oral administration as hard gelatin capsules with a gold opaque body and a blue opaque cap, imprinted “APO AM60” in black ink. They are supplied as follows: NDC Number Size 51407-104-30 Bottles of 30 Atomoxetine capsules, USP 80 mg are available for oral administration as hard gelatin capsules with a white opaque body and an orange opaque cap, imprinted “APO AM80” in black ink. They are supplied as follows: NDC Number Size 51407-105-30 Bottles of 30 Atomoxetine capsules, USP 100 mg are available for oral administration as hard gelatin capsules with an orange opaque body and an orange opaque cap, imprinted “APO AM100” in black ink. They are supplied as follows: NDC Number Size 51407-106-30 Bottles of 30 16.2 Storage and Handling Store atomoxetine capsules, USP at 20°C to 25°C (68°F to 77°F) excursions permitted from 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature].

Adverse event reports

Source: openFDA FAERS
23,661
FAERS reports mentioning this drug
as of 2026-09-25T03:42:24+00:00
A report count is not a risk measure. FAERS accepts voluntary and mandatory reports without establishing causation, and reporting is influenced by how widely a drug is used, how long it has been marketed, and media attention. FDA states that reports “do not prove that the drug caused the event”. Compare rates, not totals.

Attributed to this product's most-reported active ingredient: ATOMOXETINE HYDROCHLORIDE. Combination products with more than six active ingredients are not attributed, because a report count summed across a long ingredient list measures the list, not the medicine.

Packaging and NDCs

Source: NDC Directory
Every National Drug Code package associated with this medication. The NDC is the identifier used for dispensing, billing and pharmacovigilance in the United States.
Package NDC Product NDC Labeler Description Marketing start
50090-4236-0 50090-4236 A-S Medication Solutions 30 CAPSULE in 1 BOTTLE (50090-4236-0) March 29, 2019
60505-2830-3 60505-2830 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2830-3) May 21, 2018
60505-2831-3 60505-2831 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2831-3) May 21, 2018
60505-2832-3 60505-2832 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2832-3) May 21, 2018
60505-2833-3 60505-2833 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2833-3) May 21, 2018
60505-2834-3 60505-2834 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2834-3) May 21, 2018
60505-2835-3 60505-2835 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2835-3) May 21, 2018
60505-2836-3 60505-2836 Apotex Corp. 30 CAPSULE in 1 BOTTLE (60505-2836-3) May 21, 2018
50268-057-13 50268-057 AvPAK 30 BLISTER PACK in 1 BOX (50268-057-13) / 1 CAPSULE in 1 BLISTER PACK (50268-057-11) February 13, 2020
50268-058-13 50268-058 AvPAK 30 BLISTER PACK in 1 BOX (50268-058-13) / 1 CAPSULE in 1 BLISTER PACK (50268-058-11) February 13, 2020
50268-059-13 50268-059 AvPAK 30 BLISTER PACK in 1 BOX (50268-059-13) / 1 CAPSULE in 1 BLISTER PACK (50268-059-11) July 7, 2020
51407-100-30 51407-100 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-100-30) June 7, 2018
51407-101-30 51407-101 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-101-30) June 7, 2018
51407-102-30 51407-102 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-102-30) June 7, 2018
51407-103-30 51407-103 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-103-30) June 7, 2018
51407-104-30 51407-104 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-104-30) June 7, 2018
51407-105-30 51407-105 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-105-30) June 7, 2018
51407-106-30 51407-106 Golden State Medical Supply, Inc. 30 CAPSULE in 1 BOTTLE (51407-106-30) June 7, 2018
0110-3227-10 0110-3227 Lilly del Caribe, Inc. 140000 CAPSULE in 1 DRUM (0110-3227-10) November 26, 2002
0110-3228-10 0110-3228 Lilly del Caribe, Inc. 140000 CAPSULE in 1 DRUM (0110-3228-10) November 26, 2002
0110-3229-10 0110-3229 Lilly del Caribe, Inc. 140000 CAPSULE in 1 DRUM (0110-3229-10) November 26, 2002
0110-3238-10 0110-3238 Lilly del Caribe, Inc. 140000 CAPSULE in 1 DRUM (0110-3238-10) November 26, 2002
0110-3239-10 0110-3239 Lilly del Caribe, Inc. 105000 CAPSULE in 1 DRUM (0110-3239-10) November 26, 2002
0110-3250-10 0110-3250 Lilly del Caribe, Inc. 175000 CAPSULE in 1 DRUM (0110-3250-10) February 14, 2005
0110-3251-10 0110-3251 Lilly del Caribe, Inc. 150000 CAPSULE in 1 DRUM (0110-3251-10) February 14, 2005
70518-4313-0 70518-4313 REMEDYREPACK INC. 30 POUCH in 1 BOX (70518-4313-0) / 1 CAPSULE in 1 POUCH (70518-4313-1) March 19, 2025
50090-4236 50090-4236 A-S Medication Solutions — May 21, 2018
60505-2830 60505-2830 Apotex Corp. — May 21, 2018
60505-2831 60505-2831 Apotex Corp. — May 21, 2018
60505-2832 60505-2832 Apotex Corp. — May 21, 2018
60505-2833 60505-2833 Apotex Corp. — May 21, 2018
60505-2834 60505-2834 Apotex Corp. — May 21, 2018
60505-2835 60505-2835 Apotex Corp. — May 21, 2018
60505-2836 60505-2836 Apotex Corp. — May 21, 2018
50268-057 50268-057 AvPAK — February 13, 2020
50268-058 50268-058 AvPAK — February 13, 2020
50268-059 50268-059 AvPAK — July 7, 2020
51407-100 51407-100 Golden State Medical Supply, Inc. — May 30, 2017
51407-101 51407-101 Golden State Medical Supply, Inc. — May 30, 2017
51407-102 51407-102 Golden State Medical Supply, Inc. — May 30, 2017
51407-103 51407-103 Golden State Medical Supply, Inc. — May 30, 2017
51407-104 51407-104 Golden State Medical Supply, Inc. — May 30, 2017
51407-105 51407-105 Golden State Medical Supply, Inc. — May 30, 2017
51407-106 51407-106 Golden State Medical Supply, Inc. — May 30, 2017
0110-3227 0110-3227 Lilly del Caribe, Inc. — November 26, 2002
0110-3228 0110-3228 Lilly del Caribe, Inc. — November 26, 2002
0110-3229 0110-3229 Lilly del Caribe, Inc. — November 26, 2002
0110-3238 0110-3238 Lilly del Caribe, Inc. — November 26, 2002
0110-3239 0110-3239 Lilly del Caribe, Inc. — November 26, 2002
0110-3250 0110-3250 Lilly del Caribe, Inc. — February 14, 2005
0110-3251 0110-3251 Lilly del Caribe, Inc. — February 14, 2005
70518-4313 70518-4313 REMEDYREPACK INC. — March 19, 2025

Sources for this page

Every dataset that contributed a fact to this page.
Dataset Agency Used for
NDC Directory FDA Identity, ingredients, strengths, forms, routes, labelers, packages
Drugs@FDA FDA Application, sponsor, submissions, review documents, marketing status
Orange Book FDA Therapeutic equivalence codes, reference drug flags, patents, exclusivity
Drug Labeling FDA / NLM Prescribing information reproduced above
FAERS FDA Adverse event report counts

Generated September 25, 2026 · 11 sections on this page.