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Atomoxetine (Strattera) is a medication used for treating attention-deficit hyperactivity disorder (ADHD). While it can be effective, it is important to be aware of potential risks and safety precautions associated with its use. Please consider the following information and consult with your healthcare provider for any concerns:

• Suicidal Thoughts and Behavior Changes: Atomoxetine may increase the risk of suicidal thoughts or behaviors, especially in children and teenagers. This risk is higher during the initial treatment months and when dosages are adjusted. Watch for mood changes, unusual behaviors, or thoughts of self-harm, and contact your doctor immediately if these occur.

• Liver Damage: Though rare, atomoxetine can cause serious liver problems, potentially leading to liver failure. Symptoms to watch for include abdominal swelling, yellowing of the skin or eyes, dark urine, and severe stomach pain. Seek medical attention promptly if these symptoms appear, as you may need to stop the medication.

• Cardiovascular Concerns: Atomoxetine can increase blood pressure and heart rate, and there is a risk of severe heart issues like stroke or heart attack, especially in individuals with pre-existing heart conditions. Ensure your provider is aware of any heart history before beginning treatment and report symptoms like chest pain, fainting, or irregular heartbeat.

• Bipolar Disorder and Mood Swings: Individuals with bipolar disorder may experience manic or mixed episodes when taking atomoxetine. If you have a personal or family history of bipolar disorder or other mental health conditions, discuss this with your provider and monitor for unusual mood changes.

• Behavioral Changes: Some users may experience new or worsening mental health symptoms, including hallucinations, aggression, or unclear thinking. Immediate consultation with your healthcare provider is necessary if these occur.

• Prolonged Erection: A rare side effect is a prolonged, painful erection lasting more than four hours. If this arises, discontinue use and seek medical help immediately to prevent permanent damage.

• Slowed Growth in Children: Children taking atomoxetine may experience slowed growth in height and weight during the first year of treatment. Regular monitoring by a healthcare provider is recommended, and treatment may be paused if significant growth delays are detected.

Contraindications: Do not use atomoxetine if you are currently taking or have recently taken monoamine oxidase inhibitors (MAOIs), have narrow-angle glaucoma, pheochromocytoma, or certain severe heart or blood vessel problems. Consult your healthcare provider if any of these conditions apply to you.

Ensure you discuss all potential risks and benefits with your healthcare provider before starting atomoxetine, and report any adverse effects promptly.

Common side effects:

• Nausea
• Dry mouth
• Decreased appetite
• Trouble sleeping
• Fatigue
• Constipation
• Dizziness
• Drowsiness
• Decrease in sexual ability or desire in men
• Menstrual changes in women

Less common but important to monitor:

• Headaches
• Stomach pain
• Vomiting
• Erectile dysfunction
• Issues with urination

Serious side effects:

• Symptoms of liver damage
• Heart attack
• Stroke
• Prolonged, painful erection
• Allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• Isocarboxazid
• Linezolid
• Methylene Blue
• Phenelzine
• Procarbazine
• Rasagiline
• Safinamide
• Selegiline
• Tranylcypromine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Albuterol
• Bupropion
• Darunavir
• Donepezil
• Givosiran
• Panobinostat
• Paroxetine

Interactions with low risk that usually do not require a change in therapy:

• Amitriptyline
• Amoxapine
• Clomipramine
• Desipramine
• Dibenzepin
• Dothiepin
• Imipramine
• Lofepramine
• Nortriptyline
• Opipramol
• Protriptyline
• Trimipramine