Generic Strattera

Introduction

Strattera (atomoxetine) is a prescription medication approved for the treatment of attention‑deficit hyperactivity disorder (ADHD) in children, adolescents, and adults. In the United Kingdom it is classed under the Mental Health Medicines (MH) schedule and supplied by specialist psychiatric prescribers. Although originally developed for ADHD, the drug is also used off‑label for certain anxiety‑related conditions where clinicians seek a non‑stimulant option. The active compound, atomoxetine, belongs to the selective norepinephrine reuptake inhibitor (NRI) group, distinguishing it from stimulant treatments such as methylphenidate.

What is Strattera?

Strattera is the market name for the molecule atomoxetine, a selective norepinephrine reuptake inhibitor. The drug was first approved by the US Food and Drug Administration in 2002 and subsequently by the European Medicines Agency (EMA) for ADHD treatment. In the UK it is marketed by AstraZeneca (formerly by Eli Lilly) under the trade name Strattera. The formulation is supplied as hard, film‑coated tablets in strengths of 10 mg, 18 mg, 25 mg, 40 mg, and 80 mg. The tablets contain atomoxetine as the sole active ingredient; excipients include lactose, microcrystalline cellulose, magnesium stearate, and a small amount of titanium dioxide for colour.

How Strattera Works

Atomoxetine blocks the presynaptic norepinephrine transporter (NET), increasing extracellular norepinephrine (noradrenaline) in the prefrontal cortex. Elevated norepinephrine improves signal‑to‑noise ratio in neuronal circuits that underlie attention, impulse control and executive function. Unlike stimulant agents, atomoxetine does not significantly increase dopamine in the striatum, which reduces the risk of misuse and dependence.

Pharmacokinetically, atomoxetine is absorbed orally with a bioavailability of about 63 % under fasting conditions; food reduces the peak concentration but does not affect overall exposure. Peak plasma concentrations are reached 1–2 hours after dosing. The drug is metabolised primarily by the cytochrome P450 2D6 (CYP2D6) pathway, producing several inactive metabolites that are eliminated renally. The elimination half‑life varies with metabolic phenotype: approximately 5 hours in extensive metabolizers and up to 21 hours in poor metabolizers. This variability underpins the need for dose adjustments based on genotype or observed tolerability.

Conditions Treated with Strattera

• Attention‑Deficit Hyperactivity Disorder (ADHD) – adult and paediatric
  ADHD prevalence in the UK is estimated at 3–5 % of school‑aged children and around 2.5 % of adults. Strattera provides a non‑stimulant therapeutic option, particularly for patients with a history of substance misuse, cardiovascular concerns, or intolerable side effects from stimulants.

• ADHD – comorbid anxiety
  Clinical guidelines (NICE CG188) acknowledge atomoxetine as an alternative when anxiety limits the use of stimulants. The norepinephrine‑centric mechanism can attenuate anxiety symptoms while improving attention.

• Off‑label: Chronic tic disorders & mood‑related dysregulation
  Small open‑label series have reported modest benefit in patients with Tourette syndrome or emotional lability, though these uses remain investigational and are not formally licensed.

Who is Strattera For?

Strattera is most appropriate for individuals who meet diagnostic criteria for ADHD and for whom a stimulant is unsuitable or ineffective. Typical candidates include:

• Adults (≥ 18 years) with persistent inattentiveness, hyperactivity or impulsivity that impairs occupational, academic or social functioning.
• Adolescents (≥ 12 years) who have contraindications to stimulants, such as cardiac arrhythmias, uncontrolled hypertension, or a personal/family history of substance use disorder.
• Patients preferring a once‑daily, non‑controlled substance regimen.

Contra‑indications encompass known hypersensitivity to atomoxetine, coadministration with monoamine oxidase inhibitors (MAOIs), and severe hepatic impairment. Caution is advised in patients with pre‑existing narrow‑angle glaucoma, severe renal impairment, or those who are CYP2D6 poor metabolizers, as exposure may be substantially higher.

Risks, Side Effects, and Interactions

Common

• Gastrointestinal: nausea, dry mouth, constipation, dyspepsia.
• Central nervous system: headache, insomnia, dizziness, somnolence.
• Psychiatric: increased irritability, mood swings, occasional mild anxiety.

Rare

• Cardiovascular: transient increases in systolic or diastolic blood pressure, tachycardia.
• Hepatic: asymptomatic elevations in liver enzymes (ALT, AST).
• Sexual dysfunction: decreased libido or erectile difficulty.

Serious

• Suicidal ideation: elevated risk in children, adolescents, and young adults, particularly during early treatment or dose changes. Immediate clinical review is mandatory if emergent thoughts occur.
• Severe hepatic injury: rare cases of drug‑induced hepatitis with jaundice have been documented; discontinue if liver function tests rise > 3 ×  Upper Limit of Normal (ULN).
• Hypertensive crisis: rare, but possible in patients with uncontrolled hypertension; monitor blood pressure regularly, especially after dose escalation.

Drug‑Drug Interactions

• CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine): may increase atomoxetine plasma concentrations up to 5‑fold, raising the risk of adverse events. Dose reduction or alternative therapy is recommended.
• CYP2D6 inducers (e.g., rifampicin, carbamazepine): can reduce exposure, potentially diminishing efficacy.
• Monoamine oxidase inhibitors: concurrent use is contraindicated because of heightened risk of hypertensive reactions.
• Sympathomimetic agents (e.g., decongestants, pseudoephedrine): may amplify cardiovascular effects; monitor vitals.

Practical Use: Dosing, Missed Dose, Overdose

Standard dosing for adults generally starts at 40 mg once daily, with a target maintenance dose of 80 mg. The dose can be increased to 100 mg or 120 mg based on clinical response and tolerability. For children and adolescents weighing less than 70 kg, the recommended initial dose is .5 mg/kg/day, titrated to a maximum of 1.4 mg/kg/day (not to exceed 100 mg).

Missed dose – If a dose is forgotten and the scheduled time is more than 12 hours away, skip the missed dose and resume the regular dosing schedule. Doubling up is discouraged because it may precipitate cardiovascular or psychiatric side effects.

Overdose – Acute ingestion of significantly higher than prescribed amounts can lead to severe hypertension, tachyarrhythmia, seizures, or serotonin syndrome when combined with serotonergic agents. Immediate medical attention is required; supportive care and cardiac monitoring are the mainstays of treatment.

Practical precautions

• Take the tablet with a glass of water, preferably in the morning with or without food.
• Avoid abrupt discontinuation; tapering over 1–2 weeks reduces the likelihood of rebound irritability or mood change.
• Regularly monitor blood pressure, heart rate, and weight, especially after dose adjustments.
• Discuss any concomitant antidepressants, antihypertensives, or over‑the‑counter cold remedies with a clinician to prevent interactions.

Buying Strattera from Our Online Pharmacy

Patients in the United Kingdom seeking a reliable source of atomoxetine can obtain it through our online pharmacy. Our service offers several advantages:

• Affordability: Prices are set close to manufacturer cost, providing a cost‑effective alternative to branded Strattera.
• Verified quality: We source tablets only from licensed international wholesalers who meet stringent EU‑GMP standards; each batch is accompanied by a certificate of analysis.
• Discrete, guaranteed delivery: Orders are packaged in unmarked envelopes and dispatched via a tracked service (express delivery within 7 days for most mainland UK addresses, regular airmail typically arrives within 2‑3 weeks).
• Pharmacy‑broker model: By partnering with overseas licensed pharmacies, we can legally import atomoxetine for personal use under the UK’s “specials” provision, respecting patient privacy while ensuring regulatory compliance.

Our online pharmacy is designed for individuals who encounter barriers accessing medication through conventional NHS channels, lack private insurance cover, or require a generic alternative to the branded version. All transactions are encrypted and GDPR‑compliant.

FAQ

• **Can Strattera be taken with coffee or other caffeine‑containing drinks?
  Yes, moderate caffeine intake does not generally affect atomoxetine’s metabolism. However, high amounts of caffeine may exacerbate insomnia or jitteriness, especially when treatment is initiated.

• **Does Strattera require refrigeration?
  No, Strattera tablets should be stored at controlled room temperature (15 °C–30 °C). Avoid exposure to excessive heat, humidity, or direct sunlight.

• **What does the Strattera tablet look like?
  Tablets are oval, film‑coated, and colour‑coded by strength: 10 mg (white), 18 mg (pink), 25 mg (green), 40 mg (blue), 80 mg (orange). Imprints include “AZ 10”, “AZ 18”, etc., indicating the manufacturer AstraZeneca.

• **Is atomoxetine the same as the brand‑name Strattera?
  Atomoxetine is the generic name; Strattera is the original brand formulation. Both contain the identical active substance, and therapeutic outcomes are expected to be comparable when bioequivalence is established.

• **Can Strattera be imported for personal use without a UK prescription?
  Under current UK law, personal importation of prescription‑only medicines is permitted when the product is for non‑commercial use, the is from a licensed foreign pharmacy, and the patient possesses a valid prescription from a UK‑registered prescriber. Importing without a prescription may be deemed illegal.

• **Are there any known ethnic differences in how Strattera is metabolised?
  CYP2D6 allele frequencies vary across populations; Asian groups have a higher proportion of poor metabolizers, which can lead to increased plasma concentrations and may necessitate lower maintenance doses. Clinicians often adjust dosing based on observed tolerability rather than ethnicity alone.

• **How long does it typically take to see clinical improvement?
  Unlike stimulants, atomoxetine’s therapeutic effect builds gradually. Most patients report noticeable symptom reduction after 2–4 weeks, with maximal benefit observed around 6–8 weeks of steady dosing.

• **Can Strattera affect drug testing for employment or sports?
  Atomoxetine is not a controlled substance and is not screened for in standard workplace or athletic drug panels. However, some specialized tests for norepinephrine reuptake inhibitors exist; athletes should consult their governing body’s prohibited‑substance list.

• **What differences exist between the UK and US formulations?
  The UK (EU) formulation contains a lower amount of titanium dioxide (E171) following recent EU regulations, and the tablet coating uses a different polymer to meet UK pharmacopoeia standards. The active dose strength and pharmacokinetic profile remain equivalent.

• **Is there evidence that Strattera reduces the risk of substance misuse compared with stimulants?
  Large cohort studies in the US and Europe have demonstrated lower rates of diversion and misuse among atomoxetine users versus stimulant cohorts, likely due to its non‑controlled‑substance status and lack of euphoriant effect.

Glossary

Norepinephrine Reuptake Inhibitor (NRI)

A class of drugs that block the transporter responsible for re‑absorbing norepinephrine into presynaptic neurons, thereby increasing its concentration in the synaptic cleft.

CYP2D6 Poor Metabolizer

An individual whose genetic makeup leads to reduced activity of the liver enzyme CYP2D6, resulting in slower clearance of drugs metabolised by this pathway, such as atomoxetine.

Therapeutic Window

The dosage range in which a medication provides clinical benefit without causing unacceptable side effects.

Off‑label Use

Prescription of a medication for an indication, age group, dosage, or route of administration that has not been formally approved by regulatory agencies.

⚠️ Disclaimer

The information provided about Strattera is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Strattera for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.