What is the recommended dose of atomoxetine (Attention Deficit Hyperactivity Disorder - ADHD) medication when administered at night?

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From the FDA Drug Label

Atomoxetine capsules should be initiated at a total daily dose of approximately 0.5 mg/kg and increased after a minimum of 3 days to a target total daily dose of approximately 1.2 mg/kg administered either as a single daily dose in the morning or as evenly divided doses in the morning and late afternoon/early evening.

The recommended dose of atomoxetine when administered at night is part of the evenly divided doses in the morning and late afternoon/early evening, with a target total daily dose of approximately 1.2 mg/kg.

  • For children and adolescents up to 70 kg body weight, the total daily dose should not exceed 1.4 mg/kg or 100 mg, whichever is less.
  • For children and adolescents over 70 kg body weight and adults, the dose may be increased to a maximum of 100 mg after 2 to 4 additional weeks if an optimal response is not achieved 1.

From the Research

Atomoxetine is typically taken once daily in the morning for ADHD treatment, but it can be taken at night if daytime drowsiness occurs, with a recommended dose of 40mg daily for adults, gradually increasing to a target dose of 80mg daily after 3 days, with a maximum of 100mg daily, as supported by the study 2. When administering atomoxetine at night, it is essential to consider the potential effects on sleep and daytime functioning. The standard starting dose for adults is 40mg daily, which can be gradually increased to a target dose of 80mg daily after 3 days, with a maximum of 100mg daily. For children and adolescents weighing less than 70kg, dosing starts at 0.5mg/kg/day, potentially increasing to 1.2mg/kg/day after 3 days, as noted in the study 3. Some key points to consider when taking atomoxetine at night include:

  • It may help manage side effects like drowsiness and can improve sleep in some patients, as mentioned in the study 4.
  • However, it may cause insomnia in others, so timing should be personalized, as noted in the study 5.
  • Unlike stimulants, atomoxetine works continuously throughout the day as it increases norepinephrine levels in the brain, taking 1-4 weeks to reach full effectiveness, as supported by the study 6.
  • Patients should maintain consistent timing of doses and consult their healthcare provider before making any changes to their medication schedule. It is also important to note that suboptimal dosing of atomoxetine may be associated with poor patient outcomes, as discussed in the study 2. Therefore, it is crucial to follow the recommended dosing guidelines and consult with a healthcare provider to determine the best course of treatment for each individual patient.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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