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阿托西汀Strattera

[ 人气:149 | 日期: 2020-08-04 | 返回 | 打印 ]
阿托西汀Strattera
药品名称:阿托西汀Strattera
药品别名:托莫西汀;Tomoxetine;Atomoxetine hydrochloride;Strattera
英 文 名:阿托西汀Strattera
药品价格:$ 美国市场售价 149.22 美元
研发公司:
适 用 症:适用于注意缺陷障碍(ADHD)的治疗。
型号规格:胶囊装,每粒含有效成份10mg/18mg/25mg/40mg/60mg/80mg/100mg多种规格,每瓶30粒装。
药品详情:

【阿托西汀Strattera 简述】
 
    阿托西汀Strattera又名托莫西汀;Tomoxetine;Atomoxetine hydrochloride;Strattera等,本品可选择性抑制去甲肾上腺上腺上腺素的突触前运转,增强去甲肾上腺上腺上腺素功能,从而改善ADHD的症状,间接促进认知的完成和注意力的集中。对其他神经递质受体(如胆碱能、组胺、多巴胺、5-羟色胺以及α-肾上腺素受体) 几乎无亲和力。

阿托西汀Strattera_香港济民药业
 
【阿托西汀Strattera 适应症】
 
    本品适用于适用于注意缺陷障碍(ADHD)的治疗。
 
【阿托西汀Strattera 规格】
 
    本品为胶囊装,每粒含有效成份10mg/18mg/25mg/40mg/60mg/80mg/100mg多种规格,每瓶30粒装。
 
【阿托西汀Strattera 服用方法】
 
    体重70kg以下的儿童和青少年,阿托西汀的初始剂量约为每日0.5mg/kg,最少需经过3天方可增加至约每日1.2mg/kg的目标剂量,每日1次晨服或在早晨和下午/傍晚分2次眼用。最大日剂量不超过1.4mg/kg或100mg。对于体重在70kg及以上的儿童、青少年及成人,阿托西汀的初始剂量约为每日40mg,最少经过3天方可增加至约每日80mg的目标剂量,每日1次晨服或在早晨和下午/傍晚分2次服用。疗效不明显者用药2~4周后,可增加至最大日剂量100mg。阿托西汀可单服或与食物同服。肝功能中度损伤者,剂量降至正常剂量的50%,严重肝功能障碍者,剂量降至正常剂量的25%。
 
【阿托西汀Strattera 注意事项】
 
1.阿托西汀不得与单胺氧化化酶抑制剂(MAOI)联用,在停用MAOI 2周后方可使用。
 
2.与氟西汀、帕罗西汀或奎尼丁等CYP2D6抑制剂联用时需调整阿托西汀剂量。
 
3.可增加肝毒性的风险,肝脏疾病患者慎用。中、重度肝功能不全者及CYP2D6代谢酶缺乏者应酌情减量。
 
4.6岁以下儿童及老年患者的阿托西汀安全性和疗效尚未明确。
 
5.阿托西汀可使血压升高和心率加快,高血压、心动过速、心血管或脑血管疾病患者慎用。阿托西汀也可引起直立性低血压,低血压或有低血压倾向的患者慎用。
 
6.使用沙丁胺醇或其他β2受体激动剂治疗者慎用。
 
7.哺乳期妇女慎用阿托西汀。
 
8.代谢能力弱者、有药物依赖史者慎用。
 
9.阿托西汀可引起尿潴留,尿潴留或肾功能异常者慎用。
 
【阿托西汀Strattera 不良反应】
 
    阿托西汀可致严重肝损伤、皮肤瘙痒、黄疸、尿色深、右上腹部压痛、流行性感冒样症状。

Strattera(Atomoxetine)

 
Atomoxetine, sold under the brand name Strattera among others, is a medication used to treat attention deficit hyperactivity disorder(ADHD).[6] Use is only recommended in those who are at least six years old.[6] It is taken by mouth.[6]
 
Common side effects include abdominal pain, loss of appetite, nausea, feeling tired, and dizziness.[6] Serious side effects may include angioedema, liver problems, stroke, psychosis, heart problems, suicide, and aggression.[6][7] Safety in pregnancy and breastfeeding is not clear.[8] Atomoxetine is a norepinephrine reuptake inhibitor which is how it is believed to work.[6]
 
Atomoxetine was approved for medical use in the United States in 2002.[6] A month's supply in the United Kingdom costs the NHS about 53 £ as of 2019.[7] In the United States, the wholesale cost of this amount is about 77 USD.[9] In 2016, it was the 245th most prescribed medication in the United States, with more than 2 million prescriptions.[10]
 
Medical uses
Attention deficit hyperactivity disorder
Atomoxetine is approved for use in children, adolescents, and adults.[11] However, its efficacy has not been studied in children under six years old.[2] Its primary advantage over the standard stimulant treatments for ADHD is that it has little known abuse potential.[2] While it has been shown to significantly reduce inattentive and hyperactive symptoms, the responses were lower than the response to stimulants. Additionally, 40% of participants who were treated with atomoxetine experienced residual ADHD symptoms.[12]
 
The initial therapeutic effects of atomoxetine usually take 2–4 weeks to become apparent.[1]A further 2–4 weeks may be required for the full therapeutic effects to be seen.[13] Its efficacy may be less than that of stimulant medications.[14]
 
Unlike α2 adrenoceptor agonists such as guanfacine and clonidine, atomoxetine's use can be abruptly stopped without significant discontinuation effects being seen.[2]
 
Contraindications
 
Contraindications include:[2]
§  Hypersensitivity to atomoxetine or any of the excipients in the product
§  Symptomatic cardiovascular disease including:
-moderate to severe hypertension
-atrial fibrillation
-atrial flutter
-ventricular tachycardia
-ventricular fibrillation
-ventricular flutter
-advanced arteriosclerosis
§  Severe cardiovascular disorders
§  Pheochromocytoma
§  Concomitant treatment with monoamine oxidase inhibitors
§  Narrow angle glaucoma
§  Poor metabolizers (due to the metabolism of atomoxetine by CYP2D6)
 
Adverse effects
 
Very common (>10% incidence) adverse effects include:
§  Nausea (26%)
§  Xerostomia (Dry mouth) (20%)
§  Appetite loss (16%)
§  Insomnia (15%)
§  Fatigue (10%)
§  Headache
§  Cough
§  Vomiting (in children and adolescents)
Common (1–10% incidence) adverse effects include:
§  Constipation (8%)
§  Dizziness (8%)
§  Erectile dysfunction (8%)
§  Somnolence (sleepiness) (8%)
§  Abdominal pain (7%)
§  Urinary hesitation (6%)
§  Tachycardia (high heart rate) (5–10%)
§  Hypertension (high blood pressure) (5–10%)
§  Irritability (5%)
§  Abnormal dreams (4%)
§  Dyspepsia (4%)
§  Ejaculation disorder (4%)
§  Hyperhidrosis (abnormally increased sweating) (4%)
§  Vomiting (4%)
§  Hot flashes (3%)
§  Paraesthesia (sensation of tingling, tickling, etc.) (3%)
§  Menstrual disorder (3%)
§  Weight loss (2%)
§  Depression
§  Sinus headache
§  Dermatitis
§  Mood swings
Uncommon (0.1–1% incidence) adverse effects include:
§  Suicide-related events
§  Hostility
§  Emotional lability
§  Aggression
§  Psychosis
§  Syncope (fainting)
§  Tremor
§  Migraine
§  Hypoaesthesia
§  Seizure
§  Palpitations
§  Sinus tachycardia
§  QT interval prolongation
§  Increased blood bilirubin
§  Allergic reactions
Rare (0.01–0.1% incidence) adverse effects including:
§  Raynaud's phenomenon
§  Abnormal/increased liver function tests
§  Jaundice
§  Hepatitis
§  Liver injury
§  Acute liver failure
§  Urinary retention
§  Priapism[17]
§  Male genital pain
The FDA of the US has issued a black box warning for suicidal behaviour/ideation.[3] Similar warnings have been issued in Australia.[2][18] Unlike stimulant medications, atomoxetine does not have abuse liability or the potential to cause withdrawal effects on abrupt discontinuation.[2]
 
Overdose
 
Atomoxetine is relatively non-toxic in overdose. Single-drug overdoses involving over 1500 mg of atomoxetine have not resulted in death.[2] The most common symptoms of overdose include:[2]
§  Gastrointestinal symptoms
§  Somnolence
§  Dizziness
§  Tremor
§  Abnormal behaviour
§  Hyperactivity
§  Agitation
§  Dry mouth
§  Tachycardia
§  Hypertension
§  Mydriasis
Less common symptoms:[2]
§  Seizures
§  QTc interval prolongation
The recommended treatment for atomoxetine overdose includes use of activated charcoal to prevent further absorption of the drug.[2]
 




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