Chemical: Drug
atomoxetine

last updated 02/07/2014

1. DPWG Guideline for atomoxetine and CYP2D6

Summary

For CYP2D6 ultrarapid metabolizers, be alert to reduced efficacy of atomoxetine or select an alternative drug. Be alert to ADEs in CYP2D6 poor metabolizers.

Annotation

The Royal Dutch Pharmacists Association - Pharmacogenetics Working Group has evaluated therapeutic dose recommendations for atomoxetine based on CYP2D6 genotypes [Article:21412232].

Phenotype (Genotype) Therapeutic Dose Recommendation Level of Evidence Clinical Relevance
PM (two inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) alleles) Standard dose. Dose increase probably not necessary; be alert to ADEs. Published controlled studies of moderate quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints. Clinical effect (S): short-lived discomfort (< 48 hr) without permanent injury: e.g. reduced decrease in resting heart rate; reduction in exercise tachycardia; decreased pain relief from oxycodone; ADE resulting from increased bioavailability of atomoxetine (decreased appetite, insomnia, sleep disturbance etc); neutropenia > 1.5x109/l; leucopenia > 3.0x109/l; thrombocytopenia > 75x109/l; moderate diarrhea not affecting daily activities; reduced glucose increase following oral glucose tolerance test.
IM (two decreased-activity (*9, *10, *17, *29, *36, *41) alleles or carrying one active (*1, *2, *33, *35) and one inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) allele, or carrying one decreased-activity (*9, *10, *17, *29, *36, *41) allele and one inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) allele) No recommendations. Published controlled studies of good quality* relating to phenotyped and/or genotyped patients or healthy volunteers, and having relevant pharmacokinetic or clinical endpoints. Minor clinical effect (S): QTc prolongation (<450 ms female, <470 ms male); INR increase < 4.5; Kinetic effect (S).
UM (a gene duplication in absence of inactive (*3-*8, *11-*16, *19-*21, *38, *40, *42) or decreased-activity (*9, *10, *17, *29, *36, *41) alleles) Insufficient data to allow calculation of dose adjustment. Be alert to reduced efficacy or select alternative drug (e.g., methylphenidate, clonidine). -- --
  • *See Methods or PMID: 18253145 for definition of "good" and "moderate" quality.
  • S: statistically significant difference.
  • Please see attached PDF for detailed information about the evaluated studies: Atomoxetine CYP2D6


Annotated Labels

  1. FDA Label for atomoxetine and CYP2D6
  2. PMDA Label for atomoxetine and CYP2D6
  3. HCSC Label for atomoxetine and CYP2D6

last updated 06/13/2016

1. FDA Label for atomoxetine and CYP2D6

Actionable PGx

Summary

Dose adjustments of atomoxetine (Strattera) may be necessary in CYP2D6 poor metabolizers (PMs) or if CYP2D6 inhibitors are used concomitantly. Laboratory tests are available to identify CYP2D6 poor metabolizers.

There's more of this label. Read more.


last updated 01/26/2015

2. PMDA Label for atomoxetine and CYP2D6

Actionable PGx

Summary

The PMDA package insert for atomoxetine states that individuals who are CYP2D6 poor metabolizers (PMs) and administered atomoxetine may have higher exposure to the drug and be at a greater risk of experiencing adverse events. The insert recommends dosing these patients with discretion.

There's more of this label. Read more.


last updated 06/08/2015

3. HCSC Label for atomoxetine and CYP2D6

Actionable PGx

Summary

The product monograph for atomoxetine notes that CYP2D6 poor metabolizers (PMs) have a 10-fold higher area under the curve (AUC) and a 5-fold higher peak concentration of the drug as compared to extensive metabolizers (EM); this leads to a higher rate of some adverse events for PMs compared to EMs.

There's more of this label. Read more.


PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for atomoxetine

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
VIP CA VA CYP2D6 *1 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *1xN N/A N/A N/A
VIP CA VA CYP2D6 *2 N/A N/A N/A
VIP CA VA CYP2D6 *3 N/A N/A N/A
VIP CA VA CYP2D6 *4 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *4xN N/A N/A N/A
No VIP available CA VA CYP2D6 *5 N/A N/A N/A
VIP No VIP available VA CYP2D6 *6 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *7 N/A N/A N/A
VIP No VIP available VA CYP2D6 *9 N/A N/A N/A
VIP CA VA CYP2D6 *10 N/A N/A N/A
VIP No VIP available VA CYP2D6 *17 N/A N/A N/A
VIP No VIP available VA CYP2D6 *29 N/A N/A N/A
VIP No VIP available VA CYP2D6 *41 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *87 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *88 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *89 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *90 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *91 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *92 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *93 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *94 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *95 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *96 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *97 N/A N/A N/A
No VIP available No VIP available VA CYP2D6 *98 N/A N/A N/A
No VIP available No Clinical Annotations available VA
CYP2D6 poor metabolizer phenotype N/A N/A N/A
No VIP available No Clinical Annotations available VA
CYP2D6 poor metabolizer N/A N/A N/A
No VIP available No Clinical Annotations available VA
CYP2D6 poor metabolizers N/A N/A N/A
VIP No Clinical Annotations available No Variant Annotations available
rs1065852 NC_000022.10:g.42526694G=, NC_000022.10:g.42526694G>A, NC_000022.11:g.42130692G=, NC_000022.11:g.42130692G>A, NG_008376.3:g.4300C=, NG_008376.3:g.4300C>T, NM_000106.5:c.100C=, NM_000106.5:c.100C>T, NM_001025161.2:c.100C=, NM_001025161.2:c.100C>T, NP_000097.3:p.Pro34=, NP_000097.3:p.Pro34Ser, NP_001020332.2:p.Pro34=, NP_001020332.2:p.Pro34Ser, NT_187682.1:g.53033G=, NT_187682.1:g.53033G>A, NW_004504305.1:g.53019A=, NW_004504305.1:g.53019A>G, NW_009646208.1:g.16258A=, NW_009646208.1:g.16258A>G, XM_005278353.1:c.100T=, XM_005278353.1:c.100T>C, XM_005278354.1:c.-1454C>T, XM_005278354.1:c.-1454T>C, XM_005278354.3:c.-1454C>T, XM_005278354.3:c.-1454T>C, XM_011529966.1:c.100C=, XM_011529966.1:c.100C>T, XM_011529967.1:c.100C=, XM_011529967.1:c.100C>T, XM_011529968.1:c.100C=, XM_011529968.1:c.100C>T, XM_011529969.1:c.37+605C>T, XM_011529969.1:c.37+605T>C, XM_011529970.1:c.100C=, XM_011529970.1:c.100C>T, XM_011529971.1:c.37+605C>T, XM_011529971.1:c.37+605T>C, XM_011529972.1:c.100C=, XM_011529972.1:c.100C>T, XM_011547541.1:c.-1454C>T, XM_011547541.1:c.-1454T>C, XM_011547750.1:c.37+605C>T, XM_011547750.1:c.37+605T>C, XM_011547751.1:c.-1114C>T, XM_011547751.1:c.-1114T>C, XM_011547756.1:c.42+469A>G, XM_011547756.1:c.42+469G>A, XM_011548819.1:c.-1454C>T, XM_011548819.1:c.-1454T>C, XP_005278410.1:p.Ser34=, XP_005278410.1:p.Ser34Pro, XP_011528268.1:p.Pro34=, XP_011528268.1:p.Pro34Ser, XP_011528269.1:p.Pro34=, XP_011528269.1:p.Pro34Ser, XP_011528270.1:p.Pro34=, XP_011528270.1:p.Pro34Ser, XP_011528272.1:p.Pro34=, XP_011528272.1:p.Pro34Ser, XP_011528274.1:p.Pro34=, XP_011528274.1:p.Pro34Ser, XR_430455.2:n.328+4A>G, XR_430455.2:n.328+4G>A, XR_952536.1:n.-1751A>G, XR_952536.1:n.-1751G>A, XR_952537.1:n.-1751A>G, XR_952537.1:n.-1751G>A, XR_952538.1:n.-1751A>G, XR_952538.1:n.-1751G>A, XR_952539.1:n.-1462A>G, XR_952539.1:n.-1462G>A, XR_952745.1:n.1257C=, XR_952745.1:n.1257C>T, rs117813846, rs58862176
G > A
SNP
P34S
No VIP available CA VA
rs12708954 NC_000016.10:g.55697687C>A, NC_000016.9:g.55731599C>A, NG_016969.1:g.47058C>A, NM_001043.3:c.1261-210C>A, NM_001172501.1:c.1261-210C>A, NM_001172502.1:c.946-210C>A, NM_001172504.1:c.1261-210C>A, XM_006721263.2:c.1261-210C>A, XM_011523295.1:c.1261-210C>A, XM_011523296.1:c.1126-210C>A, XM_011523297.1:c.1126-210C>A, XM_011523298.1:c.1148-210C>A, XM_011523299.1:c.538-210C>A, XM_011523300.1:c.538-210C>A, XR_933403.1:n.1878-210C>A
C > A
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs16947 NC_000022.10:g.42523943A=, NC_000022.10:g.42523943A>G, NC_000022.11:g.42127941G=, NC_000022.11:g.42127941G>A, NG_008376.3:g.7051C=, NG_008376.3:g.7051C>T, NM_000106.5:c.886C=, NM_000106.5:c.886C>T, NM_001025161.2:c.733C=, NM_001025161.2:c.733C>T, NP_000097.3:p.Arg296=, NP_000097.3:p.Arg296Cys, NP_001020332.2:p.Arg245=, NP_001020332.2:p.Arg245Cys, NT_187682.1:g.50282A=, NT_187682.1:g.50282A>G, NW_004504305.1:g.50268G=, NW_004504305.1:g.50268G>A, NW_009646208.1:g.13507G=, NW_009646208.1:g.13507G>A, XM_005278353.1:c.742C=, XM_005278353.1:c.742C>T, XM_005278354.1:c.586C=, XM_005278354.1:c.586C>T, XM_005278354.3:c.586C=, XM_005278354.3:c.586C>T, XM_011529966.1:c.886C=, XM_011529966.1:c.886C>T, XM_011529967.1:c.886C=, XM_011529967.1:c.886C>T, XM_011529968.1:c.886C=, XM_011529968.1:c.886C>T, XM_011529969.1:c.742C=, XM_011529969.1:c.742C>T, XM_011529970.1:c.733C=, XM_011529970.1:c.733C>T, XM_011529971.1:c.742C=, XM_011529971.1:c.742C>T, XM_011529972.1:c.843+233C>T, XM_011529972.1:c.843+233T>C, XM_011547541.1:c.586C=, XM_011547541.1:c.586C>T, XM_011547750.1:c.742T=, XM_011547750.1:c.742T>C, XM_011547751.1:c.670T=, XM_011547751.1:c.670T>C, XM_011547756.1:c.-2094A>G, XM_011547756.1:c.-2094G>A, XM_011548819.1:c.586C=, XM_011548819.1:c.586C>T, XP_005278410.1:p.Arg248=, XP_005278410.1:p.Arg248Cys, XP_005278411.1:p.Arg196=, XP_005278411.1:p.Arg196Cys, XP_011528268.1:p.Arg296=, XP_011528268.1:p.Arg296Cys, XP_011528269.1:p.Arg296=, XP_011528269.1:p.Arg296Cys, XP_011528270.1:p.Arg296=, XP_011528270.1:p.Arg296Cys, XP_011528271.1:p.Arg248=, XP_011528271.1:p.Arg248Cys, XP_011528272.1:p.Arg245=, XP_011528272.1:p.Arg245Cys, XP_011528273.1:p.Arg248=, XP_011528273.1:p.Arg248Cys, XP_011545843.1:p.Arg196=, XP_011545843.1:p.Arg196Cys, XP_011546052.1:p.Cys248=, XP_011546052.1:p.Cys248Arg, XP_011546053.1:p.Cys224=, XP_011546053.1:p.Cys224Arg, XP_011547121.1:p.Arg196=, XP_011547121.1:p.Arg196Cys, XR_430455.2:n.-1930A>G, XR_430455.2:n.-1930G>A, XR_952745.1:n.2000+233C>T, XR_952745.1:n.2000+233T>C, rs117039205, rs57836231
A > G
SNP
R296C
VIP No Clinical Annotations available No Variant Annotations available
rs28371706 NC_000022.10:g.42525772G>A, NC_000022.11:g.42129770G>A, NG_008376.3:g.5222C>T, NM_000106.5:c.320C>T, NM_001025161.2:c.320C>T, NP_000097.3:p.Thr107Ile, NP_001020332.2:p.Thr107Ile, NT_187682.1:g.52111G>A, NW_004504305.1:g.52097G>A, NW_009646208.1:g.15336G>A, XM_005278353.1:c.320C>T, XM_005278354.1:c.-532C>T, XM_005278354.3:c.-532C>T, XM_011529966.1:c.320C>T, XM_011529967.1:c.320C>T, XM_011529968.1:c.320C>T, XM_011529969.1:c.177C>T, XM_011529970.1:c.320C>T, XM_011529971.1:c.177C>T, XM_011529972.1:c.320C>T, XM_011547541.1:c.-532C>T, XM_011547750.1:c.177C>T, XM_011547751.1:c.-192C>T, XM_011547756.1:c.-265G>A, XM_011548819.1:c.-532C>T, XP_005278410.1:p.Thr107Ile, XP_011528268.1:p.Thr107Ile, XP_011528269.1:p.Thr107Ile, XP_011528270.1:p.Thr107Ile, XP_011528271.1:p.His59=, XP_011528272.1:p.Thr107Ile, XP_011528273.1:p.His59=, XP_011528274.1:p.Thr107Ile, XP_011546052.1:p.His59=, XR_430455.2:n.-101G>A, XR_952745.1:n.1477C>T, rs587777915, rs59604033
G > A
SNP
T107I
VIP No Clinical Annotations available No Variant Annotations available
rs28371725 NC_000022.10:g.42523805C>T, NC_000022.11:g.42127803C>T, NG_008376.3:g.7189G>A, NM_000106.5:c.985+39G>A, NM_001025161.2:c.832+39G>A, NT_187682.1:g.50144C>T, NW_004504305.1:g.50130C>T, NW_009646208.1:g.13369C>T, XM_005278353.1:c.841+39G>A, XM_005278354.1:c.685+39G>A, XM_005278354.3:c.685+39G>A, XM_011529966.1:c.985+39G>A, XM_011529967.1:c.985+39G>A, XM_011529968.1:c.985+39G>A, XM_011529969.1:c.841+39G>A, XM_011529970.1:c.832+39G>A, XM_011529971.1:c.841+39G>A, XM_011529972.1:c.844-169G>A, XM_011547541.1:c.724G>A, XM_011547750.1:c.841+39G>A, XM_011547751.1:c.769+39G>A, XM_011548819.1:c.724G>A, XP_011545843.1:p.Glu242Lys, XP_011547121.1:p.Glu242Lys, XR_952745.1:n.2001-169G>A, rs57124011, rs587777916
C > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs35742686 NC_000022.10:g.42524244delT, NC_000022.11:g.42128242delT, NG_008376.3:g.6750delA, NM_000106.5:c.775delA, NM_001025161.2:c.622delA, NP_000097.3:p.Arg259Glyfs, NP_001020332.2:p.Arg208Glyfs, NT_187682.1:g.50583delT, NW_004504305.1:g.50569delT, NW_009646208.1:g.13808delT, XM_005278353.1:c.631delA, XM_005278354.1:c.475delA, XM_005278354.3:c.475delA, XM_011529966.1:c.775delA, XM_011529967.1:c.775delA, XM_011529968.1:c.775delA, XM_011529969.1:c.631delA, XM_011529970.1:c.622delA, XM_011529971.1:c.631delA, XM_011529972.1:c.775delA, XM_011547541.1:c.475delA, XM_011547750.1:c.631delA, XM_011547751.1:c.559delA, XM_011547756.1:c.-1793delT, XM_011548819.1:c.475delA, XP_005278410.1:p.Arg211Glyfs, XP_005278411.1:p.Arg159Glyfs, XP_011528268.1:p.Arg259Glyfs, XP_011528269.1:p.Arg259Glyfs, XP_011528270.1:p.Arg259Glyfs, XP_011528271.1:p.Arg211Glyfs, XP_011528272.1:p.Arg208Glyfs, XP_011528273.1:p.Arg211Glyfs, XP_011528274.1:p.Arg259Glyfs, XP_011545843.1:p.Arg159Glyfs, XP_011546052.1:p.Arg211Glyfs, XP_011546053.1:p.Arg187Glyfs, XP_011547121.1:p.Arg159Glyfs, XR_430455.2:n.-1629delT, XR_952745.1:n.1932delA, rs45593132, rs60790764
T > -
T > T
indel
R259G
No VIP available CA VA
rs3785143 NC_000016.10:g.55661194C>T, NC_000016.9:g.55695106C>T, NG_016969.1:g.10565C>T, NM_001043.3:c.274+4226C>T, NM_001172501.1:c.274+4226C>T, NM_001172504.1:c.274+4226C>T, XM_006721263.2:c.274+4226C>T, XM_011523295.1:c.274+4226C>T, XM_011523296.1:c.274+4226C>T, XM_011523297.1:c.274+4226C>T, XM_011523298.1:c.274+4226C>T, XR_933403.1:n.891+4226C>T, rs56530353, rs60390089
C > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs3892097 NC_000022.10:g.42524947C=, NC_000022.10:g.42524947C>T, NC_000022.11:g.42128945C=, NC_000022.11:g.42128945C>T, NG_008376.3:g.6047G=, NG_008376.3:g.6047G>A, NM_000106.5:c.506-1A>G, NM_000106.5:c.506-1G>A, NM_001025161.2:c.353-1A>G, NM_001025161.2:c.353-1G>A, NT_187682.1:g.51286C=, NT_187682.1:g.51286C>T, NW_004504305.1:g.51272T=, NW_004504305.1:g.51272T>C, NW_009646208.1:g.14511C=, NW_009646208.1:g.14511C>T, XM_005278353.1:c.363-2A>G, XM_005278353.1:c.363-2G>A, XM_005278354.1:c.207-2A>G, XM_005278354.1:c.207-2G>A, XM_005278354.3:c.207-2A>G, XM_005278354.3:c.207-2G>A, XM_011529966.1:c.506-1A>G, XM_011529966.1:c.506-1G>A, XM_011529967.1:c.506-1A>G, XM_011529967.1:c.506-1G>A, XM_011529968.1:c.506-1A>G, XM_011529968.1:c.506-1G>A, XM_011529969.1:c.363-2A>G, XM_011529969.1:c.363-2G>A, XM_011529970.1:c.353-1A>G, XM_011529970.1:c.353-1G>A, XM_011529971.1:c.363-2A>G, XM_011529971.1:c.363-2G>A, XM_011529972.1:c.506-1A>G, XM_011529972.1:c.506-1G>A, XM_011547541.1:c.207-2A>G, XM_011547541.1:c.207-2G>A, XM_011547750.1:c.363-2A>G, XM_011547750.1:c.363-2G>A, XM_011547751.1:c.290-1A>G, XM_011547751.1:c.290-1G>A, XM_011547756.1:c.-1090C>T, XM_011547756.1:c.-1090T>C, XM_011548819.1:c.207-2A>G, XM_011548819.1:c.207-2G>A, XR_430455.2:n.-926C>T, XR_430455.2:n.-926T>C, XR_952745.1:n.1663-1A>G, XR_952745.1:n.1663-1G>A, rs1800716, rs28371711, rs60082401, rs606231227
C > T
SNP
VIP No Clinical Annotations available No Variant Annotations available
rs5030655 NC_000022.10:g.42525086delA, NC_000022.11:g.42129084delA, NG_008376.3:g.5908delT, NM_000106.5:c.454delT, NM_001025161.2:c.353-140delT, NP_000097.3:p.Trp152Glyfs, NT_187682.1:g.51425delA, NW_004504305.1:g.51411delA, NW_009646208.1:g.14650delA, XM_005278353.1:c.363-141delT, XM_005278354.1:c.155delT, XM_005278354.3:c.155delT, XM_011529966.1:c.454delT, XM_011529967.1:c.454delT, XM_011529968.1:c.454delT, XM_011529969.1:c.311delT, XM_011529970.1:c.353-140delT, XM_011529971.1:c.311delT, XM_011529972.1:c.454delT, XM_011547541.1:c.155delT, XM_011547750.1:c.311delT, XM_011547751.1:c.238delT, XM_011547756.1:c.-951delA, XM_011548819.1:c.155delT, XP_005278411.1:p.Val52Glyfs, XP_011528268.1:p.Trp152Glyfs, XP_011528269.1:p.Trp152Glyfs, XP_011528270.1:p.Trp152Glyfs, XP_011528271.1:p.Val104Glyfs, XP_011528273.1:p.Val104Glyfs, XP_011528274.1:p.Trp152Glyfs, XP_011545843.1:p.Val52Glyfs, XP_011546052.1:p.Val104Glyfs, XP_011546053.1:p.Trp80Glyfs, XP_011547121.1:p.Val52Glyfs, XR_430455.2:n.-787delA, XR_952745.1:n.1611delT, rs11568727, rs28371709
A > -
A > A
indel
W152G
VIP No Clinical Annotations available No Variant Annotations available
rs5030656 NC_000022.10:g.42524176_42524178delCTT, NC_000022.11:g.42128174_42128176delCTT, NG_008376.3:g.6816_6818delAAG, NM_000106.5:c.841_843delAAG, NM_001025161.2:c.688_690delAAG, NP_000097.3:p.Lys281del, NP_001020332.2:p.Lys230del, NT_187682.1:g.50515_50517delCTT, NW_004504305.1:g.50501_50503delCTT, NW_009646208.1:g.13740_13742delCTT, XM_005278353.1:c.697_699delAAG, XM_005278354.1:c.541_543delAAG, XM_005278354.3:c.541_543delAAG, XM_011529966.1:c.841_843delAAG, XM_011529967.1:c.841_843delAAG, XM_011529968.1:c.841_843delAAG, XM_011529969.1:c.697_699delAAG, XM_011529970.1:c.688_690delAAG, XM_011529971.1:c.697_699delAAG, XM_011529972.1:c.841_843delAAG, XM_011547541.1:c.541_543delAAG, XM_011547750.1:c.697_699delAAG, XM_011547751.1:c.625_627delAAG, XM_011547756.1:c.-1861_-1859del, XM_011548819.1:c.541_543delAAG, XP_005278410.1:p.Lys233del, XP_005278411.1:p.Lys181del, XP_011528268.1:p.Lys281del, XP_011528269.1:p.Lys281del, XP_011528270.1:p.Lys281del, XP_011528271.1:p.Lys233del, XP_011528272.1:p.Lys230del, XP_011528273.1:p.Lys233del, XP_011528274.1:p.Lys281del, XP_011545843.1:p.Lys181del, XP_011546052.1:p.Lys233del, XP_011546053.1:p.Lys209del, XP_011547121.1:p.Lys181del, XR_430455.2:n.-1697_-1695del, XR_952745.1:n.1998_2000delAAG, rs587777919
CTT > -
CTT > CTT
indel
VIP No Clinical Annotations available No Variant Annotations available
rs59421388 NC_000022.10:g.42523610C>T, NC_000022.11:g.42127608C>T, NG_008376.3:g.7384G>A, NM_000106.5:c.1012G>A, NM_001025161.2:c.859G>A, NP_000097.3:p.Val338Met, NP_001020332.2:p.Val287Met, NT_187682.1:g.49949C>T, NW_004504305.1:g.49935C>T, NW_009646208.1:g.13174C>T, XM_005278353.1:c.868G>A, XM_005278354.1:c.712G>A, XM_005278354.3:c.712G>A, XM_011529966.1:c.1012G>A, XM_011529967.1:c.1012G>A, XM_011529968.1:c.1012G>A, XM_011529969.1:c.868G>A, XM_011529970.1:c.859G>A, XM_011529971.1:c.868G>A, XM_011529972.1:c.870G>A, XM_011547541.1:c.*118G>A, XM_011547750.1:c.868G>A, XM_011547751.1:c.796G>A, XM_011548819.1:c.*118G>A, XP_005278410.1:p.Val290Met, XP_005278411.1:p.Val238Met, XP_011528268.1:p.Val338Met, XP_011528269.1:p.Val338Met, XP_011528270.1:p.Val338Met, XP_011528271.1:p.Val290Met, XP_011528272.1:p.Val287Met, XP_011528273.1:p.Val290Met, XP_011528274.1:p.Thr290=, XP_011546052.1:p.Val290Met, XP_011546053.1:p.Val266Met, XR_952745.1:n.2027G>A
C > T
SNP
V338M
VIP No Clinical Annotations available No Variant Annotations available
rs61736512 NC_000022.10:g.42525134C>T, NC_000022.11:g.42129132C>T, NG_008376.3:g.5860G>A, NM_000106.5:c.406G>A, NM_001025161.2:c.353-188G>A, NP_000097.3:p.Val136Met, NT_187682.1:g.51473C>T, NW_004504305.1:g.51459C>T, NW_009646208.1:g.14698C>T, XM_005278353.1:c.363-189G>A, XM_005278354.1:c.107G>A, XM_005278354.3:c.107G>A, XM_011529966.1:c.406G>A, XM_011529967.1:c.406G>A, XM_011529968.1:c.406G>A, XM_011529969.1:c.263G>A, XM_011529970.1:c.353-188G>A, XM_011529971.1:c.263G>A, XM_011529972.1:c.406G>A, XM_011547541.1:c.107G>A, XM_011547750.1:c.263G>A, XM_011547751.1:c.190G>A, XM_011547756.1:c.-903C>T, XM_011548819.1:c.107G>A, XP_005278411.1:p.Arg36His, XP_011528268.1:p.Val136Met, XP_011528269.1:p.Val136Met, XP_011528270.1:p.Val136Met, XP_011528271.1:p.Arg88His, XP_011528273.1:p.Arg88His, XP_011528274.1:p.Val136Met, XP_011545843.1:p.Arg36His, XP_011546052.1:p.Arg88His, XP_011546053.1:p.Val64Ile, XP_011547121.1:p.Arg36His, XR_430455.2:n.-739C>T, XR_952745.1:n.1563G>A
C > T
SNP
V136M
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • Tomoxetina [Spanish]
  • Tomoxetine
  • Tomoxetine [INN]
  • Tomoxetinum [Latin]
Trade Names
  • Strattera
Brand Mixture Names

PharmGKB Accession Id

PA134688071

Type(s):

Drug

Description

Atomoxetine is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). It is sold in the form of the hydrochloride salt of atomoxetine. This chemical is manufactured and marketed under the brand name Strattera; by Eli Lilly and Company and as a generic Attentin by Torrent Pharmaceuticals. There is currently no generic available within the United States due to patent restrictions. Wikipedia

Source: Drug Bank

Pharmacogenetics

Pharmacokinetics

Atomoxetine has a plasma half-life of approximately 5 hours and is metabolized by CYP2D6 and subsequently glucuronidated and excreted in the urine [Article:15910008]. Atomoxetine is highly bound to plasma albumin (ALB) [Article:15910008]. The two primary oxidative metabolites of atomoxetine are N-desmethylatomoxetine and 4-hydroxatomoxetine [Articles:11694667, 15910008]. Biotransformation studies in human liver microsomes indicate that in patients with compromised CYP2D6 activity, multiple low-affinity enzymes will participate in the formation of 4-hydroxyatomoxetine [Article:11854152]. The same study identified CYP2C19 as an enzyme responsible for the biotransformation of atomoxetine to N-desmethylatomoxetine [Article:11854152]. A meta-analysis of CYP2D6 genetic variants has indicated significant pharmacogenetic differences in atomoxetine treatment [Article:17242628]. Both atomoxetine and N-desmethylatomoxetine inhibit CYP3A activity in vitro [Article:14610241]. Also in human hepatic microsomes, atomoxetine, N-desmethylatomoxetine and 4-hydroxatomoxetine significantly inhibit CYP2D6 enzyme activity [Article:14610241].

Pharmacodynamics

Atomoxetine is a selective noradrenaline reuptake inhibitor approved for the treatment of Attention Deficit Disorder with Hyperactivity (ADHD). Atomoxetine binds selectively to the presynaptic norepinephrine transporter (SLC6A2) with minimal affinity for the other monoamine transporters or receptors [Articles:11694667, 6123593]. An in vitro study showed also effective glutamate receptor antagonism by atomoxetine at low micromolar concentrations [Article:20423340].

Clinical efficacy of atomoxetine treatment in Attention Deficit Disorder with Hyperactivity patients showed potential dependence upon a series of genetic polymorphisms across the exons 4 to 9 of the SLC6A2 gene [Article:19387424]. A study investigating the adverse effects of atomoxetine on the cardiovascular system found that increases in pulse and blood pressure were small and atomoxetine was not associated with QT interval prolongation [Article:12862507].

Source: PharmGKB

Indication

For the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) alone or in combination with behavioral treatment, as an adjunct to psychological, educational, social, and other remedial measures.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

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 through in-vitro studies. Atomoxetine appears to have minimal affinity for other noradrenergic receptors or for other neurotransmitter transporters or receptors.

Source: Drug Bank

Pharmacology

Atomoxetine is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). Atomoxetine is classified as a norepinephrine reuptake inhibitor, and is approved for use in children, adolescents, and adults. However, its efficacy has not been studied in children under six years old. Its advantage over stimulants for the treatment of ADHD is that it has less abuse potential than stimulants, is not scheduled as a controlled substance and has proven in clinical trials to offer 24 hour coverage of symptoms associated with ADHD in adults and children.

Source: Drug Bank

Food Interaction

In the presence of food, the absorption rate is reduced, without the quantity absorbed being affected.|Take without regard to meals.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Atomoxetine is primarily metabolized by the CYP2D6 pathway to 4-hydroxyatomoxetine. 4-Hydroxyatomoxetine is equipotent to atomoxetine as an inhibitor of the norepinephrine transporter but circulates in plasma at much lower concentrations (1% of atomoxetine concentration in EMs and 0.1% of atomoxetine concentration in PMs).

Source: Drug Bank

Protein Binding

At therapeutic concentrations, 98% of atomoxetine in plasma is bound to protein, primarily albumin.

Source: Drug Bank

Absorption

Atomoxetine is rapidly absorbed after oral administration, with absolute bioavailability of about 63% in EMs and 94% in PMs. Drugs that elevate gastric pH (magnesium hydroxide/aluminum hydroxide, omeprazole) have no effect on atomoxetine bioavailability. Absorption is minimally affected by food.

Source: Drug Bank

Half-Life

5 hours

Source: Drug Bank

Toxicity

The most commonly reported symptoms accompanying acute and chronic overdoses are somnolence, agitation, hyperactivity, abnormal behavior, and gastrointestinal symptoms.

Source: Drug Bank

Volume of Distribution

  • 0.85 L/kg

Source: Drug Bank

Chemical Properties

Chemical Formula

C17H21NO

Source: Drug Bank

Isomeric SMILES

Cc1ccccc1O[C@H](CCNC)c2ccccc2

Source: OpenEye

Canonical SMILES

CNCC[C@@H](OC1=CC=CC=C1C)C1=CC=CC=C1

Source: Drug Bank

Average Molecular Weight

255.3547

Source: Drug Bank

Monoisotopic Molecular Weight

255.162314299

Source: Drug Bank

SMILES

CNCC[C@@H](OC1=CC=CC=C1C)C1=CC=CC=C1

Source: Drug Bank

InChI String

InChI=1S/C17H21NO/c1-14-8-6-7-11-16(14)19-17(12-13-18-2)15-9-4-3-5-10-15/h3-11,17-18H,12-13H2,1-2H3/t17-/m1/s1

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
SLC6A2 (source: Drug Bank)
SLC6A4 (source: Drug Bank)

Drug Interactions

Interaction Description
amiodarone - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
amiodarone - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - amiodarone The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - chloroquine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - diphenhydramine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - fluoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - fluphenazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - haloperidol The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - isocarboxazid Possible severe adverse reaction with this combination (source: Drug Bank)
atomoxetine - mibefradil The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - paroxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - perphenazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - phenelzine Possible severe adverse reaction with this combination (source: Drug Bank)
atomoxetine - primaquine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - propafenone The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - propoxyphene The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - quinidine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - ritonavir The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - terbinafine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - thioridazine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - tranylcypromine Possible severe adverse reaction with this combination (source: Drug Bank)
atomoxetine - vinorelbine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
atomoxetine - yohimbine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
chloroquine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
chloroquine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
diphenhydramine - atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
diphenhydramine - atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
fluoxetine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
fluoxetine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
fluphenazine - atomoxetine This CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
fluphenazine - atomoxetine This CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
haloperidol - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
haloperidol - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
isocarboxazid - atomoxetine Possible severe adverse reaction with this combination (source: Drug Bank)
isocarboxazid - atomoxetine Possible severe adverse reaction with this combination (source: Drug Bank)
perphenazine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
perphenazine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
phenelzine - atomoxetine Possible severe adverse reaction with this combination (source: Drug Bank)
phenelzine - atomoxetine Possible severe adverse reaction with this combination (source: Drug Bank)
primaquine - atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
primaquine - atomoxetine The CYP2D6 inhibitor could increases the effect and toxicity of atomoxetine (source: Drug Bank)
propafenone - atomoxetine Tje CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
propafenone - atomoxetine Tje CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
propoxyphene - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
propoxyphene - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
quinidine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
quinidine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
quinine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
quinine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
rasagiline - atomoxetine Possible severe adverse reaction with this combination (source: Drug Bank)
thioridazine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
thioridazine - atomoxetine The CYP2D6 inhibitor could increase the effect and toxicity of atomoxetine (source: Drug Bank)
tranylcypromine - atomoxetine The MAO inhibitor, Tranylcypromine, may increase the central neurotoxic effects of the Atomoxetine. These agents should not be administered within 14 days of each other. (source: Drug Bank)
trazodone - atomoxetine The 2D6 inhibitor, Trazodone, may increase the efficacy of Atomoxetine by decreasing Atomoxetine metabolism and clearance. Monitor for changes in Atomoxetine efficacy if Trazodone is initiated, discontinued or dose changed. (source: Drug Bank)
trazodone - atomoxetine The 2D6 inhibitor, Trazodone, may increase the efficacy of Atomoxetine by decreasing Atomoxetine metabolism and clearance. Monitor for changes in Atomoxetine efficacy if Trazodone is initiated, discontinued or dose changed. (source: Drug Bank)
triprolidine - atomoxetine The CNS depressants, Triprolidine and Atomoxetine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
triprolidine - atomoxetine The CNS depressants, Triprolidine and Atomoxetine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to atomoxetine: 31

No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Single Dose, CYP2D6 Genotype-Stratified Pharmacokinetic Study of Atomoxetine in Children with ADHD. Clinical pharmacology and therapeutics. 2015. Brown Jacob T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Effect of 24 Cytochrome P450 2D6 Variants Found in the Chinese Population on Atomoxetine Metabolism in vitro. Pharmacology. 2016. Liang Bingqing, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Effects of the CYP2D6*10 allele on the pharmacokinetics of atomoxetine and its metabolites. Archives of pharmacal research. 2015. Byeon Ji-Yeong, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
CYP2D6 predicted metabolizer status and safety in adult patients with attention-deficit hyperactivity disorder participating in a large placebo-controlled atomoxetine maintenance of response clinical trial. Journal of clinical pharmacology. 2015. Fijal Bonnie A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Atomoxetine pharmacogenetics: associations with pharmacokinetics, treatment response and tolerability. Pharmacogenomics. 2015. Brown Jacob T, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacology and pharmacogenetics of pediatric ADHD with associated aggression: a review. The Psychiatric quarterly. 2013. Patel Bianca D, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Adrenergic neurotransmitter system transporter and receptor genes associated with atomoxetine response in attention-deficit hyperactivity disorder children. Journal of neural transmission (Vienna, Austria : 1996). 2013. Yang Li, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Challenges in pharmacogenetics. European journal of clinical pharmacology. 2013. Cascorbi Ingolf, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Effects of atomoxetine on the QT interval in healthy CYP2D6 poor metabolizers. British journal of clinical pharmacology. 2013. Loghin Corina, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Pharmacokinetics, safety, and tolerability of atomoxetine and effect of CYP2D6*10/*10 genotype in healthy Japanese men. Journal of clinical pharmacology. 2012. Matsui A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Inter-individual variability of in vivo CYP2D6 activity in different genotypes. Drug metabolism and pharmacokinetics. 2012. Chiba Koji, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Prospective-retrospective biomarker analysis for regulatory consideration: white paper from the industry pharmacogenomics working group. Pharmacogenomics. 2011. Patterson Scott D, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pediatric pharmacogenetic and pharmacogenomic studies: the current state and future perspectives. European journal of clinical pharmacology. 2011. Russo Roberta, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Pharmacogenetics: From Bench to Byte- An Update of Guidelines. Clinical pharmacology and therapeutics. 2011. Swen J J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Systematic review of pharmacoeconomic studies of pharmacogenomic tests. Pharmacogenomics. 2010. Beaulieu Mathieu, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Recognition of impaired atomoxetine metabolism because of low CYP2D6 activity. Pediatric neurology. 2010. ter Laak Maureen A, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
A haplotype of the norepinephrine transporter (Net) gene Slc6a2 is associated with clinical response to atomoxetine in attention-deficit hyperactivity disorder (ADHD). Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2009. Ramoz Nicolas, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available VIP No VIP available
Cytochrome P450 2D6. Pharmacogenetics and genomics. 2009. Owen Ryan P, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
ADME pharmacogenetics: current practices and future outlook. Expert opinion on drug metabolism & toxicology. 2009. Grossman Iris. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Functional pharmacogenetics/genomics of human cytochromes P450 involved in drug biotransformation. Analytical and bioanalytical chemistry. 2008. Zanger Ulrich M, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
PhRMA white paper on ADME pharmacogenomics. Journal of clinical pharmacology. 2008. Williams J Andrew, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
CYP2D6 metabolizer status and atomoxetine dosing in children and adolescents with ADHD. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2008. Trzepacz Paula T, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Atomoxetine pharmacokinetics in healthy Chinese subjects and effect of the CYP2D6*10 allele. British journal of clinical pharmacology. 2007. Cui Yi M, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Comparative metabolic capabilities and inhibitory profiles of CYP2D6.1, CYP2D6.10, and CYP2D6.17. Drug metabolism and disposition: the biological fate of chemicals. 2007. Shen Hongwu, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Combined overdose of atomoxetine and methylphenidate in a cytochrome P450 2D6 poor metabolizer. Journal of clinical psychopharmacology. 2007. Reimers Arne, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
CYP2D6 and clinical response to atomoxetine in children and adolescents with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry. 2007. Michelson David, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Potential interactions of methylphenidate and atomoxetine with dextromethorphan. Journal of the American Pharmacists Association : JAPhA. 2006. Ciccone Patrick E, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Atomoxetine hydrochloride: clinical drug-drug interaction prediction and outcome. The Journal of pharmacology and experimental therapeutics. 2004. Sauer John-Michael, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Disposition and metabolic fate of atomoxetine hydrochloride: the role of CYP2D6 in human disposition and metabolism. Drug metabolism and disposition: the biological fate of chemicals. 2003. Sauer John-Michael, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Identification of the human cytochromes P450 responsible for atomoxetine metabolism. Drug metabolism and disposition: the biological fate of chemicals. 2002. Ring Barbara J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Atomoxetine in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a randomized, placebo-controlled, dose-response study. Pediatrics. 2001. Michelson D, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0002-3227-30
DrugBank:
DB00289
ChEBI:
127342
KEGG Drug:
D02574
PubChem Compound:
54841
PubChem Substance:
214424
46506160
Drugs Product Database (DPD):
2262800
BindingDB:
50133749
ChemSpider:
49516
Therapeutic Targets Database:
DAP000721
FDA Drug Label at DailyMed:
309de576-c318-404a-bc15-660c2b1876fb

Clinical Trials

These are trials that mention atomoxetine and are related to either pharmacogenetics or pharmacogenomics.

No trials found.

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Sources for PharmGKB drug information: DrugBank, PubChem.