Psychopharmacologic Drugs : Other Mental Disorders
OSTRA1 “Strattera capsule” 18 mg/cap
OSTRA2 “Strattera capsule” 25 mg/cap
OSTRA3 “Strattera capsule” 40 mg/cap
OSTRA6 “Strattera capsule” 60 mg/cap
適應症：注意力缺損/過動症（ADHD）。
Usual dose:
ADHD:
Adult: 40 mg/day; increase after a minimum of 3 days to a target dose of approximately 80 mg/day, max. 100 mg/day may be considered after 2-4 additional wks in p’ts who have not achieved adequate response on lower doses.
Pediatric: (acute treatment)
(≧6yrs, ≦70 kg): 0.5 mg/kg/day; increase after a minimum of 3 days to a target dose of 1.2 mg/kg/day; max. Is 1.4 mg/kg/day or 100 mg/day (whichever is less).
(≧6yrs, >70 kg): 40 mg/day; increase after a minimum of 3 days to a target dose of approximately 80 mg/day; max.100 mg/day may be considered after 2- 4 additional weeks in patients who have not achieved adequate response on lower doses.
Pediatric: (maintenance) 1.2-1.8 mg/kg/day, max. 1.4 mg/kg/day or 100 mg/day, whichever is less (≦70 kg) or (> 70 kg)100 mg/day.
Concomitant strong CYP2D6 inhibitor therapy or CYP2D6 poor metabolizers, adults and children/adolescents > 70 kg: initial dose, 40 mg/day; increase to 80 mg/day only if symptoms do not improve after 4 wks and the initial dose is well tolerated; ≦70 kg: initial dose, 0.5 mg/kg/day ; increase up to 1.2 mg/kg/day only if symptoms do not improve after 4 wks and the initial dose is well tolerated.
Hepatic impairment (Child-Pugh Class B): initial and target doses reduced to 50% of the normal dose; (Child-Pugh Class C): initial and target doses reduced to 25% of the normal dose.
Contraindication:
MAO inhibitors use; narrow angle glaucoma; suicidal ideation has occurred with atomoxetine therapy; cardiovascular disease, cerebrovascular disease, hypertension, tachycardia; liver injury has been reported rarely; bipolar disorder.
Adverse effect:
Common: loss of appetite, abnormal behavior, restlessness, hypertension, tachyarrhythmia, thrombocytopenia, hallucinations.
Serious: contact dermatitis, decreased body growth, lowered convulsive threshold, tic, psychotic disorder, drug dependence.
健保使用規範：（93/9/1、96/5/1、96/9/1、97/5/1）
1.限六歲至十八歲（含），依 DSM 或 ICD 標準診斷為注意力不全過動症患者且對短效型 methylphenidate（如 Ritalin） 治療之副作用無法耐受，或治療一個月以上，療效不佳者使用，並於病歷上記載使用理由（96/9/1）。
2.如符合前項規定且已使用本類藥品治療半年以上，而十八歲後仍需服用者，需於病歷上詳細記載以往病史及使用理由（96/9/1）。
3.Atomoxetine HCl 原則上每日限使用 1 粒，惟每日劑量需超過 60mg 時，應於病歷中記載理由，則每日至多可使用 2 粒，每日最大劑量為 100mg（97/5/1）。