New cardiovascular advice for Strattera

The manufacturer of Strattera (atomoxetine) has clarified the recommendations for cardiovascular assessment before starting treatment.

Pre-existing conditions likely to deteriorate include severe hypertension, advanced heart failure, progressive unstable angina, cardiomyopathies, cerebral aneurysm, stroke and recent or recurrent MI
Pre-existing conditions likely to deteriorate include severe hypertension, advanced heart failure, progressive unstable angina, cardiomyopathies, cerebral aneurysm, stroke and recent or recurrent MI

In an analysis of pooled trial data, investigators noted a clinically significant increase in heart rate and blood pressure in 6-12 per cent of children and adults treated with atomoxetine.

The increase was similar to that observed in patients treated with methylphenidate.

In agreement with the MHRA, the following recommendations have been made:

  • Strattera is contraindicated in patients with severe cardiovascular or cerebrovascular disease that is likely to deteriorate following an increase in heart rate or blood pressure.
  • Strattera should be used with caution if underlying medical conditions could worsen if heart rate or blood pressure increases.
  • Assess patients for cardiac disease before starting Strattera and refer for specialist cardiac evaluation if heart disease is suspected.
  • Measure heart rate and blood pressure before starting treatment, during treatment, after dose adjustment and then at least every 6 months.
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