Description
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Stratter’s indications
Treatment of attention deficit hyperactivity disorder (ADHD) in children over the age of 6 years, as well as in adolescents and adults, as part of a comprehensive treatment program.
The use of Stratter
Treatment should be carried out by an ADHD treatment specialist. The diagnosis should be made in accordance with the criteria of the diagnostic and statistical manual of mental disorders IV revision (DSM-IV) or the basic principles of ICD-10 (ICD-10). For oral use. The drug can be used as a single daily dose in the morning with or without food. For patients in whom the use of Strattera as a single daily dose does not give a satisfactory clinical effect, it may be recommended to use it 2 times a day, in the morning and after lunch, with a uniform dose distribution. Dosage for children / adolescents with a body weight of up to 70 kg. Treatment should begin with a total daily dose of about 0.5 mg / kg of body weight. This dose should be maintained for at least 7 days before increasing the dose, depending on the clinical response and tolerability. The recommended maintenance dose is approximately 1.2 mg/ kg/ day (depending on the patient’s weight and atomoxetine dosage). There is no additional effect from doses of more than 1.2 mg / kg / day. The safety of single doses of more than 1.8 mg/kg/day and total daily doses of more than 1.8 mg/kg has not been systematically evaluated. The duration of treatment is determined individually. In some cases, treatment is possible until adulthood. Dosage for children / adolescents with a body weight of more than 70 kg. The initial total daily dose is 40 mg. This dose should be maintained for at least 7 days before increasing the dose, depending on the clinical response and tolerability. The recommended maintenance dose is 80 mg. There is no additional effect from doses of more than 80 mg. The maximum recommended total daily dose is 100 mg. The safety of single doses over 120 mg and total daily doses over 150 mg has not been systematically evaluated. The duration of treatment is determined individually. In some cases, it may be advisable to treat up to adulthood. Additional information on the safety of the use of this drug. Atomoxetine should be used in accordance with national clinical guidelines regarding the treatment of ADHD, if any. There were no pronounced withdrawal symptoms described in the research program. In cases of significant negative effects, the use of atomoxetine may be discontinued immediately or by gradually reducing the dose. If patients continue treatment with atomoxetine for more than 1 year, it is recommended to re-determine the need for therapy by an ADHD specialist. For adolescents whose symptoms persist after reaching adulthood and in whom the benefits of treatment are clearly determined, it may be advisable to continue treatment until adulthood. However, it is impractical to start treating a patient in adulthood. The comprehensive treatment program, as a rule, includes psychological, educational and social measures and is aimed at stabilizing the condition of children with behavioral syndrome, which is characterized by symptoms that may include chronic prolonged insufficient attention, a tendency to distraction, emotional lability, impulsivity, moderate or severe hyperactivity, minor neurological symptoms and EEG abnormalities. Learning disability is not necessary. Pharmacological treatment is not indicated for all children with this syndrome, and the decision regarding the use of medication should be based on a very careful assessment of the severity of symptoms in a child, taking into account his age, persistence and severity of symptoms. Special groups of liver failure. For patients with moderate hepatic insufficiency (class B on the Child-Pugh scale), the initial and final doses should be reduced to 50% of the usual dose. For patients with severe hepatic insufficiency (class C on the Child-Pugh scale), the initial dose and final doses should be reduced to 25% of the usual dose. Kidney failure. Patients with end-stage renal insufficiency were exposed to a higher systemic effect of atomoxetine than healthy subjects (an increase of approximately 65%), but no differences were observed if the effect was adjusted for the dose per unit body weight. Thus, Stratter can be prescribed to patients with ADHD with end-stage renal insufficiency or with a lower level of renal insufficiency using the usual dosage regimen. Atomoxetine may exacerbate hypertension in patients with end-stage renal failure. Approximately 7% of the representatives of the Caucasian race have a genotype that corresponds to the non-functional CYP 2D6 enzyme (the so-called “slow metabolizers” of CYP 2D6). Patients with this genotype experience several times greater exposure to atomoxetine compared to patients with a functional enzyme. Thus, slow metabolizers are more susceptible to the risk of negative phenomena. For patients with a genotype corresponding to slow metabolizers, a lower initial dose and a slower dose increase are recommended. Elderly patients. The drug is not used
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