Atomoxetine; Vortioxetine/Strong 2D6 Inhibitors Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Bupropion, cinacalcet, fluoxetine, paroxetine, quinidine or terbinafine(taken by mouth) may slow down how quickly your liver processes atomoxetine or vortioxetine.

What might happen:

The amount of atomoxetine or vortioxetine in your blood may increase and cause more side effects than normal. Atomoxetine side effects may include increased blood pressure, faster heart rate, irritability, nausea, vomiting, or decreased appetite. Vortioxetine side effects may include headache, nausea, vomiting, dizziness, or abnormal dreams.

What you should do about this interaction:

Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to adjust the dose of your atomoxetine or vortioxetine. Let your doctor know if you have any side effects from your medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

  • 1.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/D rugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
  • 2.Trintellix (vortioxetine) US prescribing information. Takeda Pharmaceuticals America, Inc. April 11, 2017.
  • 3.Chen G, Lee R, Hojer AM, Buchbjerg JK, Serenko M, Zhao Z. Pharmacokinetic Drug Interactions Involving Vortioxetine (Lu AA21004), a Multimodal Antidepressant. Clin Drug Investig 2013 Oct;33(10):727-36.
  • 4.This information is based on or an extract from the UW Metabolism and Transport Drug Interaction Database (DIDB) Platform, Copyright University of Washington 1999-2014..
  • 5.Strattera (atomoxetine hydrochloride) US prescribing information. Eli Lilly and Company April, 2015.
  • 6.Pexeva (paroxetine mesylate) US prescribing information. Noven Therapeutics, LLC December, 2012.
  • 7.Belle DJ, Ernest CS, Sauer JM, Smith BP, Thomasson HR, Witcher JW. Effect of potent CYP2D6 inhibition by paroxetine on atomoxetine pharmacokinetics. J Clin Pharmacol 2002 Nov;42(11):1219-27.