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Published: 5 March 2015

Atomoxetine and Raynaud's Phenomenon

Prescriber Update 36(1): 3
March 2015

Key Messages

  • Raynaud's phenomenon is a very rare (<0.1%) reaction associated with atomoxetine.
  • Patients should be encouraged to seek medical attention if they experience symptoms in their hands including sensations of coldness, burning pain, paraesthesias or intermittent colour changes of one or more digits.
  • If Raynaud's phenomenon is diagnosed then atomoxetine treatment may need to be withdrawn.


The Centre for Adverse Reactions Monitoring (CARM) has received a report of Raynaud's phenomenon in a very young patient who was being treated with atomoxetine. The patient exhibited severe Raynaud's phenomenon that resolved as soon as atomoxetine was discontinued. This case report highlights a rare reaction to atomoxetine which can be extremely painful for patients. The association between atomoxetine and Raynaud's phenomenon is listed as very rare (<0.1%) in the data sheet.1

Atomoxetine is a non-stimulant treatment indicated for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults and children six years of age and older.1 Raynaud's phenomenon is a reversible vasospasm in parts of the hand in response to cold, emotional stress or vibration. 2 Symptoms of Raynaud's phenomenon include sensations of coldness, burning pain, paraesthesias or intermittent colour changes of one or more digits. If left untreated, Raynaud's phenomenon may result in tissue loss or digital gangrene.2

The primary treatments for Raynaud's phenomenon are to avoid cold and other triggers. Medical treatment may include calcium channel blockers for vasodilation.

Healthcare professionals should advise patients and caregivers to seek medical attention if they experience symptoms of Raynaud's phenomenon in the first few months after starting atomoxetine.

Please report all suspicions of medicine adverse reactions to CARM.

References
  1. Eli Lilly and Company (NZ) Limited. 2013. Strattera Data Sheet. 6 August 2013. URL: www.medsafe.govt.nz/profs/datasheet/s/Stratteracap.pdf (accessed 12 January 2015).
  2. Merck Manual Online. 2014. Raynaud Syndrome. URL: www.merckmanuals.com/professional/cardiovascular_disorders/peripheral_arterial_disorders/raynaud_syndrome.html?qt=raynaud&alt=sh (accessed 12 January 2015).
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