Drug interactions
Atomoxetine + Procainamide
Severity: Major
Atomoxetine and Procainamide: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Procainamide is a class IA antiarrhythmic that prolongs the QT interval and carries a risk of torsades de pointes. Atomoxetine may add to this effect, increasing proarrhythmic risk.
What this interaction means in plain words
Atomoxetine and Procainamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive QT prolongation, with procainamide blocking cardiac potassium and sodium channels.
What to do
Avoid the combination where possible and use a non-QT-prolonging option for ADHD. If both are required, monitor ECG, QTc and electrolytes closely.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- ATOMAID 10 mg Capsules, Hard - SmPC sections 4.3/4.5 (class statement: class IA and III antiarrhythmics; "such as neuroleptics, class IA and III antiarrhythmics, moxifloxacin, erythromycin, methadone mefloquine, tricyclic antidepressants, lithium or cisapride") — electronic medicines compendium (UK SmPC)
Other interactions of Atomoxetine
- Atomoxetine + Isocarboxazid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Atomoxetine + Rasagiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Atomoxetine with Procainamide?
MediHelp rates the interaction as major. Atomoxetine and Procainamide can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Procainamide is a class IA antiarrhythmic that prolongs the QT interval and carries a risk of torsades de pointes. Atomoxetine may add to this effect, increasing proarrhythmic risk.
How serious is the interaction between Atomoxetine and Procainamide?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and use a non-QT-prolonging option for ADHD. If both are required, monitor ECG, QTc and electrolytes closely.
What other medicines interact with Atomoxetine?
MediHelp also lists interactions of Atomoxetine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Atomoxetine page.
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