Atomoxetine (Straterra®)

Last Update: 08 May 2025

Medication

Table of content

1. What is it? 2. What are the risks according to research? 3. Breastfeeding/ chestfeeding 4. What about fathers and sperm donors? 5. Key points

Welcome to our fact sheet on atomoxetine during pregnancy and breastfeeding/chestfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.

The HEALTHY PREGNANCY HUB team is collaborating with MotherToBaby to share information on this topic. The original version is available here (March 2023).

Serene, our chatbot, can also answer your questions about medications during pregnancy.

Please note that this fact sheet is based on United States information and has been adapted for Canada, with a review by our Canadian experts. Minor differences may exist between the two countries. Always consult your healthcare professional for information tailored to your situation.

1. What is atomoxétine?

Methylphenidate is a stimulant medication that has been used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and sleep disorders (narcolepsy). It has also been used to lower appetite. Methylphenidate is sold under brand names including Ritalin®, Metadate®, Cotempla®, and Concerta®. A transdermal (skin) patch called Daytrana® is approved for children and adolescents in the United States.

Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.

2. What does research say about the risks during pregnancy?

I take atomoxetine, and I was told that I am a poor/slow metabolizer. What does that mean for my pregnancy?

Some people metabolize atomoxetine slower than others. People who are slow metabolizers might have higher levels of the medication in their blood. It is not known if this could affect a pregnancy differently than people who metabolize the medication more quickly.

I take atomoxetine. Can it make it harder for me to get pregnant?

Studies have not been done in humans to see if atomoxetine could make it harder to get pregnant. Animal studies did not show a change in fertility.

Does taking atomoxetine increase the chance for miscarriage?

Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not been done to see if atomoxetine could increase the chance of miscarriage.

Does taking atomoxetine increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Atomoxetine has not been well studied for use during pregnancy. Four human studies have not suggested a greater chance for birth defects. Most of these studies used a prescription database to see who had a prescription for atomoxetine during their pregnancy. This cannot tell us if the prescription for atomoxetine was taken during their pregnancy. When looking at doses typically used by humans, animal studies did not suggest an increased chance for birth defects. With levels higher than those used with human treatment, there is some question of a higher chance for birth defects. It is not known if this information would apply to people who are considered poor metabolizers.

Does taking atomoxetine in pregnancy increase the chance of other pregnancy-related problems?

It is not known if atomoxetine can cause other pregnancy-related problems. One study of 453 individuals who filled a prescription for atomoxetine during the first 20 weeks of pregnancy showed no increased chance for placental abruption (when the placenta pulls away from the wall of the uterus before labor starts), smallness for gestational age, preterm birth (birth before 37 weeks of pregnancy), or preeclampsia (dangerously high blood pressure).

Does taking atomoxetine in pregnancy cause long-term problems in behavior or learning for the child?

Few studies have been done to see if dextroamphetamine can increase the chance of behavior or learning issues for the child. A recent large study showed no increased risks on long-term outcomes.

3. Breastfeeding/ chestfeeding while taking atomoxetine

There are no studies on the use of atomoxetine while breastfeeding/chestfeeding. If breastfeeding/chestfeeding and taking the medication, and you suspect the baby has any symptoms such as excess sedation, contact the child’s healthcare provider. Be sure to talk to your healthcare provider about all your breastfeeding/chestfeeding questions.

4. What about fathers and sperm donors?

If a male takes atomoxetine, could it affect fertility (ability to get a person pregnant) or increase the chance of birth defects?

Studies have not been done to see if atomoxetine could affect a male’s fertility or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures here.

Key points

Atomoxetine (Strattera®) is a medication prescribed to treat attention deficit hyperactivity disorder (ADHD).
It is important not to stop or change this treatment without first talking to your healthcare provider.
There have been very few studies on atomoxetine during pregnancy. So, we don’t know if this medication could increase the risk of miscarriage, birth defects, or other complications. A large recent study did not find an increased risk of long-term problems for the child.
Atomoxetine has not been studied during breastfeeding or chestfeeding.
Always talk to your healthcare provider to discuss the benefits and risks of this treatment during pregnancy or while breastfeeding or chestfeeding.

References

Please click here to view references.

Disclaimer

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