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Table 2 Contraindications Listed on the SPC for Medications Licensed in the UK for ADHD

From: A systematic review of the safety information contained within the Summaries of Product Characteristics of medications licensed in the United Kingdom for Attention Deficit Hyperactivity Disorder. how does the safety prescribing advice compare with national guidance?

Category

Non-stimulant

Stimulants

Brand Name

Strattera®

Ritalin®

Concerta®

(18-36/27 mg)

Equasym XL®

Medikinet®

Medikinet XL®

(5/10-40 mg)

Not applicable

Generic Name

Atomoxetine

MPH

MPH

MPH

MPH

MPH

Dexamfetamine

General

       

Hypersensitivity

X

X

X

X

X

X

X

(Narrow angle) Glaucoma

(X)

X

X

X

X

X

X

With MAIOs/Within 14 days

X

X

X

X

X

X

X

Pregnancy/lactation

      

X

Pronounced anacidity of the stomach

     

X

 

With H2-receptor blockers/antacid therapy

     

X

 

Sucrose/lactose intolerances and related disorders

      

X

Porphyria

      

X

Pheochromocytoma

X

X

X

X

X

X

 

Psychiatric

       

Hyperexcitability

      

X

Severe depression

 

X

X

X

X

X

 

Anorexia nervosa

 

X

X

X

X

X

 

Psychopatho-logical personality structure

 

X

X

X

X

X

 

Suicidal tendency

 

X

X

X

X

X

 

Psychotic symptoms

 

X

X

X

X

X

 

Schizophrenia

 

X

X

X

X

X

 

Mania/bipolar disorder

 

X

X

X

X

X

 

Severe mood disorders

 

X

X

X

X

X

 

Drug or alcohol abuse

      

X

Endocrinological

       

Hyperthyroidism/thyrotoxicosis

 

X

X

X

X

X

X

Cardiac

       

Patients with severe cardiovascular § or cerebrovascular † disorders whose condition would be expected to deteriorate if they experienced increases in blood pressure or heart rate that could be clinically important

X

      

Pre existing cardiovascular disorders:§*

       

   Angina

 

X

X

X

X

X

 

   Life threatening arrhythmias and channelopathies

 

X

X

X

X

X

 

   (Moderate or) Severe hypertension

 

X

X

X

X

X

(X)

   Heart failure

 

X

X

X

X

X

 

   Myocardial infarction

 

X

X

X

X

X

 

   Arterial occlusive disease

 

X

X

X

X

X

 

   Haemodynamically significant congenital heart disease

 

X

X

X

X

X

 

   Cardiomyopathies

 

X

X

X

X

X

 

Known risk factors for cerebrovascular disorder

 

X

     

Structural cardiac abnormality

      

X

Symptomatic cardiovascular disease

      

X

Advanced arteriosclerosis

      

X

Pre-existing (severe) cerebrovascular disorders

(X)†

X

X

X

X

X

 

Neurological

       

Tourette's syndrome/similar dystonias

      

X

  1. *Categorised among pre-existing cardiovascular disorders and counted as one contraindication
  2. §Cardiovascular conditions listed on the atomoxetine SPC as examples of severe cardiovascular disorders
  3. †As specified and counted within cardiac contraindication for atomoxetine
  4. ADHD: attention deficit hyperactivity disorder; MAOI: monoamine oxidase inhibitors; MPH: methylphenidate; SPC: Summary of Product Characteristics; UK: United Kingdom
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Child and Adolescent Psychiatry and Mental Health

ISSN: 1753-2000