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Doxepin is the generic form of the brand-name drug Silenor, a prescription medication used to treat anxiety and depression.
It’s also used to treat insomnia (trouble with sleeping).
Doxepin belongs to a group of drugs called tricyclic antidepressants, which increase the brain’s levels of serotonin and norepinephrine, two chemicals known as neurotransmitters that relay messages in the brain.
Doxepin Warnings You should not take doxepin if you have glaucoma or problems with urination.
Doxepin is safe for elderly people, but there may be an increased risk of confusion or drowsiness.
Dosing may also differ due to decreased kidney function or heart problems.
Doxepin is not approved for use in children under age 12.
Do not use if you are allergic to doxepin or to similar medications such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).
Do not use doxepin if you have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days.
A dangerous drug interaction could occur.
MAOIs include: Furazolidone (Furoxone) Isocarboxazid (Marplan) Linezolid (Zyvox) Phenelzine (Nardil) Rasagiline (Azilect) Selegiline (Emsam) Tranylcypromine (Parnate) Report any new or worsening symptoms to your doctor, including: Behavior or mood changes, such as feeling impulsive, irritable, agitated, hostile, aggressive, or restless Anxiety Panic attacks Trouble sleeping Increased depression Suicidal thoughts or thoughts of harming yourself Hyperactivity (mental or physical) To make sure doxepin is safe for you, tell your doctor if you have: Sleep apnea (breathing stops during sleep) Diabetes (doxepin may raise or lower blood sugar) Bipolar disorder (manic-depression) Some children, teenagers, and young adults have thoughts of suicide when first taking an antidepressant.
Your doctor will need to check your progress at regular visits while you are using doxepin.
Your family or other caregivers should also be alert to changes in your mood or symptoms.
Doxepin and Pregnancy It’s not known whether doxepin will harm an unborn baby.
Tell your doctor if you are pregnant or might become pregnant while using this medication.
Doxepin is excreted into human breast milk in small amounts.
Respiratory depression has been reported in one breastfeeding infant.
The American Academy of Pediatrics classifies doxepin as a drug “whose effect on nursing infants is unknown but may be of concern,” so it’s best not to breastfeed while taking this medication.
Do not give this medicine to a child without medical advice.
BasicDescription Back to Top Doxepin Side Effects Doxepin may cause side effects.
Call your doctor if any of these symptoms are severe or do not go away: Nausea Drowsiness Weakness or tiredness Nightmares Dry mouth Skin more sensitive to sunlight than usual Changes in appetite or weight Constipation Difficulty urinating Frequent urination Blurred vision Changes in sex drive or ability Excessive sweating If you experience any of the following symptoms, call your doctor immediately: Jaw, neck, and back muscle spasms Slow or difficult speech Shuffling walk Uncontrollable shaking of a part of the body Fever Difficulty breathing or swallowing Rash Yellowing of the skin or eyes Irregular heartbeat Back to Top Doxepin Interactions Taking doxepin with other drugs that make you sleepy or slow your breathing can increase these effects.
Ask your doctor before taking doxepin with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Before taking doxepin, tell your doctor if you have used a selective serotonin-reuptake inhibitor or SSRI antidepressant in the past five weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).
You must wait at least five weeks after stopping fluoxetine ( Prozac ) before you can take doxepin.
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with doxepin, especially: Bupropion (Wellbutrin) Cimetidine (Tagamet) St.
John’s wort (Hypericum perforatum) Terbinafine (Lamisil) Tolazamide (Tolinase) Antidepressants or other medication used to treat mental illness Heart rhythm medications such as flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quinora) This list is not complete and many other drugs can interact with doxepin.
This includes prescription and over-the-counter (OTC) medicines, vitamins, herbal supplements, and recreational drugs.
Give a list of all your medicines to any healthcare provider who treats you.
Doxepin and Alcohol Do not drink alcohol while taking doxepin.
Doxepin can increase the effects of alcohol, which could be dangerous.
Doxepin may impair your thinking or reaction time, so avoid driving or operating heavy machinery until you’re aware of its effects on you.
Back to Top Doxepin Dosage The usual dose of doxepin is 75 to 300 milligrams (mg) daily, administered at bedtime or in three divided doses.
The average daily dose is 150 mg daily.
Optimal improvement in depressive symptoms is seen after two to three weeks; anti-anxiety effects occur much sooner.
Doxepin comes as a capsule, a tablet, or concentrate (liquid) to take by mouth.
It’s usually taken one to three times a day and may be taken with or without food.
Try to take doxepin at around the same time(s) every day.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take doxepin exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor.
Doxepin concentrate (oral liquid) comes with a specially marked dropper for measuring the dose.
Ask your pharmacist to show you how to use the dropper.
Dilute the concentrate in four ounces (120 mL) of water; whole or skim milk; or orange, grapefruit, tomato, prune, or pineapple juice just before taking it.
Do not mix it with carbonated beverages (soft drinks).
It may take several weeks or longer for you to feel the full effect of doxepin.
Continue to take doxepin even if you feel well.
Do not stop taking doxepin without talking to your doctor.
Your doctor will probably want to decrease your dose gradually.
Doxepin Overdose Call 911 or a poison control line at 1-800-222-1222.
An overdose of doxepin can be fatal.
Missed Dose of Doxepin Take the missed dose as soon as you remember.
Skip the missed dose if it’s almost time for your next scheduled dose.
Do not take extra medicine to make up the missed dose.
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