Doxepin
Why this is used
Doxepin is used to treat depression and anxiety. Doxepin is in a class of medications called tricyclic antidepressants. It works by increasing the amounts of certain natural substances in the brain that are needed for mental balance.
How to take it
Doxepin comes as a capsule, a tablet, or concentrate (liquid) to take by mouth. It is 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 4 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.
Side effects
<p></p> <p></p> <p></p> <p>Doxepin may cause side effects. Call your doctor if any of these symptoms are severe or do not go away:
<ul>
<li>
nausea</li>
<li>
drowsiness</li>
<li>
weakness or tiredness</li>
<li>
nightmares</li>
<li>
dry mouth</li>
<li>
skin more sensitive to sunlight than usual</li>
<li>
changes in appetite or weight</li>
<li>
constipation</li>
<li>
difficulty urinating</li>
<li>
frequent urination</li>
<li>
blurred vision</li>
<li>
changes in sex drive or ability</li>
<li>
excessive sweating</li></ul></p> <p></p> <p>If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
<ul>
<li>
jaw, neck, and back muscle spasms</li>
<li>
slow or difficult speech</li>
<li>
shuffling walk</li>
<li>
uncontrollable shaking of a part of the body</li>
<li>
fever</li>
<li>
difficulty breathing or swallowing</li>
<li>
rash</li>
<li>
yellowing of the skin or eyes</li>
<li>
irregular heartbeat</li></ul>If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at <a href='http://www.fda.gov/Safety/MedWatch'>http://www.fda.gov/Safety/MedWatch</a>] or by phone [1-800-332-1088].Doxepin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.</p>
<ul>
<li>
nausea</li>
<li>
drowsiness</li>
<li>
weakness or tiredness</li>
<li>
nightmares</li>
<li>
dry mouth</li>
<li>
skin more sensitive to sunlight than usual</li>
<li>
changes in appetite or weight</li>
<li>
constipation</li>
<li>
difficulty urinating</li>
<li>
frequent urination</li>
<li>
blurred vision</li>
<li>
changes in sex drive or ability</li>
<li>
excessive sweating</li></ul></p> <p></p> <p>If you experience any of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately:
<ul>
<li>
jaw, neck, and back muscle spasms</li>
<li>
slow or difficult speech</li>
<li>
shuffling walk</li>
<li>
uncontrollable shaking of a part of the body</li>
<li>
fever</li>
<li>
difficulty breathing or swallowing</li>
<li>
rash</li>
<li>
yellowing of the skin or eyes</li>
<li>
irregular heartbeat</li></ul>If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at <a href='http://www.fda.gov/Safety/MedWatch'>http://www.fda.gov/Safety/MedWatch</a>] or by phone [1-800-332-1088].Doxepin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.</p>
Precautions
Before taking doxepin, tell your doctor and pharmacist if you are allergic to doxepin, amoxapine, or any other medications. tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Your doctor will probably tell you not to take doxepin. If you stop taking doxepin, you should wait at least 14 days before you start to take an MAO inhibitor. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antihistamines; anticoagulants (blood thinners) such as warfarin (Coumadin); cimetidine (Tagamet); flecainide (Tambocor); levodopa (Larodopa, Sinemet); lithium (Eskalith, Lithobid); medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; propafenone (Rythmol); quinidine; sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); sleeping pills; thyroid medications; tolazamide (Tolinase); and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Your doctor may tell you not to take doxepin if you have taken fluoxetine in the past 5 weeks. tell your doctor if you have or have ever had glaucoma (an eye condition) or difficulty urinating. Your doctor will probably tell you not to take doxepin. tell your doctor if you have or have ever had an enlarged prostate (a male reproductive gland), diabetes, seizures, an overactive thyroid gland, or liver, kidney, or heart disease. talk to your doctor about the risks and benefits of taking doxepin if you are 65 years of age or older. Older adults should not usually take doxepin because it is not as safe or effective as other medications that can be used to treat the same condition. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking doxepin. you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. remember that alcohol can add to the drowsiness caused by this medication.
Overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Educational reference only — talk to a pharmacist or prescriber about Doxepin.