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Doxepin (Depression, Anxiety)

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A tiny number of kids, teenagers, and young adults (up to 24 years old) who took mood-elevating antidepressants like doxepin during clinical research developed suicide thoughts (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental diseases may have a higher risk of committing suicide than those who do not take these medications. However, experts disagree on how significant this risk is and how much it has to be taken into account when determining whether or not a kid or adolescent should take an antidepressant. Doxepin is often not recommended for use in children under the age of 18, although in some circumstances, a doctor may determine that it is the most effective treatment for a child’s illness.

Even if you are an adult above the age of 24, you should be aware that taking doxepin or other antidepressants may cause your mental health to change in unexpected ways. Suicidal thoughts may come to mind, especially at the start of treatment and whenever your dose is changed. Any of the following symptoms should prompt you, your family, or your carer to call your doctor immediately away: Depression that is either new or worsening, thoughts of self-harm or suicide, plans or attempts to do so, excessive worry, agitation, panic attacks, trouble falling or keeping asleep, aggressive conduct, irritability, acting without thinking, intense restlessness, and frenetic, unnatural excitement. Make sure your family or carer is aware of any symptoms that could be significant so they can contact the doctor on your behalf if you are unable to call for help.

If you are taking doxepin, your doctor will want to visit you frequently, especially at the start of your treatment. Make sure to show up for all of your doctor’s appointment times.

When you start doxepin therapy, your doctor or pharmacist will give you the manufacturer’s patient information leaflet (Medication Guide). If you have any questions, carefully read the material and contact your doctor or pharmacist. The FDA website also offers the Medication Guide.

No of your age, you, your parent, or your carer should discuss the advantages and disadvantages of treating your disease with an antidepressant or with alternative treatments with your doctor before starting an antidepressant. The dangers and advantages of not treating your ailment should also be discussed. You should be aware that your chance of committing suicide is significantly increased if you suffer from depression or any mental disorder. This risk is increased if you or a family member currently has, or previously had, bipolar disorder (depression followed by periods of extreme excitement) or mania (frenzied, abnormally excited mood), or if you have ever considered or tried suicide. Discuss your ailment, symptoms, and personal and family medical history with your doctor. What kind of treatment is best for you will be decided by both you and your doctor.

Why is this medication prescribed?

Doxepin is used to treat anxiety and depression. Doxepin belongs to the group of drugs known as tricyclic antidepressants. It functions by boosting the levels of specific organic compounds in the brain that are necessary for mental equilibrium.

For the treatment of insomnia, doxepin is also available as a tablet. Doxepin’s use for treating depression or anxiety is the only topic covered in this monograph. Read the doxepin monograph if you’re taking this drug for insomnia (insomnia).

How should this medicine be used?

Doxepin is available as a liquid concentrate or pill for oral use. It can be taken with or without food and is typically taken one to three times per day. Doxepin should ideally be taken every day at roughly the same time(s). Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Take doxepin precisely as advised. Never take it in larger or less amounts or more frequently than directed by your doctor.

The oral liquid form of doxepin concentration has a dropper with a dose marking on it. To learn how to use the dropper, ask your pharmacist to demonstrate. Just before taking the concentrate, dilute it in 4 ounces (120 mL) of water, whole or skim milk, orange, grapefruit, tomato, prune, or pineapple juice. Never combine it with fizzy drinks (soft drinks).

You might not experience doxepin’s full effects for a few weeks or longer. Doxepin should be taken even if you feel fine. Do not discontinue taking Doxepin before consulting your physician. Your dose should be gradually reduced, as recommended by your doctor.

Other uses for this medicine

Doxepin is also sometimes used to treat chronic hives without a known cause. The dangers of using this drug for your illness should be discussed with your doctor.

Other prescriptions for this drug are possible. For more information, consult your physician or pharmacist.

What special precautions should I follow?

Before taking doxepin,

  • If you have any allergies, including to doxepin, amoxapine, loxapine, any other drugs, or any of the substances in doxapine capsules or concentrate, notify your doctor and pharmacist right away.
  • Inform your doctor if you are currently using an MAO inhibitor, such as tranylcypromine (Parnate), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), or if you have stopped taking one within the last 14 days. Moreover, let your physician know if you are receiving or using linezolid or methylene blue (Provayblue) (Zyvox). Most likely, your doctor will advise against taking Doxepin. You should wait at least 14 days after stopping doxepin before starting an MAO inhibitor.
  • Inform your doctor and pharmacist about all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products that you are now taking or intend to use. Incorporate any of the following: a few antipsychotics, including bupropion (Wellbutrin, Zyban, and others, in Contrave); cimetidine (Tagamet); duloxetine (Cymbalta); flecainide (Tambocor); propafenone (Rythmol); and fluphenazine, perphenazine, prochlorperazine, prochlorperazine (Compro, Procomp); quinidine (in Nuedexta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and tolazamide are examples of selective serotonin reuptake inhibitors (SSRIs) (Tolinase). Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects. If you’ve recently taken fluoxetine, your doctor could advise against taking doxepin.
  • If you have glaucoma or trouble urinating, let your doctor know. Most likely, your doctor will advise against taking Doxepin.
  • Inform your doctor if you currently have or previously had asthma, liver or kidney problems, excessive alcohol consumption, or any of the aforementioned conditions.
  • Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you become pregnant while taking this medicine.
  • If you are 65 years of age or older, discuss the advantages and disadvantages of taking doxepin with your doctor. Doxepin is typically not recommended for usage in older individuals since it is less reliable and less efficient than alternative drugs that can be used to treat the same condition.
  • You should be aware that this medicine may cause you to feel sleepy. Prior to understanding how this drug affects you, avoid using machinery or driving a car.
  • Inquire with your doctor if drinking alcohol is okay for you to do so while taking doxepin. Doxepin’s adverse effects can be made worse by alcohol.
  • You must to be aware that doxepin may result in angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Before beginning this medicine, discuss having your eyes checked with your doctor. Call your doctor or get emergency medical attention as soon as possible if you have nausea, eye pain, vision changes such as seeing coloured rings around lights, or swelling or redness in or around the eyes.

What special dietary instructions should I follow?

Continue eating normally unless your doctor instructs you otherwise.

What should I do if I forget a dose?

If you miss a dosage, take it as soon as you recall. If your next dose is approaching, skip the missed one and carry on with your regular dosing regimen. To make up for a missing dose, do not take a second one.

What side effects can this medication cause?

Doxepin could have negative effects. If any of these symptoms are severe or do not go away, contact your doctor right once:

  • Nausea
  • Vomiting
  • Weakness or fatigue
  • Dizziness
  • Greater size of the pupils
  • Mouth ache
  • Oral sores
  • Skin that is more susceptible to the sun than usual
  • Flushing
  • Modifications to appetite or weight
  • Alterations in the flavours of items
  • Indigestion
  • Constipation
  • Diarrhea
  • Having trouble urinating
  • Excessive urination and thirst
  • Your ears are ringing.
  • Alterations in sex drive
  • Enlarged testicles
  • Expanding breast size
  • Females with milky breast discharge
  • Excessive perspiration
  • chills
  • Headache
  • Hair fall

Call your doctor right away if you have any of the following symptoms or any of those noted in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections:

  • Eyes or skin that have a yellow tint
  • Rapid heart rate
  • Uncommon bruising or bleeding
  • Irritation, rash, or swelling on the skin

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Further negative effects of doxepin are possible. If you have any strange side effects while taking this medicine, contact your doctor right once.

What should I know about storage and disposal of this medication?

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom). Doxepin pills should be kept away from light.

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your pharmacist or the garbage/recycling department in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at for additional information.

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning.

In case of emergency/overdose

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

  • Inconsistent heartbeat
  • Feeling restless, perplexed, or anxious
  • Difficulty concentrating
  • Seizures
  • Muscular rigidity
  • Vomiting
  • Greater size of the pupils
  • Hallucination (seeing things or hearing voices that do not exist)
  • Fever
  • Body temperature is low
  • Coma (loss of consciousness for a period of time)

What other information should I know?

Keep all of your doctor’s appointments.

No one else should take your medication. Any queries you may have regarding medication refills should be directed to your pharmacist.

You should keep a written record of every medication you take, including any over-the-counter (OTC) items, prescription drugs, and dietary supplements like vitamins and minerals. This list should be brought with you whenever you see a doctor or are admitted to the hospital. You should always have this information with you in case of emergencies.

Brand names

  • Sinequan® Capsules
  • Sinequan® Concentrated Solution
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