Doxepin (Silenor) is used to treat insomnia in patients who have trouble sleeping (having trouble falling asleep or staying asleep). Doxepin (Silenor) belongs to the tricyclic antidepressant drug class. It functions by reducing brain activity to promote sleep.

For the treatment of depression and anxiety, doxepin is also offered as a capsule and a liquid. Doxepin (Silenor), a medication for insomnia, is the only topic covered in this monograph. Read the doxepin monograph if you are using this drug for depression or anxiety (depression, anxiety).

Silenor, a brand name for doxepin, is available as an oral tablet. Within 30 minutes of going to bed, it is typically taken once daily. Do not take Silenor (doxepin) within three hours after eating. Ask your doctor or pharmacist to explain any instructions on your prescription label that you are unsure about following. Doxepin (Silenor) should be taken as prescribed. Never take it in larger or less amounts or more frequently than directed by your doctor.

Doxepin (Silenor) will likely make you quite tired right away, and you’ll probably stay sleepy for a while after taking it. Aim to stay in bed for seven to eight hours after taking doxepin (Silenor). If you won’t be able to fall asleep straight away and stay asleep for seven to eight hours after taking doxepin (Silenor), do not take it.

During the first few days of doxepin therapy, you should start to sleep better (Silenor). Call your doctor if your sleep quality does not improve or worsen after 7 to 10 days.

The manufacturer’s patient information sheet (Medication Guide) will be provided to you by your doctor or pharmacist when you start treatment with doxepin (Silenor) and at each time you get a prescription refill. If you have any questions, carefully read the material and contact your doctor or pharmacist. The Medication Guide is also available on the Food and Drug Administration (FDA) website at http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm.

Ask your doctor or pharmacist for more details if you believe this drug should be used for something else.

Before taking doxepin (Silenor),

• If you have an allergy to doxepin (Silenor), amoxapine, loxapine, any other drugs, or any of the ingredients in doxepin (Silenor) tablets, inform your doctor and pharmacist right away. For a list of the ingredients, consult the Medication Guide or speak with your pharmacist.
• 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 any additional prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are now taking or intend to use. Incorporate any of the following: drugs for allergies, a cold, or cough; cimetidine (Tagamet); quinidine (in Nuedexta); sedatives; SSRIs such fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); tolazamide, sedatives, and other sleeping medicines. Your doctor might need to adjust your medication doses or keep a close eye out for any negative side effects. Tell your doctor about all of the medications you are taking, including any that do not appear on this list, since many other drugs may also interact with doxepin (Silenor).
• Inform your physician if you have urinary retention or have previously had untreated glaucoma (inability to empty your bladder completely or at all). Your physician might advise against taking Doxepin (Silenor).
• Inform your doctor if you currently or in the past have abused prescription pharmaceuticals, street drugs, or excessive amounts of alcohol. Moreover, let your doctor know if you now or ever experienced depression, a mental illness, suicidal thoughts, sleep apnea (a sleep disorder when breathing stops for brief periods while you sleep), kidney disease, or liver disease.
• 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 doxepin (Silenor).
• You need to be aware that doxepin (Silenor) can cause you to feel sleepy. After taking doxepin at night, avoid operating machinery, operating a vehicle, and engaging in any other risky activity (Silenor). The following day, until you are aware of how this drug affects you, do not drive a car or use machinery.
• Alcohol may intensify the drowsiness brought on by this prescription, so you should be aware of that. Avoid drinking alcohol while taking doxepin (Silenor).
• You should be aware that doxepin (Silenor) users occasionally got out of bed to drive, prepare and consume food, have sex, make phone calls, or engage in other activities while not fully awake. These people frequently had no memory of what they had done when they awoke. If you discover that you were driving or engaging in any other strange behaviour while you were asleep, call your doctor straight once.

Keep eating normally unless your doctor instructs you otherwise.

Only take Doxepin (Silenor) before going to bed. If you are having problems falling asleep and did not take doxepin (Silenor) before bed, you may do so if you can stay in bed for at least 7 to 8 hours afterward. To make up for a missed dose, do not take a second dose of doxepin (Silenor).

Doxepin (Silenor) adverse effects could occur. If any of these symptoms are severe or do not go away, let your doctor know right once:

• Nausea
• Dizziness

Further negative effects of doxepin (Silenor) are possible. If you experience any strange issues while taking this medicine, contact your doctor right away.

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).

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

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 http://goo.gl/c4Rm4p 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. http://www.upandaway.org

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

Overdose symptoms could include:

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

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.