Generic
Doxepin
5 brands available in the market
At a glance
Doxepin is a tricyclic antidepressant used for the treatment of insomnia, depression and anxiety disorders. It works by increasing levels of chemical messengers in the brain that stabilize and enhance mood.
Description
Doxepin is a tricyclic antidepressant. It inhibits serotonin and norepinephrine re-uptake, increasing their synaptic concentration in the CNS.
Indications
- Insomnia
- Depression
- Anxiety
Therapeutic class
Tricyclic antidepressant
Pharmacological class
H1 & H2-receptor antagonist
Pharmacology
Doxepin is a potent histamine H1- and H2-receptor antagonist. It inhibits serotonin and norepinephrine re-uptake, increasing their synaptic concentration in the CNS.
Mechanism of action
Doxepin inhibits serotonin and norepinephrine re-uptake by the presynaptic neuronal membrane, increasing its synaptic concentration in the CNS.
Dosage
Adult Dose: Depression/Anxiety: 25 mg/day start, gradually titrate upward; range 25-300 mg/day. Insomnia (Silenor): 3-6 mg within 30 minutes before bedtime; max 6 mg/day.
Elderly Dose: Insomnia: 3 mg before bedtime, may increase to 6 mg. Depression/Anxiety: 10 mg/day start, gradually adjust.
Administration
Oral tablet. Take in the dose and duration as advised. Do not chew, crush or break.
Missed dose
If you miss a dose of Doxepin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular schedule.
Side effects
Common Side Effects:
- Constipation
- Difficulty in urination
- Dryness in mouth
- Increased heart rate
- Orthostatic hypotension
- Weight gain
Precautions & warnings
- Helps treat insomnia, depression and anxiety.
- Inform doctor of behavioral changes, mood changes and suicidal thoughts.
- Regular blood tests may be needed to monitor blood cell count or sodium and sugar levels.
- Do not drive or do anything that requires concentration until you know how the medicine affects you.
Contraindications
- Hypersensitivity
- Mania
- Glaucoma
- Neonates (topical)
- Lactation
Drug interactions
Methylphenidate may increase plasma doxepin levels. Potentiates hypertensive action of sympathomimetics. Increased anticholinergic effects with MAOIs. Additive CNS effects with anticholinergics, CNS depressants and alcohol.
Food interactions
It is unsafe to consume alcohol with Doxepin.
Use in pregnancy
Doxepin may be unsafe during pregnancy. Animal studies have shown harmful effects. Doctor will weigh benefits and risks.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Doxepin is probably unsafe during breastfeeding. Limited human data suggests drug may pass into breastmilk and harm the baby. Monitor for excessive sleepiness and weight gain.
Pediatric use
Under 12 years: Not recommended.
Geriatric use
Lower initial dose and adjust gradually in elderly patients.
Renal / hepatic impairment
Renal impairment: Safe in kidney disease. No dose adjustment needed.
Hepatic impairment: Use with caution. Dose adjustment may be needed.
Overdose effects
Overdose may cause suicidal thoughts, confusion, loss of consciousness, seizures, heart problems. Seek emergency medical attention.
Storage conditions
Store in a cool and dry place, away from light. Keep out of reach of children.
Chemical structure
Doxepin