What is the most important information I should know about doxepin?
You should not use this medicine if you have untreated narrow-angle glaucoma or severe problems with urination.
Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking doxepin and talk with your doctor.
What is doxepin?
Doxepin is a tricyclic antidepressant.
Doxepin capsules and oral concentrate (liquid) are used to treat symptoms of depression and/or anxiety associated with alcoholism, manic depression, or other mental illness.
Doxepin tablets (Silenor) are used to treat insomnia in people who have trouble staying asleep.
This medication guide provides only information about doxepin tablets for insomnia. Doxepin tablets are not for use in treating depression.
Doxepin may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking doxepin?
You should not use this medicine if you are allergic to doxepin, amoxapine, or loxapine, or if you have:
- untreated narrow-angle glaucoma; or
- severe urination problems.
Do not use doxepin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.
Tell your doctor if you have ever had:
- sleep apnea (breathing stops during sleep);
- depression, mental illness, or addiction to drugs or alcohol;
- kidney or liver disease;
- glaucoma; or
- urination problems.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breastfeed while using Silenor.
Silenor is not approved for use by anyone younger than 18 years old.
How should I take doxepin?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Take this medicine within 30 minutes before bedtime. Do not take within 3 hours after eating.
It may take 7 to 10 days before your insomnia symptoms improve. Keep using as directed and call your doctor if your symptoms do not improve after 10 days of treatment.
Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Do not take Silenor if you do not have time for a full night's sleep before being active again.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of doxepin can be fatal.
What should I avoid while taking doxepin?
Do not drink alcohol. Dangerous side effects or death could occur.
Avoid taking Silenor within 3 hours after eating a meal.
Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.
What are the possible side effects of doxepin?
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Some people using this medicine have engaged in activity while not fully awake and later had no memory of it. This may include walking, driving, or making phone calls. If this happens to you, call your doctor right away.
Call your doctor at once if you have:
- unusual thoughts or behavior;
- confusion, hallucinations;
- depressed mood, thoughts about hurting yourself;
- uncontrolled muscle movements;
- a seizure;
- a light-headed feeling, like you might pass out;
- blisters or ulcers in your mouth, red or swollen gums, trouble swallowing;
- eye pain or redness;
- chest pain;
-
low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet; or
-
signs of infection --flu-like symptoms, swelling, skin redness, diarrhea, skin sores or white patches, trouble breathing, pain or burning when you urinate.
Common side effects may include:
- drowsiness;
- nausea; or
- cold symptoms such as stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect doxepin?
Using Silenor with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.
Tell your doctor about all your other medicines, especially:
- cimetidine (Tagamet); or
- tolazamide (Tolinase).
This list is not complete. Other drugs may affect Silenor, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Where can I get more information?
Your pharmacist can provide more information about doxepin (tablets).
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2020 Cerner Multum, Inc. Version: 4.01. Revision date: 6/18/2020.
