Antidepressants.
Medicines for depression.
An antidepressant is a medication designed to treat or alleviate the symptoms of clinical depression. Some antidepressants, notably the tricyclics, are commonly used off-label in the treatment of neuropathic pain, whether or not the patient is depressed. Smaller doses are generally used for this purpose, and they often take effect more quickly. Many antidepressants also are used for the treatment of anxiety disorders, and tricyclic antidepressants are used in the treatment of chronic pain disorders such as chronic functional abdominal pain (CFAP), myofascial pain syndrome, and post-herpetic neuralgia.
Brand Name: Adapin, Sinequan
Generic Name Doxepin
What are doxepin capsules?
DOXEPIN (Sinequan®) belongs to a group of medicines called tricyclic antidepressants. Doxepin can lift your spirits and relieve your depression. Generic doxepin capsules are available.
What should my health care professional know before I take doxepin?
They need to know if you have any of these conditions:
•If you frequently drink alcohol-containing beverages
•asthma or breathing difficulties
•diabetes
•difficulty passing urine
•glaucoma
•heart disease, including a previous heart attack or abnormal heart beat/rhythm
•liver disease
•thyroid disease, including increased or decreased thyroid activity
•over 65 years old
•Parkinson's disease
•prostate trouble
•schizophrenia
•seizure disorder
•stomach disease, reflux or digestive disorders
•surgery scheduled
•an unusual or allergic reaction to doxepin, sulfites, tartrazine dye, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
How should I take this medicine?
Take doxepin capsules by mouth. Follow the directions on the prescription label. Swallow the capsules with a drink of water. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not stop taking except on your prescriber's advice.
Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.
Elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller doses.
What if I miss a dose?
If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. If you are only taking doxepin once a day at bedtime and forget your dose, check with your prescriber or health care professional before taking it in the morning.
What drug(s) may interact with doxepin?
Doxepin can interact with many other medicines. Some interactions can be very important. Make sure your prescriber or health care professional knows about all other medicines you are taking. Many important interactions are listed below:
Do not take doxepin with any of the following medications:
•astemizole (Hismanal®)
•cisapride (Propulsid®)
•probucol
•terfenadine (Seldane®)
•thioridazine (Mellaril®)
•medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®)
•other medicines for mental depression (may be duplicate therapies or cause additive side effects)
Doxepin may also interact with any of the following medications:
•alcohol
•antacids
•atropine and related drugs like hyoscyamine, scopolamine, tolterodine and others
•barbiturate medicines for inducing sleep or treating seizures (convulsions), such as phenobarbital
•blood thinners, such as warfarin
•bromocriptine
•bupropion
•cimetidine
•clonidine
•cocaine
•delavirdine
•diphenoxylate
•disulfiram
•donepezil
•drugs for treating HIV infection
•female hormones, including contraceptive or birth control pills and estrogen
•galantamine
•herbs and dietary supplements like ephedra (Ma huang), kava kava, SAM-e, St. John's wort, valerian, or others
•imatinib, STI-571
•kaolin; pectin
•labetalol
•levodopa and other medicines for movement problems like Parkinson's disease
•lithium
•medicines for anxiety or sleeping problems
•medicines for colds, flu and breathing difficulties, like pseudoephedrine
•medicines for hay fever or allergies (antihistamines)
•medicines for weight loss or appetite control
•medicines used to regulate abnormal heartbeat or to treat other heart conditions (examples: amiodarone, bepridil, disopyramide, dofetilide, encainide, flecainide, ibutilide, mibefradil, procainamide, propafenone, quinidine, and others)
•metoclopramide
•muscle relaxants, like cyclobenzaprine
•other medicines for mental or mood problems and psychotic disturbances
•prescription pain medications like morphine, codeine, tramadol and others
•procarbazine
•seizure (convulsion) or epilepsy medicine such as carbamazepine or phenytoin
•stimulants like dexmethylphenidate or methylphenidate
•some antibiotics (examples: erythromycin, gatifloxacin, levofloxacin, linezolid, moxifloxacin, sotalol, sparfloxacin)
•tacrine
•thyroid hormones such as levothyroxine
Tell your prescriber or health care professional: about all other medicines you are taking including non-prescription medicines; if you are a frequent user of drinks with caffeine or alcohol; if you smoke; or if you use illegal drugs. These can affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.
What side effects might I notice from taking doxepin?
Side effects that you should report to your prescriber or health care professional as soon as possible:
•blurred vision or eye pain
•breast enlargement in both males and females
•fainting spells
•fast heartbeat
•fever or chills, with increased sweating
•hallucinations (seeing or hearing things that are not really there)
•muscle stiffness or problems with movement
•pain or difficulty passing urine, loss of bladder control
•seizures (convulsions)
•sexual difficulties
•stomach pain
•swelling of the testicles
•tingling in feet or hands
•unusual bleeding or bruising
•unusual weakness or tiredness
Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
•anxiety
•confusion or nervousness
•constipation or diarrhea
•difficulty sleeping (insomnia)
•drowsiness or dizziness
•dry mouth
•nausea, vomiting
•skin rash, itching, increased sensitivity to sun or UV light
•weight gain
What should I watch for while taking doxepin?
Visit your prescriber or health care professional for regular checks on your progress. It can take several days before you feel the full effect of doxepin. If you have been taking doxepin regularly for some time, do not suddenly stop taking it. Ask your prescriber or health care professional for advice. Even after you stop taking doxepin it can still affect your body for several days.
If you are going to have surgery, tell your prescriber or health care professional that you are taking doxepin well before the scheduled date of surgery.
You may get dizzy, drowsy or have blurred vision; until you know how doxepin affects you, do not drive, use machinery, or do anything that needs mental alertness. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can increase the side effects of doxepin; avoid alcoholic drinks.
If you are diabetic, check your blood sugar levels more often than usual, especially during the first few weeks of treatment with doxepin. Doxepin can affect your blood sugar levels. Call your prescriber or health care professional for advice if you notice a change in the results of your urine or blood sugar tests.
Where can I keep my medicine?
Keep out of the reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Throw away any unused medicine after the expiration date.
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