Doxepin

Description

Doxepin is an antidepressant medicine. It is used to treat insomnia (trouble falling and staying asleep), depression (a mental condition that negatively affects your mood and ability to carry out daily activities) and anxiety (a feeling of fear or panic). It is also used as a cream to relieve skin itching caused by skin conditions such as eczema (dry, red, itchy and bumpy skin with irritation). Doxepin is available on prescription in a tablet, capsule and cream form. Doxepin shows some common side effects like nausea, vomiting, dry mouth, constipation, dizziness, etc. Consult your doctor if these symptoms stay for a long time or if they become severe. Doxepin should be taken exactly as advised by your doctor. Take it at the same time every day. as it will help you to remember. Do not skip doses or discontinue the treatment without consulting your doctor as it may cause withdrawal symptoms such as fatigue, sleep disturbances, irritability, etc. To avoid these, gradual dose reduction is necessary under your doctor’s supervision. Doxepin should be avoided if you are allergic to it. Inform your doctor if you have diabetes, liver problems, or a history of seizures (a condition that occurs due to abnormal brain activity causing fits) or glaucoma (an eye condition that occurs due to increased pressure within the eyeballs) before taking this medicine. Inform your doctor about your current medicines to avoid any undesired effects. Consult your doctor if you are pregnant, planning a pregnancy, or are breastfeeding. Children below 12 years of age should not take Doxepin.

Side effects

Major & minor side effects for Doxepin

  • Dizziness
  • Drowsiness
  • Headache
  • Confusion
  • Tremors
  • Increased heartbeat
  • Skin rash
  • Indigestion
  • Altered sense of taste
  • Loss of appetite
  • Constipation
  • Dry mouth
  • Blurred vision
  • Hypotension
  • Nausea
  • Burning or stinging sensation at application site

Uses of Doxepin

What is it prescribed for?

  • Depression
  • Anxiety
  • Insomnia
  • Eczema
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Concerns

Commonly asked questions

  • Onset of action
    Doxepin has a slow onset of action and may take 4 to 6 weeks to show its anti-depressant effects.
  • Duration of effect
    The amount of time for which Doxepin remains active in your body is not clinically established.
  • Safe with alcohol?
    Consumption of alcohol is not recommended during treatment with Doxepin as it may increase the risk of side effects such as drowsiness, confusion, blurred vision, sweating, muscle stiffness, light-headedness, etc.
  • Is it habit forming?
    No habit forming tendencies were reported for Doxepin.
  • Usage in pregnancy?
    Doxepin is not recommended for use during pregnancy as it may harm your foetus. Consult your doctor if you are pregnant.
  • Usage while breast-feeding?
    Doxepin passes into breastmilk and may cause side effects in your baby. This medicine is not recommended for use if you are breastfeeding.

Allergy

Avoid taking Doxepin if you are allergic to it. Seek immediate medical attention if you notice any symptoms such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulty, etc.

Glaucoma

Glaucoma is a condition in which the optic nerve (the nerve connecting the eye to the brain) is damaged, usually due to high pressure within your eyeballs. Doxepin is not recommended if you have glaucoma as this medicine may increase the pressure within your eyeballs and worsen your condition.

Urinary retention

Urinary retention is a condition in which you cannot empty your bladder (the organ in which urine is stored) completely when you urinate. Doxepin should not be taken if you have such a condition as this medicine may increase your risk of urinary retention.
Warnings for special population

Pregnancy

Doxepin is not recommended for use during pregnancy as it may harm your foetus. Consult your doctor if you are pregnant.

Breast-feeding

Doxepin passes into breastmilk and may cause side effects in your baby. This medicine is not recommended for use if you are breastfeeding.
General warnings

Elderly

Doxepin should be used with caution in elderly people due to the increased risk of side effects. Appropriate dose adjustments may be necessary based on the clinical condition.

Suicidal tendencies

Doxepin should be used with caution due to the increased risk of suicidal thoughts. Closely monitor for any change in behaviour or mood while taking this medicine. Consult your doctor immediately if you experience any change in behaviour or suicidal thoughts.

Use in children

Doxepin is not recommended for use in children below 12 years of age due to a lack of safety and efficacy data.

Driving or operating machines

Doxepin may increase your risk of dizziness and sleepiness. Hence, avoid driving or operating machines if you experience these symptoms.

Withdrawal symptoms

Doxepin should not be discontinued suddenly as it may result in withdrawal symptoms such as headache, weakness, fatigue, sleep disturbances, irritability. etc. Gradual dose reduction should be done over a period under your doctor's supervision.

Missed Dose

Tablet and capsule: If a dose of Doxepin is missed, take the dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and take the next dose. Do not double the dose to make up for the missed one. Cream: Apply the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and apply the next dose. Do not apply extra cream to make up for the missed dose.

Overdose

Seek emergency medical treatment or contact the doctor in case of an overdose of Doxepin.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol

Description

N/A

Instructions

Consumption of alcohol is not recommended during treatment with Doxepin as it may increase the risk of side effects such as drowsiness, confusion, blurred vision, sweating, muscle stiffness, light-headedness, etc.
Interaction with Medicine

Linezolid

Ondansetron

Warfarin

Fluoxetine

Disease interactions

Phaeochromocytoma

Phaeochromocytoma is a rare tumour of the adrenal glands (a small gland located on top of your kidney that is responsible for producing chemical substances known as hormones). Doxepin should be used with caution if you have phaeochromocytoma as it may further worsen your condition.

Seizure disorders

Seizure is a condition that occurs due to disturbed nerve cell activity in your brain resulting in abnormal behaviour and loss of consciousness. Doxepin should be used with caution if you have a history of seizures as this medicine may trigger seizures.

Heart Disease

Doxepin may cause orthostatic hypotension (a sudden drop in blood pressure when standing up from a sitting/lying down position), irregular heartbeats, QT prolongation (a condition in which your heart muscles take a longer time to recharge between a heartbeat), heart attack or stroke (a decrease in blood supply to your brain). Hence, this medicine should be used with caution if you have heart problems. Consult your doctor before starting the treatment with this medicine.

Diabetes

Doxepin should be used with caution if you have diabetes (high blood sugar levels) due to the increased risk of altered blood sugar levels. Regularly monitor your blood sugar levels while taking this medicine.

Bone marrow suppression

Bone marrow suppression is a condition in which there is decreased production of blood cells in your bone marrow (a spongy substance present at the centre of your bones). Doxepin should be taken with caution if you have bone marrow suppression as it may cause a further decrease in blood counts.

Tardive Dyskinesia

Tardive dyskinesia is a neurological condition with repetitive, involuntary body movements. Doxepin should be used with caution if you have tardive dyskinesia as it may further worsen your condition.

Liver Disease

Doxepin is broken down in your liver. Hence, this medicine should be used with caution if you have pre-existing liver problems due to the increased risk of severe side effects. It may also cause further liver damage. Your doctor may suggest tests to periodically monitor your liver function and liver enzyme levels while you are taking this medicine.

Hyperthyroidism

Hyperthyroidism is a condition that occurs due to high levels of thyroid hormone in your body. Doxepin should be taken with caution if you have hyperthyroidism due to the increased risk of developing an irregular heartbeat.
Food interactions
Information not available.
Lab interactions
Information not available.
Tablet and capsule: Take Doxepin exactly as instructed by the doctor. Do not take larger amounts than prescribed. Seek emergency medical treatment in case of any severe side effects. Ensure that the course of treatment is completed. Do not stop the use of this medicine without consulting your doctor. Cream: Apply Doxepin as instructed by the doctor. Do not apply in larger amounts than prescribed. Seek emergency medical treatment in case of any severe side effects. Do not use this cream for more than 8 days.
Miscelleneous

Can be taken with or without food, as advised by your doctor

To be taken as instructed by doctor

Causes sleepiness

How it works
Doxepin works by increasing the levels of chemical substances in your brain and improving your mood. Doxepin cream works by decreasing the production of certain chemicals (such as histamine) which reduces inflammation (swelling), itching, and redness of your skin.
Legal Status

Approved

Approved

Approved

Unknown

Classification

Category

Tricyclic antidepressants, Anxiolytics, sedatives, and hypnotics, Topical antihistamines

Schedule

Schedule H

Drugs, H., 2021. Doxepin (Insomnia): MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: [Accessed 22 November 2021].

https://medlineplus.gov/druginfo/meds/a617017.html

Medicines.org.uk. 2021. [online] Available at: [Accessed 22 November 2021].

https://www.medicines.org.uk/emc/files/pil.8133.pdf

Dailymed.nlm.nih.gov. 2021. DailyMed - doxepin hydrochloride- Doxepin Hydrochloride capsule. [online] Available at: [Accessed 22 November 2021].

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=aa69c63c-ced6-4676-a16b-554f1af7d210

Drugs, H., 2021. Doxepin Topical: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: [Accessed 22 November 2021].

https://medlineplus.gov/druginfo/meds/a605040.html

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Information on this page was last updated on 23 Mar 2023

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