What is Doxepin HCL


What Is Doxepin (Silenor)?

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Doxepin is the generic form of the brand-name drug Silenor, a prescription medication used to treat anxiety and depression.

It's also used to treat insomnia (trouble with sleeping).

Doxepin belongs to a group of drugs called tricyclic antidepressants, which increase the brain's levels of serotonin and norepinephrine, two chemicals known as neurotransmitters that relay messages in the brain.

Doxepin Warnings

You should not take doxepin if you have glaucoma or problems with urination.

Doxepin is safe for elderly people, but there may be an increased risk of confusion or drowsiness. Dosing may also differ due to decreased kidney function or heart problems.

Doxepin is not approved for use in children under age 12.

Do not use if you are allergic to doxepin or to similar medications such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

Do not use doxepin if you have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days. A dangerous drug interaction could occur.

MAOIs include:

  • Furazolidone (Furoxone)
  • Isocarboxazid (Marplan)
  • Linezolid (Zyvox)
  • Phenelzine (Nardil)
  • Rasagiline (Azilect)
  • Selegiline (Emsam)
  • Tranylcypromine (Parnate)

Report any new or worsening symptoms to your doctor, including:

  • Behavior or mood changes, such as feeling impulsive, irritable, agitated, hostile, aggressive, or restless
  • Anxiety
  • Panic attacks
  • Trouble sleeping
  • Increased depression
  • Suicidal thoughts or thoughts of harming yourself
  • Hyperactivity (mental or physical)

To make sure doxepin is safe for you, tell your doctor if you have:

Some children, teenagers, and young adults have thoughts of suicide when first taking an antidepressant.

Your doctor will need to check your progress at regular visits while you are using doxepin.

Your family or other caregivers should also be alert to changes in your mood or symptoms.

Doxepin and Pregnancy

It's not known whether doxepin will harm an unborn baby.

Tell your doctor if you are pregnant or might become pregnant while using this medication.

Doxepin is excreted into human breast milk in small amounts. Respiratory depression has been reported in one breastfeeding infant.

The American Academy of Pediatrics classifies doxepin as a drug "whose effect on nursing infants is unknown but may be of concern," so it's best not to breastfeed while taking this medication.

Do not give this medicine to a child without medical advice.

Doxepin Side Effects

Doxepin may cause side effects. Call your doctor if any of these symptoms are severe or do not go away:

  • Nausea
  • Drowsiness
  • Weakness or tiredness
  • Nightmares
  • Dry mouth
  • Skin more sensitive to sunlight than usual
  • Changes in appetite or weight
  • Constipation
  • Difficulty urinating
  • Frequent urination
  • Blurred vision
  • Changes in sex drive or ability
  • Excessive sweating

If you experience any of the following symptoms, call your doctor immediately:

  • Jaw, neck, and back muscle spasms
  • Slow or difficult speech
  • Shuffling walk
  • Uncontrollable shaking of a part of the body
  • Fever
  • Difficulty breathing or swallowing
  • Rash
  • Yellowing of the skin or eyes
  • Irregular heartbeat

Doxepin Interactions

Taking doxepin with other drugs that make you sleepy or slow your breathing can increase these effects.

Ask your doctor before taking doxepin with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking doxepin, tell your doctor if you have used a selective serotonin-reuptake inhibitor or SSRI antidepressant in the past five weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

You must wait at least five weeks after stopping fluoxetine (Prozac) before you can take doxepin.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with doxepin, especially:

This list is not complete and many other drugs can interact with doxepin.

This includes prescription and over-the-counter (OTC) medicines, vitamins, herbal supplements, and recreational drugs.

Give a list of all your medicines to any healthcare provider who treats you.

Doxepin and Alcohol

Do not drink alcohol while taking doxepin.

Doxepin can increase the effects of alcohol, which could be dangerous.

Doxepin may impair your thinking or reaction time, so avoid driving or operating heavy machinery until you're aware of its effects on you.

Doxepin Dosage

The usual dose of doxepin is 75 to 300 milligrams (mg) daily, administered at bedtime or in three divided doses.

The average daily dose is 150 mg daily. Optimal improvement in depressive symptoms is seen after two to three weeks; anti-anxiety effects occur much sooner.

Doxepin comes as a capsule, a tablet, or concentrate (liquid) to take by mouth.

It's usually taken one to three times a day and may be taken with or without food.

Try to take doxepin at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Take doxepin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Doxepin concentrate (oral liquid) comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper.

Dilute the concentrate in four ounces (120 mL) of water; whole or skim milk; or orange, grapefruit, tomato, prune, or pineapple juice just before taking it. Do not mix it with carbonated beverages (soft drinks).

It may take several weeks or longer for you to feel the full effect of doxepin. Continue to take doxepin even if you feel well.

Do not stop taking doxepin without talking to your doctor. Your doctor will probably want to decrease your dose gradually.

Doxepin Overdose

Call 911 or a poison control line at 1-800-222-1222.

An overdose of doxepin can be fatal.

Missed Dose of Doxepin

Take the missed dose as soon as you remember.

Skip the missed dose if it's almost time for your next scheduled dose.

Do not take extra medicine to make up the missed dose.

Doxepin Pictures

Doxepin 10 mg-WAT, beige, capsule
Doxepin 75 mg-MYL, green, capsule
Doxepin 50 mg-WAT, yellow, capsule
Doxepin 100 mg-PAR, green/white, capsule
Doxepin 50 mg-MYL, white, capsule
Doxepin 100 mg-MYL, green/white, capsule
Doxepin 75 mg-PAR, green, capsule
Doxepin 100 mg-WAT, green/white, capsule
Doxepin 50 mg-PAR, white, capsule
Doxepin 150 mg-PAR, blue/white, capsule
Doxepin 75 mg-WAT, green, capsule
Doxepin 25 mg-PAR, white/yellow, capsule
Doxepin 10 mg-MYL, white, capsule
Doxepin 25 mg-MYL, white/yellow, capsule
Doxepin 25 mg-WAT, white/yellow, capsule
Doxepin 10 mg-PAR, white, capsule

Doxepin FAQ

Q: What is doxepin 25 mg used for?

A: Doxepin is in a group of drugs called tricyclic antidepressants. Doxepin affects chemicals in the brain that may become unbalanced. Doxepin is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions. Doxepin may also be used for other purposes. Kristen Dore, PharmD

Q: I take doxepin daily to help me sleep and help pain due to fibromyalgia. I know from taking it previously for depression that it makes me crave sweets and have a huge appetite. I found out I had diabetes last year. I am wondering if the doxepin is making my weight fluctuate? I have lost 50 lbs, but have not been able to lose any more.

A: Doxepin is in a drug class called tricyclic antidepressants. Doxepin is used to treat depression and anxiety, which may be associated with a variety of conditions. Doxepin works by increasing certain natural brain substances, which are needed for mental health. According to Doxepin’s prescribing information, weight gain has been occasionally observed as a side effect of doxepin. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. There are many causes of weight fluctuations. Derek Dore, PharmD

Q: Is doxepin the same when the generic is made by several different drug companies?

A: According to the FDA, regulations state the every doxepin product must be within 90 percent of its stated strength on the label. Furthermore, each generic formulation must undergo testing illustrating that the medication's absorption, deposition and metabolism is very similar to the results from the brand, from its original NDA submission. With that said, there have been occasions where the generic formulation is not comparable to the brand name or even other generics and has caused significant problems. From our perspective, many of the generic companies are now actually owned or at least partially owned by the larger drug manufacturers, and quality control has been improving. For the generic manufacturers that are not owned or operated by the larger drug manufacturers, they are in most cases, publicly owned companies and their reputation can be ruined with one bad lot. For that reason, it is my belief that generic companies are trying harder than ever to make a product that is commensurate with the original brand name substance. In some cases, you may find that the generic may actually be an improvement over the original brand. Matt Curley, PharmD

By Katie Coronado | Medically Reviewed by Sherry Brooks, MD

Latest Update: 2014-09-16
Copyright © 2014 Everyday Health Media, LLC

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