$Unique_ID{BRK03138} $Pretitle{} $Title{doxepin} $Subject{Adapin Pennwalt Sinequan Fisons Tricyclic antidepressant doxepin mental depression concentration certain chemicals nerve transmission brain} $Volume{} $Log{ Sinequan*0313801.scf} Copyright (C) 1993 Publications International, Ltd. doxepin ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) Adapin (Pennwalt) doxepin (various manufacturers) Sinequan (Fisons) TYPE OF DRUG Tricyclic antidepressant INGREDIENT doxepin DOSAGE FORMS Capsules (10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg) Oral concentrate (10 mg per ml) STORAGE Doxepin capsules and oral concentrate should be stored at room temperature in tightly closed containers. This medication should never be frozen. USES Doxepin is used to relieve the symptoms of mental depression. This medication belongs to a group of drugs referred to as the tricyclic antidepressants. These medicines are thought to relieve depression by increasing the concentration of certain chemicals necessary for nerve transmission in the brain. TREATMENT This medication should be taken exactly as your doctor prescribes. You can take it with food to lessen the chance of stomach irritation (unless your doctor tells you to do otherwise). Each dose of the oral concentrate should be diluted in at least four ounces (half a glass) of water, milk, or fruit juice just prior to administration. Measure the correct amount carefully with the dropper provided. DO NOT mix the medication with grape juice or with carbonated beverages, since they may decrease the medicine's effectiveness. If you miss a dose of this medication, take the missed dose as soon as possible, then return to your regular dosing schedule. If, however, the dose you missed was a once-a-day bedtime dose, do not take that dose in the morning; check with your doctor instead. If the dose is taken in the morning, it may cause some unwanted side effects. Never double the dose. The antidepressant effects of therapy with this medication may not become apparent for two or three weeks. SIDE EFFECTS Minor. Blurred vision, constipation, cramps, diarrhea, dizziness, drowsiness, dry mouth, fatigue, indigestion, insomnia, loss of appetite, nausea, peculiar tastes in the mouth, restlessness, sweating, vomiting, weakness, or weight gain or loss. As your body adjusts to the medication, these side effects should disappear. This drug may cause increased sensitivity to sunlight. Therefore, avoid prolonged exposure to sunlight and sunlamps. Wear protective clothing and use an effective sunscreen. Dry mouth can be relieved by chewing sugarless gum or by sucking on ice chips or a piece of hard candy. To relieve constipation, increase the amount of fiber in your diet (fresh fruits and vegetables, salads, bran, and whole-grain breads), exercise, and drink more water (unless your doctor directs you to do otherwise). To avoid dizziness or light-headedness when you stand, contract and relax the muscles of your legs for a few moments before rising. Do this by pushing one foot against the floor while raising the other foot slightly, alternating feet so that you are "pumping" your legs in a pedaling motion. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about agitation, anxiety, chest pain, confusion, convulsions, difficulty in urinating, enlarged or painful breasts (in both sexes), fainting, fever, fluid retention, hair loss, hallucinations, headaches, impotence, mood changes, mouth sores, nervousness, nightmares, numbness in the fingers or toes, palpitations, ringing in the ears, seizures, skin rash, sleep disorders, sore throat, a tendency to bleed or bruise, tremors, uncoordinated movements or balance problems, or yellowing of the eyes or skin. INTERACTIONS Doxepin interacts with a number of other types of medications: 1. Extreme drowsiness can occur when this medicine is taken with central nervous system depressants (such as alcohol, antihistamines, barbiturates, benzodiazepine tranquilizers, muscle relaxants, narcotics, pain medications, phenothiazine tranquilizers, and sleeping medications) or with other antidepressants. 2. Doxepin may decrease the effectiveness of antiseizure medications and may block the blood-pressure-lowering effects of clonidine and guanethidine. 3. Oral contraceptives (birth control pills) and estrogen-containing drugs can increase the side effects and reduce the effectiveness of the tricyclic antidepressants (including doxepin). 4. Cimetidine can decrease the elimination of doxepin from the body, which can increase the possibility that side effects will occur. 5. Tricyclic antidepressants may increase the side effects of thyroid medications and over-the-counter (nonprescription) cough, cold, allergy, asthma, sinus, and diet medications. 6. The concurrent use of this drug and monoamine oxidase (MAO) inhibitors should be avoided, because the combination may result in fever, convulsions, or high blood pressure. At least 14 days should separate the use of this drug and the use of an MAO inhibitor. BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor if you have had unusual or allergic reactions to any medications, especially to doxepin or any of the other tricyclic antidepressants (amitriptyline, imipramine, trimipramine, amoxapine, protriptyline, desipramine, maprotiline, and nortriptyline). * Be sure to tell your doctor if you have a history of alcoholism or if you have ever had asthma, high blood pressure, liver or kidney disease, heart disease, a heart attack, circulatory disease, stomach problems, intestinal problems, difficulty in urinating, enlarged prostate gland, epilepsy, glaucoma, thyroid disease, mental illness, or electroshock therapy. * If this drug makes you dizzy or drowsy, do not take part in any activity that requires alertness, such as driving a car or operating potentially dangerous equipment. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor or dentist that you are taking this medication. * Do not stop taking this drug suddenly. Abruptly stopping it can cause nausea, headache, stomach upset, fatigue, or a worsening of your condition. Your doctor may want to reduce the dosage gradually. * The effects of this medication may last as long as seven days after you have stopped taking it, so continue to observe all precautions during that period. * Be sure to tell your doctor if you are pregnant. The effects of this drug during pregnancy have not been thoroughly studied in humans. Studies in animals have shown that this medication can cause side effects to the fetus if given to the mother in large doses during pregnancy. Also, tell your doctor if you are breast-feeding an infant. Small amounts of this drug can pass into breast milk and may cause unwanted effects in the nursing infant. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.