Doxepin

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Mar 08, 2024

Warnings

Doxepin Risks, Warnings, and Complications

Doxepin can cause serious health problems in some people. Talk to your doctor or pharmacist about other ways to treat depression if you are at increased risk of complications from doxepin use.

SUICIDAL THOUGHTS AND BEHAVIOR: Taking antidepressant drugs, including doxepin, can lead to an increase in suicidal thinking and behavior in people below 24 years of age with major depressive disorder. However, suicidality appears to be decreased in geriatric patients above 65 years of age. Tell your doctor immediately if you develop worsening symptoms of depression, mood changes, or suicidal thoughts or behavior. The risk is especially high when you first start treatment and after dose changes.
SCREENING FOR BIPOLAR DISORDER: An episode of depression can be the presenting symptom in people with bipolar disorder. Using antidepressant drugs to treat depression in individuals with manic depressive disorders can trigger a manic/mixed episode. Before starting doxepin, tell your doctor if you have a personal or family history of bipolar disorder or other psychiatric illnesses.
ANGLE CLOSURE GLAUCOMA: Doxepin can cause dilatation (widening) of the pupils, which can trigger an attack of angle closure glaucoma (increased pressure inside the eye). Tell your doctor if you have a history of eye problems before starting antidepressant therapy. Call your doctor immediately if you develop eye pain, swelling, or vision changes while on this medicine.
PREGNANCY AND LACTATION: Based on animal studies, doxepin does not appear to cause fetal harm. However, randomized placebo-controlled trials have not been done in humans to confirm if this antidepressant drug is safe during pregnancy. There are reports of drowsiness and apnea (brief periods of stopped breathing) in infants nursed on breast milk by mothers who were taking doxepin. Tell your doctor if you are pregnant or breast-feeding.

Precautions Before Starting Doxepin

Tell your healthcare provider if you have ever had an allergic reaction to doxepin, any of the active or inactive ingredients in doxepin capsules or liquid concentrate, loxapine, amoxapine, other tricyclic antidepressants, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal remedies. This can help avoid possible drug interactions.

Give your doctor a complete medical history. Doxepin may not be safe for people with certain medical conditions such as urinary problems, glaucoma, asthma, liver disease, kidney disease, or alcohol abuse.

Older adults (above 65 years of age) should talk to their doctor about the risks versus benefits of doxepin drug therapy. There may be other safer medications available.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breast-feeding.

Precautions During Use of Doxepin

Keep all your healthcare appointments while on doxepin. Your doctor may adjust your dose based on your response.

Doxepin can make you drowsy and dizzy. Do not drive a car or operate machinery until you know how this medicine affects you. Avoid drinking alcohol while on doxepin because alcohol can make side effects worse.

Doxepin can make your skin sensitive to sunlight. Wear protective clothing and sunblock and avoid unnecessary exposure to UV radiation.

Tell your doctor that you are on doxepin before any surgery, including dental procedures.

Tell your doctor if you become pregnant while on doxepin.

Call your doctor for medical advice without delay if you develop any unusual behavior or mood changes during doxepin therapy.

Seek emergency medical attention if you develop eye pain, swelling, redness, or vision changes, such as seeing colored rings surrounding lights.

Doxepin Drug Interactions

Certain drugs can affect how doxepin works. A drug interaction can increase the risk of severe adverse reactions.

Tell your healthcare professional if you are taking monoamine oxidase inhibitors (MAO inhibitors) such as selegiline (Eldepryl, Emsam, Zelapar), isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and methylene blue, or you have taken these drugs in the past 14 days. Your doctor will tell you not to take doxepin if this is the case.

Also, tell your doctor if you have taken fluoxetine (Prozac) within the past 5 weeks.

The following other drugs can have interactions with doxepin:

Antipsychotic drugs such as chlorpromazine, thioridazine, perphenazine, fluphenazine, prochlorperazine (Compro, Procomp), and trifluoperazine
Antidepressants such as bupropion (Wellbutrin, Zyban, in Contrave)
Antidepressants such as duloxetine (Cymbalta)
Antidepressants called selective serotonin reuptake inhibitors (SSRIs), for example, fluoxetine (Prozac, Selfemra, Sarafem, in Symbyax), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), sertraline (Zoloft), and paroxetine (Brisdelle, Paxil, Pexeva)
H2 blockers such as cimetidine (Tagamet)
Medications prescribed for an irregular heart rhythm, such as flecainide (Tambocor), quinidine (in Nuedexta), and propafenone (Rythmol)
Diabetes medications such as tolazamide (Tolinase)

The above list may not describe all possible interactions of doxepin. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, OTC (non-prescription) medications, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

Find the best discount on Doxepin »