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Doxepin (By mouth)

Doxepin (DOX-e-pin)

Treats depression, anxiety, and sleep disorders. This medicine is a tricyclic antidepressant (TCA).

Brand Name(s):

Silenor

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

You should not use this medicine if you have had an allergic reaction to doxepin, or other tricyclic antidepressants (such as Elavil® or Tofranil®), maprotiline (Ludiomil®), or trazodone (Desyrel®). Do not use this medicine if you have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days. Do not use this medicine if you have narrow-angle glaucoma, bipolar disorder, or problems passing urine.

How to Use This Medicine:

Capsule, Liquid, Tablet

  • Take your medicine as directed.
  • If you are using the Sinequan® oral liquid or capsule once a day, you may take it at bedtime.
  • To use the Sinequan® oral liquid:
    • Measure the dose with the marked dropper that comes with the medicine.
    • It must be mixed with one-half glass (4 ounces) of water, milk, or fruit juice (orange, grapefruit, tomato, prune, or pineapple) before you drink it. Do not use grape juice or carbonated beverages (soda pop). Mix the medicine just before taking the dose. Do not prepare it ahead of time.
  • To use the Silenor® tablet:
    • Do not take the tablet within 3 hours of a meal. It may not work as well, or it might make you sleepy the next day if you take it with or right after a meal.
    • Take the tablet 30 minutes before going to bed, when you are ready to go to sleep.
    • Do not take the medicine unless you can get a full night's sleep (7 to 8 hours). If you wake up too soon, you may feel drowsy from the medicine.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • If you use only one dose at bedtime, skip the missed dose and wait until the next night. You should not use two doses in the same day.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you are using disulfiram (Antabuse®), cimetidine (Tagamet®), tolazamide (Tolinase®), a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®), or certain medicines for heart rhythm problems (such as flecainide, propafenone, quinidine, Cardioquin®, Quinaglute®, Rythmol®, or Tambocor®).
  • Tell your doctor if you have used other medicines for depression (such as citalopram, escitalopram, fluoxetine, paroxetine, sertraline, Celexa®, Lexapro?, Paxil®, Prozac®, or Zoloft®).
  • Do not drink alcohol while you are using this medicine.
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, breathing problems, severe sleep apnea (breathing stops during sleeping), or a history of mental illness.
  • For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor or your child's doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or are getting worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depression) or has tried to commit suicide.
  • If you are using the Sinequan® oral capsule or liquid for depression, it may take 2 to 3 weeks before you or your child start to feel better.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • Silenor® tablets may cause sleep-related behaviors such as driving a car (sleep-driving), walking (sleep-walking), having sex, making phone calls, or preparing and eating food while asleep or not fully awake. If any of these reactions occur, tell your doctor right away.
  • If you think you need to take Silenor® tablets for more than 10 days, talk to your doctor.
  • This medicine may make you drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are drowsy or not alert.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Changes in behavior, or thoughts of hurting yourself or others.
  • Fast, pounding, or uneven heartbeat.
  • Feeling nervous, restless, anxious, agitated, or excited for no reason.
  • Fever, chills, cough, sore throat, and body aches.
  • Jerky muscle movement you cannot control (often in your face, tongue, or jaw).
  • Lightheadedness or fainting.
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
  • Problems with balance or walking.
  • Problems with urination.
  • Ringing, buzzing, or other unexplained noise in the ears.
  • Seizures or tremors.
  • Severe confusion, or seeing or hearing things that are not there.
  • Sleepiness or unusual drowsiness.
  • Swelling in your hands, ankles, or feet.
  • Trouble sleeping.
  • Twitching or muscle movements you cannot control.
  • Unexplained fever, chills, or sweating.
  • Unusual bleeding or bruising.
  • Unusual tiredness or weakness.
  • Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

  • Blurred vision.
  • Change in taste.
  • Constipation, diarrhea, nausea, vomiting, or upset stomach.
  • Drowsiness or dizziness.
  • Dry mouth or mouth sores.
  • Hair loss.
  • Headache.
  • Problems having sex.
  • Sensitivity to sunlight.
  • Skin rash or itching.
  • Stuffy or runny nose.
  • Swelling in the scrotum or testicles.
  • Swelling of the breasts or breast soreness in both females and males.
  • Warmth or redness in your face, neck, arms, or upper chest.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088


Last Updated: 7/4/2014


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