Doxepin

CAUTION:
Studies have shown that children and teenagers who take antidepressants ('mood elevators') such as doxepin may be more likely to think about harming or killing themselves or to plan or try to do so than children who do not take antidepressants. Children younger than 18 years of age should not normally take doxepin.If your child’s doctor has prescribed doxepin for your child, you should watch his or her behavior very carefully, especially at the beginning of treatment and any time his or her dose is increased or decreased. Your child may develop serious symptoms very suddenly, so it is important to pay attention to his or her behavior every day. Call your child’s doctor right away if he or she experiences any of these symptoms: new or worsening depression; thinking about harming or killing him- or herself or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling or staying asleep; irritability; aggressive behavior; acting without thinking; severe restlessness; frenzied abnormal excitement, or any other sudden or unusual changes in behavior.Your child’s doctor will want to see your child often while he or she is taking doxepin, especially at the beginning of his or her treatment.Your child’s doctor may also want to speak with you or your child by telephone from time to time.

O  General Information and Indications:

Doxepin, an antidepressant, is used to treat depression and anxiety.

O  Information For Users:

Doxepin comes as a capsule or concentrate (oral liquid) to take by mouth. It is usually taken one to three times a day and may be taken with or without food. Follow the directions on your prescription label, ask your doctor or pharmacist If you have any questions. Take doxepin exactly as directed. Do not take more or less of it or take it more often than prescribed by your health care provider.

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 4 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). If you take doxepin concentrate and methadone syrup, the two liquids can be mixed together with Gatorade, lemonade, orange juice, Tang, or water but not with grape juice.

Continue taking doxepin even if you feel well. Do not discontinue taking doxepin without informing your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

O  Special precautions:

o Inform your doctor or pharmacist if you have allergy to doxepin or any other medications.
o Inform your doctor and pharmacist what prescription and nonprescription drugs you are taking or have taken within the last 2 weeks, especially antihistamines; anticoagulants [warfarin (Coumadin)]; cimetidine (Tagamet); estrogens; fluoxetine (Prozac); levodopa (Sinemet, Larodopa); lithium (Eskalith, Lithobid); MAO inhibitors [phenelzine (Nardil), tranylcypromine (Parnate)]; medication for high blood pressure, seizures, Parkinson's disease, diabetes, asthma, colds, or allergies; methylphenidate (Ritalin); muscle relaxants; oral contraceptives; sedatives; sleeping pills; thyroid medications; tranquilizers; and vitamins.
o Inform your doctor if you or anyone in your family has or has ever had depression, bipolar disorder (mood that changes from depressed to abnormally excited), or mania (frenzied, abnormally excited mood), or if you or anyone in your family has thought about or attempted suicide. Also inform your doctor if you are breast-feeding glaucoma, an enlarged prostate, difficulty in urination, diabetes, seizures, an overactive thyroid gland, or liver, kidney, or heart disease.
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this drug, call your doctor without delay.
o if you are having surgery, including dental surgery, Inform your doctor or dentist that you are taking doxepin.
o you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
o remember that alcohol can add to the drowsiness caused by this drug.
o Inform your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.
o you should know that your mental health may change in unexpected ways, especially at the beginning of your treatment and any time that your dose is increased or decreased. These changes may occur at any time if you have depression or another mental illness, whether or not you are taking doxepin or any other medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

O  Possible Adverse Effects:

Side effects from doxepin are common:

o upset stomach
o drowsiness
o tiredness or weakness
o anxiety or excitemen
o insomnia (sleeplessness)
o nightmares
o dry mouth
o skin more sensitive to sunlight than usual
o changes in appetite or weight

Inform your doctor if any of the following symptoms are severe or do not go away:

o constipation
o difficulty in urination
o frequent urination
o blurred vision (Impaired vision)
o changes in sex drive or ability, impotence
o excessive sweating (hyperhidrosis)

If you experience any of the following symptoms or those listed in the CAUTION section, call your doctor without delay:

o jaw, neck, and back muscle spasms
o slow or difficult speech
o shuffling walk
o persistent fine tremor or inability to sit still
o fever
o difficulty swallowing or breathing
o severe skin rash
o yellowing of the skin or eyes, jaundice
o irregular heartbeat

O  Brand Name(s):

o Adapin®
o Sinequan®