Doxepin

Indications
 Oral
Depression
Adult: As hydrochloride: Initially, 75 mg daily adjusted according to response; up to 300 mg daily in severely depressed patients; 25-50 mg daily in mildly affected patients. Total daily dose >100 mg should be given in divided doses.
Child:
Contraindications
 Hypersensitivity; mania, glaucoma, neonates (topical); lactation.
Warnings / Precautions
 Epilepsy, CV disease, pregnancy, history of urinary retention, glaucoma; gradual withdrawal. May impair ability to drive or operate machinery.
Adverse Reactions
 Drowsiness, dizziness, confusion, headache, dry mouth, constipation, blurring of vision, hypotension, tachycardia, rashes. Topical: Burning, stinging, scaling, oedema and dryness.
Drug Interactions
 Methylphenidate may increase plasma doxepin levels.
Potentially Fatal: Potentiates hypertensive action of sympathomimetics. Increased anticholinergic effects with MAOIs. Additive CNS effects with anticholinergics, CNS depressants and alcohol.
See Below for More doxepin Drug Interactions
Mechanism of Actions
 Doxepin inhibits serotonin and norepinephrine re-uptake by the presynaptic neuronal membrane increasing its synaptic conc in the CNS.
Absorption: Readily absorbed from the GIT (oral).
Distribution: Widely distributed; crosses the blood-brain barrier; enters breast milk. Protein-binding: Extensive.
Metabolism: Extensively hepatic via demethylation to desmethyldoxepin, hydroxylation, N-oxidation.
Excretion: Urine (as metabolites); 8-24 hrs (elimination half-life).
Administration
 May be taken with or without food.
Storage Conditions
 Oral: Store at 15-30°C.
ATC Classification
 N06AA12 - doxepin ; Belongs to the class of non-selective monoamine reuptake inhibitors. Used in the management of depression.
Storage
 Oral: Store at 15-30°C.
Available As
  • Doxepin 10 mg
  • Doxepin 25 mg
  • Doxepin 3.30% w/w
  • Doxepin 5% w/v
  • Doxepin 5% w/w
  • Doxepin 75 mg

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