$Unique_ID{BRK01938}
$Pretitle{}
$Title{DOXEPIN}
$Subject{Adapin (Pennwalt)
doxepin (various manufacturers)
Sinequan (Fisons)}
$Volume{}
$Log{
Sinequan*0193801.scf}

Copyright (C) 1991 Publications International, Ltd.


DOXEPIN
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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,
increasing the possibility of side effects.
     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 tricyclic antidepressants 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 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, nortriptyline).
     * 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.

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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.
