Sinequan

Generic Name: doxepin (Sinequan) (DOX e pin)

Brand Names: SINEquan

What is doxepin (Sinequan)?

Doxepin is in a group of drugs called tricyclic antidepressants. Doxepin affects chemicals in the brain that may become unbalanced.

Doxepin (Sinequan or other generic name) is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions.

Doxepin may also be used for purposes not listed in this medication guide.

What is the most important information I should know about doxepin (Sinequan)?

You should not use doxepin if you are allergic to it, or if you have glaucoma or problems with urination. Do not use doxepin if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take doxepin before the MAO inhibitor has cleared from your body.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking doxepin (Sinequan)?

You should not use doxepin if you are allergic to it, or if you have glaucoma or problems with urination. Do not use doxepin if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take doxepin before the MAO inhibitor has cleared from your body.

To make sure you can safely take doxepin, tell your doctor if you have any of these other conditions:

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  sleep apnea (breathing stops during sleep); or

  
  


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  bipolar disorder (manic-depression).

  
  


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  diabetes (doxepin may raise or lower blood sugar).

  
  

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. It is not known whether doxepin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. It is not known whether doxepin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give doxepin to anyone younger than 18 years old without the advice of a doctor.

How should I take doxepin (Sinequan)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Measure doxepin oral concentrate (liquid) with the special dose-measuring dropper provided. Do not use a regular table spoon. If you do not have a dose-measuring dropper, ask your pharmacist for one.

Empty the measured dose from the medicine dropper into a small glass (4 ounces) of water, milk, orange juice, grapefruit juice, tomato juice, prune juice, or pineapple juice. Do not use grape juice or a carbonated soft drink to mix doxepin oral concentrate. Stir the mixture and drink all of it right away. Do not save it for later use.

It may take 2 to 3 weeks before your depression symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Do not stop using doxepin suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using doxepin. Store at room temperature away from moisture, heat, and light.

See also: Sinequan dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of doxepin can be fatal.

Overdose symptoms may include uneven heartbeats, extreme drowsiness, agitation, vomiting, dilated pupils, blurred vision, confusion, hallucinations, feeling hot or cold, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.

What should I avoid while taking doxepin (Sinequan)?

Do not drink alcohol. Doxepin can increase the effects of alcohol, which could be dangerous. Doxepin may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Doxepin (Sinequan) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

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  fast heart rate;

  
  


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  confusion, hallucinations, unusual thoughts, seizure (convulsions);

  
  


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  easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  
  


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  feeling like you might pass out;

  
  


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  restless muscle movements in your eyes, tongue, jaw, or neck;

  
  


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  tremors or uncontrollable shaking;

  
  


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  urinating less than usual or not at all; or

  
  


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  extreme thirst with headache, nausea, vomiting, and weakness.

  
  

Less serious side effects may include:

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  feeling dizzy, drowsy, or tired;

  
  


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  nausea, vomiting, diarrhea, constipation, loss of appetite;

  
  


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  dry mouth, increased sweating;

  
  


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  weight gain;

  
  


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  lack of coordination;

  
  


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  numbness or tingly feeling;

  
  


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  blurred vision, headache, ringing in your ears;

  
  


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  mild skin rash or itching;

  
  


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  decreased sex drive; or

  
  


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  breast swelling (in men).

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect doxepin (Sinequan)?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by doxepin. Tell your doctor if you regularly use any of these medicines, or any other antidepressant.

Before taking doxepin, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Tell your doctor about all other medicines you use, especially:

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  cimetidine (Tagamet);

  
  


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  tolazamide (Tolinase);

  
  


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  heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Quin-G); or

  
  


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  phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine (Trilafon), prochlorperazine (Compazine, Compro), promethazine (Pentazine, Phenergan, Anergan, Antinaus), thioridazine (Mellaril), or trifluoperazine (Stelazine), and others.

  
  

There are many other drugs that can interact with doxepin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

More Sinequan resources

• Sinequan Side Effects (in more detail)
• Sinequan Dosage
• Sinequan Use in Pregnancy & Breastfeeding
• Drug Images
• Sinequan Drug Interactions
• Sinequan Support Group
• 2 Reviews for Sinequan - Add your own review/rating

• Sinequan Prescribing Information (FDA)


• Sinequan Monograph (AHFS DI)


• Sinequan Advanced Consumer (Micromedex) - Includes Dosage Information


• Sinequan MedFacts Consumer Leaflet (Wolters Kluwer)


• Doxepin MedFacts Consumer Leaflet (Wolters Kluwer)


• Doxepin Prescribing Information (FDA)


• Doxepin Hydrochloride Monograph (AHFS DI)


• Silenor Consumer Overview

Compare Sinequan with other medications

• Anxiety
• Depression
• Insomnia
• Reflex Sympathetic Dystrophy Syndrome
• Urticaria

Where can I get more information?

• Your pharmacist can provide more information about doxepin (Sinequan).

See also: Sinequan side effects (in more detail)