Sinequan (Doxepin)
Class and Category of Drug
Before you buy Sinequan (Doxepin) online, read common information about the medication.
Chemical class: Dibenzoxepin derivative
Therapeutic class: Antidepressant
Pregnancy category: Not rated
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Drug Indications and Dosages
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To treat mild to moderate depression or anxiety
Capsules, Oral Solution
Adults and adolescents. 75 to 150 mg daily at bedtime. Maximum: 150 mg daily.
To treat mild to moderate depression or anxiety with organic disease
Capsules, Oral Solution
Adults and adolescents. 25 to 50 mg daily.
To treat severe depression or anxiety
Capsules, Oral Solution
Adults and adolescents. 50 mg t.i.d., gradually increased to 300 mg daily, as indicated.
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Incompatibilities
Don't mix doxepin solution with carbonated beverages or grape juice.
Contraindications of Drug
Read contraindications if you want cheap Sinequan (Doxepin) online.
Acute recovery phase of MI; concurrent use of MAO inhibitor; glaucoma; hypersensitivity to doxepin, other tricyclic antidepressants, or their components; urine retention
Generic Drug Interactions
Drugs
amantadine, anticholinergics, antidyskinetics, antihistamines: Possibly intensified anti-cholinergic effects, causing confusion, hallucinations, and nightmares
anticonvulsants: Possibly lowered seizure threshold and decreased effects of these drugs
antithyroid drugs: Possibly increased risk of agranulocytosis
barbiturates, carbamazepine: Increased doxepin metabolism, decreased blood doxepin level, possibly lowered seizure threshold
bupropion, clozapine, cyclobenzaprine, haloperidol, loxapine, maprotiline, molindone, phenothiazines, thioxanthenes: Possibly prolonged and intensified sedative and anti-cholinergic effects of either drug, possibly increased risk of seizures
cimetidine, flecainide, phenothiazines, propafenone, quinidine, selective serotonin reuptake inhibitors, tricyclic antidepressants: Increased blood doxepin level from inhibited systemic clearance, resulting in increased risk of toxicity
clonidine, guanadrel, guanethidine: Increased risk of hypertension, especially during second week of doxepin therapy
CNS depressants: Possibly potentiated CNS depression, hypotension, and respiratory depression
corticosteroids: Possibly worsened depression
directacting sympathomimetics, such as epinephrine and norepinephrine: Potentiated effects of these drugs
disulfiram: Possibly transient delirium
fluoxetine: Possibly increased blood doxepin level
MAO inhibitors: Possibly hyperpyrexia, hypertension, seizures, and death
oral anticoagulants: Possibly increased anticoagulant effects of these drugs
pimozide: Increased risk of arrhythmias
probucol: Possibly prolonged QT interval, increased risk of ventricular tachycardia
thyroid hormones: Possibly increased therapeutic and toxic effects of both drugs
tolazamide: Possibly severe hypoglycemia
Activities
alcohol use: Possibly enhanced CNS depression, hypotension, and respiratory depression
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Drugs Adverse Reactions
Central Nervous System: Confusion, delirium, dream disturbances, drowsiness, fatigue, hallucinations, headache, nervousness, parkinsonism, restlessness, sedation, seizures, suicidal ideation (children and teens), tremor
Cardiovascular: electrocardiogram changes, orthostatic hypotension, palpitations
Eyes, Ears, Nose, And Throat: Blurred vision, dry mouth, taste perversion
Gastrointestinal: Constipation, diarrhea, heartburn, ileus, increased appetite, nausea, vomiting,
Genitourinary: Decreased libido, ejaculation disorders
Skin: Diaphoresis, jaundice
Other: Weight gain
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Nursing Considerations for Generic Drugs
If desired, mix oral solution in 120 ml of water; milk; or orange, grapefruit, tomato, or pineapple juice.
Expect to observe adverse reactions within a few hours after giving drug.
Evaluate patient for therapeutic response, such as decreased anxiety, apprehension, depression, fear, guilt, somatic symptoms, and worry; increased energy; and more restful sleep.
Keep in mind that abrupt withdrawal of doxepin after prolonged therapy can cause cholinergic rebound effects, including diarrhea, nausea, and vomiting.
Plan to discontinue drug, as prescribed, several days before elective surgery to avoid hypertension.
Monitor elderly patients for parkinsonism, especially with high-dose therapy.
Be alert for seizures. Patients with seizure disorder may need increased anticonvulsant dosage to maintain seizure control.
For patients with asthma or sulfite sensitivity, doxepin tablets may aggravate asthma or cause allergic reactions because they contain sulfites.
Follow diabetic patient's serum glucose level closely; drug may alter glucose metabolism.
If patient takes a thyroid hormone, be alert for increased responses to both drugs and, possibly, exaggerated drug-induced effects, such as arrhythmias and CNS stimulation. Untreated hypothyroidism prevents adequate response to therapy.
WARNING Monitor children and teens closely for evidence of suicidal thinking and behavior because doxepin increases the risk in these groups.
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Doxepin
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
British Pharmacopoeia, 2008 edition: Doxepin Capsules;
The United States Pharmacopeia 31, 2008: Doxepin Hydrochloride Capsules; Doxepin Hydrochloride Oral Solution.
Proprietary Preparations
Argentina: Doxederm;
Australia: Deptran; Sinequan;
Austria: Sinequan;
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