Keep your regular appointments with your doctor. This is so your doctor can check on your progress.
Doxepin may make you feel sleepy. If this happens, do not drive and do not use tools or machines. Do not drink alcohol.
Tell your doctor if you experience any troublesome side-effects.
|Type of medicine||A tricyclic antidepressant|
|Used for||The treatment of depression|
Doxepin belongs to a group of medicines called tricyclic antidepressants. It is prescribed for the treatment of depression. The exact cause of depression is not known. It can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness. With depression you have a consistently low mood and other symptoms severe enough to interfere with your normal day-to-day activities.
Doxepin can help ease the symptoms of depression. It is particularly helpful if you also have difficulty sleeping. It is thought to work by interfering with brain chemicals (called neurotransmitters) which may be involved in causing the symptoms.
Before taking doxepin
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking doxepin it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have an overactive thyroid gland.
- If you have any problems with the way your liver works, or the way your kidneys work.
- If you have epilepsy or sugar diabetes.
- If you have had problems with constipation over a long time.
- If you have any difficulties passing urine, or if you have had prostate trouble.
- If you have a heart disorder or blood vessel disease.
- If you have had a mental health problem - in particular, bipolar disorder or psychosis.
- If you have increased pressure in your eyes (glaucoma).
- If you have been told you have phaeochromocytoma - a tumour on your adrenal gland.
- If you have porphyria - a rare inherited blood disorder.
- If you are taking other medicines, including those available to buy without a prescription, as well as herbal and complementary medicines. This is especially important if you have recently taken a medicine for depression, known as a monoamine-oxidase inhibitor (MAOI).
- If you have ever had an allergic reaction to a medicine.
How to take doxepin capsules
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about doxepin and will provide you with a full list of the side-effects which you may experience from taking it.
- Doxepin can make you feel sleepy so your doctor may advise you to take a small dose when you first start taking it, and then to increase your dose gradually as your body gets used to it.
- Doxepin is often prescribed once a day at bedtime, although it can also be taken two or three times a day. Your doctor will tell you which is right for you and the directions will be printed on the label of the pack to remind you what the doctor has said. If you have any questions about how to take the capsules, ask your pharmacist for advice.
- You can take doxepin before or after meals. Many people find if helps to swallow the capsule with a drink of water.
- If you forget to take a dose, take it as soon as you remember unless your next dose is due. If it is nearly time for your next dose, then take the next dose when it is due but leave out the forgotten dose. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- You may feel that doxepin is not working for you straightaway. It can take a week or two for the effect to build up, and 4-6 weeks before you feel the full benefit. It is important that you do not stop taking it thinking that it is not helping.
- While you feel depressed, you may have distressing thoughts and think about harming yourself or ending your life. If this happens, it is very important that you tell your doctor about it straightaway.
- If you drink alcohol, ask your doctor for advice. Your doctor is likely to recommend that you do not drink alcohol while you are on doxepin as it increases the risk of side-effects, such as feeling sleepy.
- There are several types of antidepressants - each type works in a slightly different way and can have different side-effects. If you find that doxepin does not suit you then let your doctor know, as another antidepressant may be found that does.
- Some people who take doxepin find that their skin becomes more sensitive to sunlight than usual. Do not use sunbeds and try to avoid strong sunlight until you know how your skin reacts. Use a sun cream with a high sun protection factor.
- Your doctor may ask you to carry on taking doxepin even after you feel better. This is to help stop your symptoms from returning.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because a number of medicines can increase the risk of side-effects from doxepin, including some painkillers, flu remedies and antihistamines which can be bought from pharmacies.
- If you have diabetes you may need to check your blood sugar (glucose) more frequently. This is because doxepin can alter the levels of sugar in your blood. Your doctor will advise you about this.
- If you are due to have any medical treatment, tell the person carrying out the treatment that you are taking a tricyclic antidepressant, as they can interfere with some anaesthetics.
- Continue to take doxepin unless your doctor tells you otherwise. Stopping treatment suddenly can sometimes cause problems and your doctor may want you to reduce your dose gradually if this becomes necessary.
Can doxepin cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with doxepin. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Common doxepin side-effects||What can I do if I experience this?|
|Blurred vision, feeling sleepy or tired||If this happens, do not drive or use tools or machines. Do not drink alcohol|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Constipation||Try to eat a well-balanced diet containing plenty of fibre and drink plenty of water|
|Feeling faint or light-headed, especially when getting up from a sitting or lying position||Getting up more slowly may help. If you begin to feel faint, sit down until the feeling passes|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Feeling sick (nausea) or being sick (vomiting), diarrhoea||Stick to simple meals - avoid rich or spicy foods. Drink plenty of water to replace lost fluids|
|Sweating, flushing, difficulty in passing urine, increased appetite, feeling confused or anxious, disturbed sleep, lack of concentration, feeling shaky, itchy skin rash, weight changes, changes in sexual function, breast tenderness, changes in the way things taste, ringing in your ears, fast heartbeat||If any of these become troublesome, speak with your doctor for advice|
If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.
How to store doxepin capsules
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Manufacturer's PIL, Doxepin 25 mg and 50 mg Capsules; Marlborough Pharmaceuticals Ltd, The electronic Medicines Compendium. Dated December 2013.
British National Formulary 73rd Edition (Mar 2017); British Medical Association and Royal Pharmaceutical Society of Great Britain, London.