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Doxepin hydrochloride
Doxepin hydrochloride (Adapin, Sinequan)
Doxepin hydrochloride
(DOX-eh-pin)
Pregnancy Category: C
Alti-Doxepin
Apo-Doxepin
Novo-Doxepin
Rho-Doxepin
Sinequan
Triadapin
Zonalon (Rx)
Classification:
Antidepressant, tricyclic
See Also:
See also Antidepressants, Tricyclic [.
]Action/Kinetics:
Metabolized to the active metabolite, desmethyldoxepin. Moderate anticholinergic effects and orthostatic hypotension; high sedative effects. Therapeutic plasma levels of both doxepin and desmethyldoxepin: 100-200 ng/mL. Time to reach steady state: 2-8 days. t1/2: 8-24 hr.
Uses:
Psychoneurotic clients with depression or anxiety. Depression or anxiety due to organic disease or alcoholism. Psychotic depressive disorders with associated anxiety, including involutional depression and manic-depressive disorders. Depression or anxiety associated with organic disease. PUD. Dermatologic disorders including chronic urticaria, angioedema, and nocturnal pruritus due to atopic eczema.
Contraindications:
Use in children less than 12 years of age. Glaucoma or a tendency for urinary retention.
Special Concerns:
Safety has not been determined in pregnancy.
Additional Side Effects:
Doxepin has a high incidence of side effects, including a high degree of sedation, decreased libido, extrapyramidal symptoms, dermatitis, pruritus, fatigue, weight gain, edema, paresthesia, breast engorgement, insomnia, tremor, chills, tinnitus, and photophobia.
How Supplied:
Capsule: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 150 mg; Concentrate: 10 mg/mL; Cream: 5%
Dosage
•Capsules, Oral Concentrate
Antidepressant, mild to moderate anxiety or depression.
Adults, initial: 25 mg t.i.d. (or up to 150 mg can be given at bedtime); then, adjust dosage to individual response (usual optimum dosage: 75-150 mg/day). Geriatric clients, initially: 25-50 mg/day; dose can be increased as needed and tolerated.
Severe symptoms.
Initial: 50 mg t.i.d.; then, gradually increase to 300 mg/day.
Emotional symptoms with organic disease.
25-50 mg/day.
Antipruritic.
10-30 mg at bedtime.
•Cream 5%
Apply a thin film q.i.d. with at least a 3-4 hr interval between applications. |
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