Amoxapine is a tricyclic antidepressant that is used to treat symptoms of depression, anxiety, or agitation.

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

You should not use amoxapine if you have recently had a heart attack.

Do not use amoxapine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

If you take amoxapine once daily, take your dose at bedtime.

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using amoxapine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using trimipramine.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Usual Adult Dose for Depression:

Initial dose: 50 mg orally 2 to 3 times a day
Maintenance dose: 100 mg orally 2 to 3 times a day
Maximum dose: 600 mg/day

Comments:
-Increases above 300 mg/day should be made only if 300 mg/day has been ineffective during at least two weeks.
-Hospitalized patients who have been refractory to antidepressant treatment and who have no history of convulsive seizures may have dosage increased cautiously up to 600 mg/day in divided doses.
-This drug may be given in a single daily dose, not to exceed 300 mg, preferably at bedtime.
-Doses above 300 mg should be given in divided doses.

Uses:
-Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depression
-Depression accompanied by agitation or anxiety

Usual Geriatric Dose for Depression:

Initial dose: 25 mg orally 2 to 3 times a day
Maintenance dose: 50 mg orally 2 to 3 times a day
Maximum dose: 300 mg/day

Comments:
-Once an effective dosage is established, this drug may be administered in a single bedtime dose, not to exceed 300 mg.
-Recommended maintenance dosage is the lowest dose that will maintain remission.
-If symptoms reappear, the dosage should be increased to previous level until symptoms are under control.

Use:
-Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depression
-Depression accompanied by agitation or anxiety

You should not use amoxapine if you are allergic to it, or if:

• you have recently had a heart attack.

Do not use trimipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you have ever had:

• heart disease, stroke, or seizures;

• kidney disease;

• schizophrenia or other mental illness;

• diabetes (amoxapine may raise or lower blood sugar);

• bipolar disorder (manic depression);

• if you are receiving electroshock treatment;

• glaucoma; or

• problems with urination.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Tell your doctor if you are pregnant or breastfeeding.

Amoxapine is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

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

Overdose symptoms may include seizure (convulsions), acidosis, or coma.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Drinking alcohol with amoxapine can cause side effects.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult 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.

Amoxapine may cause serious side effects. Call your doctor at once if you have:

• skin rash, fever;

• uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

• pounding heartbeats or fluttering in your chest;

• chest pain or pressure, pain spreading to your jaw or shoulder;

• sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance; or

• severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects of amoxapine may include:

• drowsiness;

• constipation;

• dry mouth; or

• blurred vision.

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.

Using amoxapine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Many drugs can affect amoxapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.