Doxepin is a tricyclic antidepressant.

Doxepin capsules and oral concentrate (liquid) are used to treat symptoms of depression and/or anxiety associated with alcoholism, manic depression, or other mental illness.

Doxepin tablets (Silenor) are used to treat insomnia in people who have trouble staying asleep.

This medication guide provides only information about doxepin capsules and liquid.

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

You should not take doxepin if you have glaucoma or problems with urination.

Do not use doxepin 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.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Mix the measured dose with 4 ounces of water, milk, orange juice, grapefruit juice, tomato juice, prune juice, or pineapple juice. Do not mix with grape juice or a carbonated soft drink. Stir the mixture and drink all of it right away. Do not save it for later use.

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

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.

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

You should not use doxepin capsules or liquid if you are allergic to doxepin or similar medicines such as amoxapine or loxapine, or if you have:

• glaucoma; or

• urination problems.

Do not use doxepin 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:

• bipolar disorder (manic-depression).

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.

Doxepin is not approved for use by anyone younger than 12 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 doxepin can be fatal.

Overdose symptoms may include irregular heart rhythm, feeling like you might pass out, seizures, or coma.

Do not drink alcohol. Dangerous side effects or death could occur.

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

Get emergency medical help if you have 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.

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

• blurred vision, tunnel vision, eye pain or swelling, seeing halos around lights;

• a light-headed feeling, like you might pass out;

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

• severe constipation;

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

• painful or difficult urination.

Common side effects of doxepin may include:

• drowsiness, dizziness;

• increased blood pressure;

• vision changes;

• rash, swelling;

• nausea, vomiting, indigestion;

• little or no urination;

• dry mouth, constipation; or

• decreased or increased sex drive.

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 doxepin 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.

Other drugs may affect doxepin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.