Doxepin is a tricyclic antidepressant. When applied to the skin, doxepin topical can help relieve itching but it will not treat symptoms of depression.

Doxepin topical (for use on skin) is used to treat itchy skin in adults with eczema or other skin conditions that can lead to repeated scratching and thickened skin.

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Doxepin comes as a cream to apply to the skin. It is usually applied four times a day, at least 3 to 4 hours apart, for up to 8 days. Use doxepin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use doxepin topical exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

To use the cream, follow these steps:

1. Wash the affected skin with water and a mild soap or soapless cleansing lotion and pat dry with a soft towel.
2. Apply a thin layer of cream to the affected skin. Gently and thoroughly massage it into the skin. Be careful not to get the medication in your eyes or mouth. If you do get doxepin in your eyes, wash with plenty of water and call your doctor if your eyes are irritated.
3. Do not cover the affected area with any bandages, dressings, or wrappings.
4. Wash your hands with soap and water after you finish handling the medication.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Do not take by mouth. Topical medicine is for use only on the skin. Do not use this medicine on open wounds or on sunburned, windburned, dry, chapped, or irritated skin. If this medicine gets in your eyes, nose, mouth, rectum, or vagina, rinse with water.

Doxepin topical is usually applied 4 times each day. Allow at least 3 hours to pass between applications.

Apply a thin layer of medication to the affected skin and rub in gently.

Do not cover treated skin area with a bandage or plastic. Bandaging can increase the amount of drug absorbed through your skin and may cause harmful effects.

Do not use this medicine for longer than 8 days. Stop using the medicine and call your doctor if your symptoms do not improve.

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

You should not use doxepin topical if you are allergic to doxepin (Silenor, Sinequan), or if you have:

• untreated narrow-angle glaucoma; or

• urination problems.

Before using doxepin topical, tell your doctor about all your medical conditions or allergies.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Doxepin topical can pass into breast milk and may cause side effects in the nursing baby. Tell your doctor if you are breast-feeding.

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

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Serious overdose symptoms can occur if too much of doxepin topical is absorbed through your skin. Overdose symptoms may include extreme dizziness or drowsiness, feeling hot or cold, vomiting, confusion, agitation, trouble concentrating, irregular heartbeats, hallucinations, fainting, dilated pupils, muscle stiffness, or seizure (convulsions).

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.

Rinse with water if this medicine gets in your eyes.

Absorbing large amounts of this medicine through your skin may cause side effects that can impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol with this medicine can cause side effects.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Although the risk of serious side effects is low when doxepin topical is applied to the skin, side effects can occur if the medicine is absorbed into your bloodstream. You may feel drowsy after applying this medicine, especially if you have treated large areas of skin.

Doxepin topical may cause serious side effects. Stop using doxepin topical and call your doctor at once if you have:

• severe drowsiness;

• confusion;

• severe dry mouth;

• painful or difficult urination;

• blurred vision; or

• new or worsening skin symptoms.

Some side effects may be more likely in older adults.

Common side effects of doxepin topical may include:

• burning or stinging where the medicine was applied;

• mild drowsiness; or

• dry mouth.

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 topical with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before using doxepin topical, tell your doctor if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor about all your current medicines and any you start or stop using, especially:

• cimetidine;

• heart rhythm medication; or

• any antidepressant medication you take by mouth.

This list is not complete. Other drugs may interact with doxepin topical, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Keep all appointments with your doctor.

Do not let anyone else use 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.