II. Indications
III. Adverse Effects
- See Tricyclic Antidepressant
- Significant Anticholinergic effects, including sedation
IV. Safety
- Unknown safety in pregnancy
- Avoid in Lactation
V. Mechanism
- See Tricyclic Antidepressant
- Primarily affects Norepinephrine reuptake
VI. Dosing (Adults and Age over 12 years)
-
Mood Disorders (Major Depression, Anxiety Disorder)
- Start: 75 mg orally at bedtime
- Titrate to 50 to 150 mg/day as tolerated and to effect
- Max: 300 mg/day (divide higher doses, above 150 mg/day, twice daily)
-
Insomnia
- Adult: 6 mg orally 30 min before bed
- Elderly (over age 65 years): 3 mg orally 30 min before bed
- May advance to 6 mg orally as needed
-
Pruritus
- Start 10 to 25 mg orally at bedtime
- Titrate to 10 to 100 mg/day as tolerated and to effect
VII. Resources
VIII. References
- (2023) Med Lett Drugs Ther 62(1592): 25-32
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
doxepin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
DOXEPIN 10 MG CAPSULE | Generic | $0.12 each |
DOXEPIN 10 MG/ML ORAL CONC | Generic | $0.31 per ml |
DOXEPIN 100 MG CAPSULE | Generic | $0.48 each |
DOXEPIN 150 MG CAPSULE | Generic | $0.61 each |
DOXEPIN 25 MG CAPSULE | Generic | $0.21 each |
DOXEPIN 50 MG CAPSULE | Generic | $0.29 each |
DOXEPIN 75 MG CAPSULE | Generic | $0.39 each |
DOXEPIN HCL 3 MG TABLET | Generic | $6.96 each |
DOXEPIN HCL 6 MG TABLET | Generic | $8.43 each |
Ontology: Doxepin (C0013085)
Definition (NCI) | A dibenzoxepin derivative and tricyclic antidepressant (TCA) with antipruritic, antidepressive and anxiolytic activities. Doxepin blocks the reuptake of norepinephrine and serotonin (5-HT) into presynaptic terminals thereby prolonging the availability of the monoaminergic neurotransmitters within the synaptic cleft and enhancing their neurotransmission. Doxepin also has antagonistic effects on histamine H1, 5-HT2, alpha-1 adrenergic, and muscarinic receptors. The antipruritic effect of this agent is mediated through inhibition of histamine receptors. |
Definition (MSH) | A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D004316 |
SnomedCT | 11841005, 372587005 |
LNC | LP14717-0, MTHU004933 |
English | Doxepin, 1-Propanamine, 3-dibenz(b,e)oxepin-11(6H)-ylidene-N,N-dimethyl-, Doxepin [Chemical/Ingredient], DOXEPIN, doxepin, Doxepin (product), Doxepin (substance) |
Swedish | Doxepin |
Czech | doxepin |
Finnish | Doksepiini |
Russian | DOKSEPINGIDROKHLORID, DOKSEPIN, ДОКСЕПИН, ДОКСЕПИНГИДРОХЛОРИД |
Japanese | ドキセピン |
Croatian | DOKSEPIN |
Polish | Doksepina, Curantin |
Spanish | doxepina (producto), doxepina (sustancia), doxepina, Doxepina |
French | Doxépine |
German | Doxepin |
Italian | Doxepina |
Portuguese | Doxepina |