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Information about Sinequan

Doxepin is a tetracyclic antidepressant used to treat depression. It is thought to increase the activity of one of the brain chemicals (serotonin), which helps elevate mood.

You should not use Doxepin in the following cases: you are allergic to any ingredient in Doxepin or to other tricyclic antidepressants; you have certain prostate problems (eg, asymptomatic prostatic hypertrophy), glaucoma, or trouble urinating; you are taking cisapride, clonidine, dofetilide, H1 antagonists (eg, astemizole, terfenadine), or ibutilide, or you have taken a monoamine oxidase (MAO) inhibitor (eg, furazolidone, phenelzine, isocarboxazid) within the past 14 days.

In such cases it is obligatory to consult with your doctor or health care provider before taking this drug.

Before using Doxepin

Before using Doxepin you should tell your doctor if you have any medical conditions listed below: you are pregnant, planning to become pregnant, or are breast-feeding a baby; you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; you have allergies to medicines, foods, or other substances; you have a history of heart problems, seizures (eg, epilepsy), overactive thyroid, prostate problems (eg, benign prostatic hypertrophy [BPH]), blood problems (eg, porphyria), other mental or mood problems, suicidal thoughts or attempts, or alcohol abuse.

Be aware that Doxepin may interact with some medicines. Consult with your health care provider in case you are taking any other drugs, especially any of the following: antiarrhythmics (eg, quinidine, propafenone, flecainide), antifungal medicines (eg, fluconazole, terbinafine), carbamazepine, cimetidine, mibefradil, phenothiazines (eg, chlorpromazine, thioridazine), or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, sertraline) because side effects of Doxepin may be increased; anticoagulants (eg, warfarin), cisapride, dofetilide, H1 antagonists (eg, astemizole, terfenadine), ibutilide, sulfonylureas (eg, tolazamide, glipizide), sympathomimetics (eg, phenylephrine, pseudoephedrine), or tramadol because side effects may be increased by Doxepin; clonidine, guanadrel, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased; MAO inhibitors (eg, furazolidone, phenelzine, isocarboxazid) because severe toxic effects may occur.

It may not be a complete list of all interactions with other drugs. To prevent any complications you should check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Doxepin: Use this medicine as recommended by your doctor. Doxepin may be taken orally with or without food. Taking Doxepin at bedtime helps reduce side effects (eg, daytime drowsiness).

Try not to miss any doses. In case you miss a dose of Doxepin, take it as soon as possible. If it is almost time for your next intake, skip the missed dose and take it according to your regular dosing schedule. Do not take double doses to catch up. In case you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Important safety information

Be careful when driving, operating machinery, or performing other hazardous activities as Doxepin usage may lead to drowsiness, dizziness, or blurred vision. Try to avoid such activities. Alcohol and certain other medicines (eg, sedatives, tranquilizers, depressants) may increase the risk of unfavorable reactions while taking Doxepin. Dizziness may be increased by alcoholic beverages, hot weather, exercise, and fever. It is recommended to sit up or stand slowly, especially in the morning to prevent dizziness or fainting. You should sit or lie down at the first sign of dizziness, lightheadedness, or weakness.

Try to limit your alcohol consumption while taking Doxepin.

Children and teenagers who take Doxepin may be at increased risk for suicidal thoughts or actions. Adults may also be affected. The risk may be greater in patients who have had suicidal thoughts or actions in the past. The risk may also be greater in patients who have had bipolar (manic-depressive) illness, or if their family members have had it.

Look after patients who use Doxepin closely. Contact the doctor immediately in case new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Consult with your doctor immediately in case any signs of suicidal thoughts or actions take place.

Your sensitivity to sunlight may be increased by Doxepin. Try to avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing if you are not able to avoid such exposure.

Notify the doctor or dentist that you are using Doxepin before you undergo any medical or dental treatments, emergency care, or surgery.

You should know that improvement in your depression may start in several weeks. Do not stop taking Doxepin even if you feel better.

Lab tests may be performed while you are using Doxepin. It is important to control your progress or to check for side effects. Follow all doctor and lab appointments strictly.

The ELDERLY may be more sensitive to the effects of Doxepin. Use Doxepin with caution in this group.

It is not recommended to use Doxepin in CHILDREN younger than 12 years of age, as safety and effectiveness in this group have not been proved.

PREGNANCY and BREAST-FEEDING

In case you become pregnant, consult with your doctor and discuss the benefits and risks of using Doxepin while pregnancy. Doxepin passes into breast milk. Avoid breast-feeding a baby while taking this medicine.

Possible side effects of Doxepin

You should consult with your doctor in case you have any of side effects especially bothersome listed below: appetite loss; constipation; diarrhea; dizziness; drowsiness; dry mouth; excess sweating; headache; heartburn; increased appetite; indigestion; nausea; unpleasant taste; urinary retention; vomiting; weakness; weight gain.

Seek emergency immediately in case you have any of these severe side effects: severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal movements; aggressive or bizarre behavior; agitation; anxiety; blurred vision or other vision changes; chest pain; constipation; difficulty speaking and swallowing; disorientation; eye pain; fainting; fast, slow, or irregular heartbeat; hair loss; hallucinations; hostility; irritability; loss of balance; mood swings; nervousness or restlessness; panic attacks; ringing in the ears; seizures; shakiness; sore throat or fever; trouble sleeping; twitching of the face or tongue; unusual bleeding or bruising; yellowing of the skin or eyes.

What is the expiration date of the pills?

This information is mentioned on each blister. The expiration date is 2 years from the date of manufacture.