Tell your doctor if you have liver disease, kidney disease, asthma, thyroid disease, diabetes, stomach or intestinal problems, high blood pressure or heart disease, had a heart attack in the last 6 weeks, an enlarged prostate or difficulty urinating, or glaucoma.

Do not take doxepin if you have taken a monoamine oxidase inhibitor such as isocarboxazid (Marplan®), phenelzine (Nardil®), or tranylcypromine (Parnate®) within the last 14 days.

Doxepin may increase the effects of other drugs that cause drowsiness, including other antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Inform your doctor about all medicines that you are taking, and do not take any other prescription or over-the-counter medicines without first talking to your doctor.

You may not be able to take doxepin, or you may require a dosage adjustment or special monitoring during therapy, if you have any of the conditions listed above.

While you are taking doxepin you may need to be monitored for worsening symptoms of depression and/ or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking doxepin. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/ or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/ or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with doxepin.

It is not known whether doxepin will be harmful to an unborn baby. Do not take doxepin without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Doxepin passes into breast milk and may affect a nursing baby. Do not take doxepin without first talking to your doctor if you are breast-feeding a baby.

If you are over 60 years of age, you may be more likely to experience side effects such as drowsiness, dizziness, unsteadiness, feeling uncoordinated, and low blood pressure. Your doctor may prescribe a lower dose of this medication.

Use cautiously when driving, operating machinery, or performing other hazardous activities. Doxepin may cause drowsiness or dizziness. If you experience drowsiness or dizziness, please avoid these activities.

Dizziness is likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Additionally, use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking doxepin.

 

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