Doxepin tablet | Side Effects, Dosage, Uses & More
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Generic Name:

doxepin, Oral tablet

All Brands

  • Silenor
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Highlights for doxepin

Oral tablet
1

Doxepin is available as a tablet, capsule, and solution you take by mouth. It’s also available as a cream you apply to your skin.

2

Doxepin oral tablet is used to treat insomnia. It’s used in people who have trouble staying asleep.

3

The oral tablet is only available as the brand-name drug called Silenor. It isn’t available as a generic drug.

4

The most common side effect of this drug is drowsiness or tiredness.
You shouldn’t take this drug unless you’re able to get a full night of sleep before you must be awake.

5

You shouldn’t take this drug unless you’re able to get a full night of sleep before you must be awake.

IMPORTANT INFORMATION

Other illnesses

Tell your doctor if you still have trouble sleeping after 7–10 days of using doxepin. Your doctor may check you for other conditions that could be causing your sleep problem.

Avoid dangerous activities

You shouldn’t drive, use machinery, or do other activities that require alertness after taking doxepin. You may still feel drowsy the next day after taking this drug. Don’t drive or do other dangerous activities until you feel fully awake.

What is doxepin?

Doxepin is a prescription drug. It’s available as an oral tablet, oral capsule, oral solution, and topical cream.

Doxepin oral tablet is only available as the brand-named drug called Silenor. It isn’t available as a generic drug.

Why it's used

Doxepin is used to treat insomnia. It’s given to people who have trouble staying asleep.

How it works

Doxepin belongs to a class of drugs called hypnotics.

More Details

How it works

Doxepin belongs to a class of drugs called hypnotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It isn’t known exactly how doxepin works to help you stay asleep. It may block the activity of histamine, one of the chemical messengers in your body. This drug helps you to stay asleep and keeps you from waking up too early.

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doxepin Side Effects

Oral tablet

More Common Side Effects

Some of the more common side effects that can occur with use of doxepin include:

  • drowsiness

  • tiredness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • unusual behaviors or activities while you’re not fully awake. The next morning you may not remember what you did while you weren’t fully awake. These can include:

    • driving a car (sleep-driving)
    • preparing and eating food
    • talking on the phone
    • having sex
    • sleepwalking
  • suicidal thoughts or behaviors. This risk is higher in children, teenagers, and young adults. Symptoms include:

    • unusual changes in your mood, behaviors, thoughts, or feelings
    • changes in appetite
Pharmacist's Advice
Healthline Pharmacist Editorial Team

You shouldn’t drive, use machinery, or do other activities that require alertness after taking doxepin. You may still feel drowsy the next day after taking this drug. Don’t drive or do other dangerous activities until you feel fully awake.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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doxepin May Interact with Other Medications

Oral tablet

Doxepin can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

The use of drinks that contain alcohol can make you feel drowsier from doxepin. If you drink alcohol, talk to your doctor.

Medications that might interact with this drug

Stomach problems drugs

Certain drugs used to treat stomach problems can increase the amount of doxepin in your body. This can raise your risk of side effects. Your doctor may lower your dose of doxepin.

These drugs include:

  • cimetidine
  • esomeprazole
  • omeprazole

Antifungal drugs

Certain drugs used to treat fungal infections can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

  • fluconazole
  • terbinafine
  • voriconazole

Nausea or allergy drugs

When taken with doxepin, certain drugs used to treat allergies can increase the sedating effects of doxepin. This can make you feel extremely drowsy.

These drugs include:

  • chlorpheniramine
  • clemastine
  • cyproheptadine
  • diphenhydramine
  • hydroxyzine

Anxiety drugs

When taken with doxepin, certain drugs used to treat anxiety can increase the sedating effects of doxepin. This can make you feel extremely drowsy.

These drugs include:

  • alprazolam
  • clonazepam
  • diazepam
  • lorazepam

Sleep drugs

When taken with doxepin, certain drugs used to treat sleep problems can increase the sedating effects of doxepin. This can make you feel extremely drowsy.

These drugs include:

  • estazolam
  • eszopiclone
  • triazolam
  • zaleplon
  • zolpidem

Seizure, anxiety, and surgery drugs

When taken with doxepin, certain drugs used to treat anxiety, sleep, seizures, or used for surgical procedures can increase the sedating effects of doxepin. This can make you feel extremely drowsy.

These drugs include:

  • butalbital
  • mephobarbital
  • pentobarbital
  • phenobarbital

Depression drugs

When taken with doxepin, a class of drugs for depression called monoamine oxidase inhibitors (MAOIs) may lead to serious side effects and even death. You shouldn’t take doxepin if you’re on MAOIs or if you have used MAOIs within the past 14 days.

These drugs include:

  • isocarboxazid
  • selegiline
  • phenelzine
  • tranylcypromine

Also, certain drugs used to treat depression and anxiety can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

  • bupropion
  • duloxetine
  • fluoxetine
  • fluvoxamine
  • paroxetine
  • sertraline

Bladder drugs

Certain drugs used to treat bladder problems can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

  • darifenacin

Heart rhythm drugs

Certain drugs used to treat heart rhythm problems can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

  • dronedarone
  • quinidine

Blood-thinning drugs

Certain drugs used to prevent blood clots can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

  • ticlopidine

Kidney disease drugs

Certain drugs used to treat kidney problems can increase the amount of doxepin in your body. This can raise your risk of side effects.

These drugs include:

cinacalcet

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
narrow angle glaucoma
People with untreated narrow angle glaucoma

You shouldn’t take this drug if you have untreated glaucoma. It can worsen your condition.

urinary problems
People with severe urinary problems

You shouldn’t take this drug if you have severe urinary problems, such as trouble urinating. It can worsen your condition.

liver problems
People with liver problems

If you have liver problems, your body may process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor may start you on a lower dose. This can help keep levels of this drug from building up too much in your body.

sleep apnea
People with sleep apnea

This drug hasn’t been studied in people with sleep apnea. Doxepin may affect your breathing. Talk to your doctor about whether this drug is safe for you.

depression
People with depression

This drug may make your condition worse. It may also increase your risk of having thoughts and behaviors of hurting yourself.

pregnant women
Pregnant women

Doxepin is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

Doxepin may pass into breast milk and may cause side effects in a child who is breast-fed. These include drowsiness and breathing problems.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

for seniors
For seniors

Studies show no major differences in the safety or effectiveness of doxepin between seniors and younger adults.

Seniors may be more sensitive to doxepin. This may make them feel confused or drowsy.

for children
For children

It isn’t known if doxepin is safe and effective for children younger than 18 years of age.

call doctor
When to call the doctor

Call your doctor if you still have trouble sleeping after 7–10 days of using this drug. Your doctor may check you for other conditions that could be causing your sleep problem.

allergies
Allergies

Doxepin can cause a severe allergic reaction. Symptoms can include:

  • trouble breathing
  • swelling of your throat or tongue
  • itching
  • hives 

Call 9-1-1 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take doxepin (Dosage)

Oral tablet

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Insomnia

Brand: Silenor

Form: Oral tablet
Strengths: 3 mg, 6 mg
Adult dosage (ages 18–64 years)
  • The recommended dose is 6 mg taken once per day within 30 minutes of bedtime.
  • To lower your risk for drowsiness lasting until the next morning (hangover effect), you shouldn’t take doxepin within 3 hours of eating a meal.
  • Your doctor may start you on 3 mg taken once per day. You shouldn’t take more than 6 mg per day.
Child dosage (ages 0–17 years)

It hasn’t been confirmed if doxepin is safe and effective for people younger than 18 years of age.

Senior dosage (ages 65 years and older)

The recommended dose is 3 mg taken within 30 minutes of bedtime. Your doctor may give you 6 mg once per day if needed.

Special considerations

People with liver problems: Your doctor may start you on a lower dose of 3 mg once per day, taken 30 minutes before bedtime.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Doxepin comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

You’ll still have trouble staying asleep during the night.

If you miss doses or don’t take the drug on schedule

If you don’t take it as prescribed, this drug may not work as well, or you may feel sleepy the next day. You shouldn’t take doxepin unless you’re able to get a full night of sleep.

If you take too much

You could have dangerous levels of the drug in your body. You may have the following symptoms:

  • abnormal heart rhythms
  • low blood pressure
  • sudden involuntary body movements
  • overactive reflexes
  • muscle stiffness
  • confusion
  • trouble concentrating
  • coma (being unconscious for a long time)
  • drowsiness
  • seeing things that aren’t real
  • dilated pupils
  • agitation
  • vomiting
  • very low body temperature or very high fever
  • seizures
  • coma

If you think you’ve taken too much of the drug, act right away. Call your doctor or local poison control center, or go to the nearest emergency room.

What to do if you miss a dose

This medication is used to help you stay asleep. If you miss a dose, you shouldn’t take it in the middle of the night because you may wake up feeling drowsy the next morning. If you miss a dose and can’t get a full night of sleep before you need to be active again, take your next dose the following night.

How to tell if the drug is working

You should stay asleep better.

Doxepin is used for short-term treatment.

Don’t take doxepin within 3 hours of eating a meal

This will lower your risk for drowsiness lasting until the next morning (hangover effect).

Take doxepin within 30 minutes of bedtime

After taking this drug, you should only do activities needed to get ready for bed.

You can crush or cut the tablet

However, there’s no score line (line down the center) on the tablet. This means if you cut it, there’s no way to know if you’re getting the correct dose.

Store doxepin at room temperature

  • Keep it from 68°F to 77°F (20°C to 25°C).
  • Protect it from light.
  • Keep in tightly closed in the container it came in.
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Liver function. Your doctor may do a blood test to check your liver. This will help them tell if you need a lower dose of doxepin.
  • Mood. Pay close attention to sudden changes in your mood, behaviors, thoughts, or feelings. If you have any unusual changes, call your doctor right away.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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How Much Does doxepin Cost?

Oral tablet

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Lowest price for doxepin

Sams Club $8.05
Kroger Pharmacy $8.31
CVS Pharmacy $9.22
These prices represent the lowest priced national pharmacies for doxepin on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for doxepin on GoodRx. They may be lower than your insurance.

Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on November 19, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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