Understanding the Risks With Doxepin

Some Warnings and Precautions With Doxepin

Some doxepin precautions and warnings to be aware of include:
  • Antidepressants (including doxepin) may increase the risk of suicidal thinking or behavior in children, teenagers, and adults (see Depression and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include: anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thinking or behavior (see Doxepin and Suicide for more information).
  • Before prescribing doxepin for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and doxepin can cause problems in people with bipolar disorder.
  • For people taking doxepin, caution should be used when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting doxepin or when switching dosages. This is because doxepin may affect a person's mental or physical ability to perform these tasks. Make sure to understand how doxepin affects you before performing any tasks that require mental or physical concentration.
  • Doxepin can interact with certain medications (see Drug Interactions With Doxepin).
  • Doxepin may enhance the effects of alcohol and medicines that affect the brain. This can lead to an increased risk for drowsiness, dizziness, suicidal thoughts, and other doxepin overdose symptoms. Make sure to talk with your healthcare provider about drinking alcohol while taking doxepin.


  • If you were prescribed doxepin for insomnia treatment, be aware that sometimes sleeping problems are caused by other medical conditions (not just insomnia). If your insomnia does not improve within seven to ten days of starting doxepin, your healthcare provider should make sure there is no other medical condition causing your sleeping problems.
  • Medications like doxepin are generally not recommended for people with severe sleep apnea


  • Doxepin is a pregnancy Category C medication, meaning that it may not be safe for use during pregnancy. Discuss the benefits and risks of using doxepin during pregnancy with your healthcare provider (see Doxepin and Pregnancy for more information).


  • Doxepin passes through breast milk and may cause harm to your nursing baby. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about what makes the most sense for your particular situation (see Doxepin and Breastfeeding).
  • Special care should be used when taking doxepin if you have a history of seizures, as tricyclic antidepressants (such as doxepin) can make seizure disorders worse.
  • Doxepin may cause a dry mouth. Sucking on hard candy, chewing gum, or melting bits of ice in your mouth can provide relief.
  • The elderly appear to be more sensitive to doxepin, which can increase their risk of side effects (such as delirium and confusion). In these particular situations, healthcare providers will start people with lower doses of doxepin and monitor them more closely.
  • Do not treat yourself for the common cold, a cough, or allergies without first talking to your healthcare provider. Some over-the-counter medicines used to treat these conditions can increase the risk for developing doxepin side effects.
  • Do not stop taking doxepin without first discussing it with your healthcare provider. Stopping the medicine abruptly may increase the risk for withdrawal symptoms (see Doxepin Withdrawal).
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Doxepin HCl

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