Doxepin is prescribed to treat insomnia in people who have trouble staying asleep. It is also a treatment option for depression and anxiety. In topical form, it is prescribed to treat certain types of eczema.^1,2

Doxepin is in a class of medications called tricyclic antidepressants. It treats insomnia by slowing activity in the brain to allow sleep.³

Yes, doxepin is a tricyclic antidepressant that works by blocking receptors in the brain, including histamine. Blocking histamine can help with insomnia as well as depression and anxiety. The other receptors it may block primarily produce side effects.⁴

No, doxepin is not considered a controlled substance.⁵

No. The original brand name for doxepin, Sinequan, is no longer available. But doxepin is still available as a generic medication, and it is available under the brand name Silenor®.

Doxepin comes as a tablet to take by mouth. It is usually taken once a day, within 30 minutes of bedtime. Do not take it within three hours of a meal.⁶

You should begin to sleep better during the first few days of treatment with doxepin. If your sleep does not improve within seven to 10 days, or if it gets worse, contact your healthcare provider.⁷

Doxepin will stay in your system between two and five-and-a-half days.⁸

RedBox Rx prescribes 3 mg and 6 mg dosages of doxepin for insomnia treatment. Our U.S. licensed medical providers can help determine the right dosing of doxepin if prescribed. Start an online consult for insomnia to discuss your options.

It is best taken at least three hours after your last meal and about 30 minutes before bedtime. Plan to go to bed right after you take doxepin and to stay in bed for seven to eight hours.⁹

Research suggests doxepin improves sleep duration and reduces nighttime wakefulness, but it may not be as useful in helping patients fall asleep.^10,11 Ready our blog Prescription Sleep Medications Guide: Trazodone, Hydroxyzine, Mirtazapine and More for a more in-depth comparison.

Doxepin is $45 for a 30-day supply or $120 for a 90-day supply from RedBox Rx. No insurance required and no membership fees. We're able to offer low prices because we purchase doxepin directly from manufacturers and ship from our pharmacy in Iowa.

Our online insomnia consultation costs only $35.

Doxepin requires a prescription. Start an online consult for insomnia to discuss your options with a licensed healthcare provider.

Yes, doxepin expires. Check your medication bottle for the expiration date and always properly dispose of unused expired medication.

Yes, doxepin may cause weight gain or weight loss. Weight gain is more common.¹²

You should not drink alcohol while on this medication, as it can increase drowsiness.¹³

Using this medicine with any of the following medicines is not recommended:

• Bepridil

• Bromopride

• Cisapride

• Dronedarone

• Grepafloxacin

• Isocarboxazid

• Levoketoconazole

• Levomethadyl

• Linezolid

• Mavorixafor

• Mesoridazine

• Methylene blue

• Metoclopramide

• Moclobemide

• Ozanimod

• Phenelzine

• Pimozide

• Piperaquine

• Potassium chloride

• Potassium citrate

• Procarbazine

• Rasagiline

• Safinamide

• Saquinavir

• Selegiline

• Sparfloxacin

• Terfenadine

• Thioridazine

• Tranylcypromine

• Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both medicines:

• Abiraterone acetate

• Abiraterone acetate, micronized

• Acecainide

• Aceclofenac

• Acemetacin

• Adagrasib

• Albuterol

• Alfentanil

• Alfuzosin

• Almotriptan

• Alprazolam

• Amantadine

• Amineptine

• Amiodarone

• Amisulpride

• Amitriptyline

• Amitriptylinoxide

• Amobarbital

• Amoxapine

• Amphetamine

• Amtolmetin guacil

• Anagrelide

• Anileridine

• Apalutamide

• Apomorphine

• Aprobarbital

• Aripiprazole

• Aripiprazole lauroxil

• Arsenic trioxide

• Artemether

• Asenapine

• Aspirin

• Astemizole

• Atazanavir

• Azimilide

• Azithromycin

• Bedaquiline

• Benperidol

• Benzhydrocodone

• Benzphetamine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both medicines:

• Acenocoumarol

• Arbutamine

• Bethanidine

• Desogestrel

• Dicumarol

• Dienogest

• Drospirenone

• Ethinyl estradiol

• Ethynodiol

• Gestodene

• Guanethidine

• Levonorgestrel

• Mestranol

• Nomegestrol

• Norethindrone

• Norgestimate

• Norgestrel

• Phenprocoumon

• Propoxyphene

• S-Adenosylmethionine

• Warfarin¹⁴

Before taking doxepin:¹⁵

• Tell your doctor and pharmacist if you are allergic to doxepin (Silenor), amoxapine, loxapine, any other medications or any of the ingredients in doxepin (Silenor) tablets. Ask your pharmacist or check the Medication Guide for a list of the ingredients.

• Tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two week: a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) and tranylcypromine (Parnate). Also tell your doctor if you are taking or receiving methylene blue (Provayblue) or linezolid (Zyvox). Your doctor will probably tell you not to take doxepin. If you stop taking doxepin, you should wait at least 14 days before you start to take an MAO inhibitor.

• Some medications should not be taken with doxepin. Other medications may cause dosing changes or extra monitoring when taken with doxepin. Make sure you have discussed any medications you are currently taking or plan to take before starting doxepin with your doctor and pharmacist. Before starting, stopping or changing any medications while taking doxepin, please get the advice of your doctor or pharmacist

• The following nonprescription products may interact with doxepin: cimetidine (Tagamet); allergy medications such as diphenhydramine, loratadine, fexofenadine, chlorpheniramine or cetirizine. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking doxepin. Do not start any of these medications while taking doxepin without discussing with your healthcare provider.

• Tell your doctor if you have or have ever had glaucoma that is not being treated, or urinary retention (inability to empty your bladder completely or at all). Your doctor may tell you not to take doxepin (Silenor).

• Tell your doctor if you have or have ever drunk large amounts of alcohol, used street drugs or over-used prescription medications. Also tell your doctor if you have or have ever had depression, mental illness, suicidal thoughts, sleep apnea (a sleep disorder that causes breathing to stop for short periods during sleep), or kidney or liver disease.

• Tell your doctor if you are pregnant, plan to become pregnant or are breastfeeding. If you become pregnant while taking doxepin (Silenor), call your doctor.

• You should know that doxepin (Silenor) may make you drowsy. Do not drive a car, operate machinery or do other dangerous activities at night after taking doxepin (Silenor). Do not drive a car or operate machinery the next day until you know how this medication affects you.

• You should know that alcohol can add to the drowsiness caused by this medication. Do not drink alcohol while you are taking doxepin (Silenor).

• You should know that some people who took doxepin (Silenor) got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, were sleep-walking or were involved in other activities while not fully awake. After they woke up, these people were usually unable to remember what they had done. Call your doctor right away if you find out that you have been driving or doing anything else unusual while you were sleeping.

Unless your doctor tells you otherwise, continue your normal diet.¹⁶

Doxepin should only be taken at bedtime. If you did not take doxepin before you went to bed and you are having trouble sleeping, you may take doxepin if you will be able to stay in bed for at least seven to eight hours afterward. Do not take a double dose of doxepin to make up for a missed dose.¹⁷

Doxepin may cause side effects. Call your doctor if any of these symptoms are severe or do not go away:

• Nausea

• Vomiting

• Weakness or tiredness

• Dizziness

• Increase in pupil size

• Dry mouth

• Mouth sores

• Skin more sensitive to sunlight than usual

• Flushing

• Changes in appetite or weight

• Changes in the way things taste

• Indigestion

• Constipation

• Diarrhea

• Difficulty urinating

• Excessive thirst and urination

• Ringing in your ears

• Changes in sex drive

• Swollen testicles

• Increased breast size

• Milky discharge from nipples in females

• Excessive sweating

• Chills

• Headache

• Hair loss

If you experience any of the following symptoms or those listed in the IMPORTANT WARNING or SPECIAL PRECAUTIONS sections, call your doctor immediately:

• Yellowing of the skin or eyes

• Fast heartbeat

• Unusual bleeding or bruising

• Skin rash, itching, or swelling

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088.^18,19

Doxepin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

Doxepin may cause increased or decreased sexual ability, desire, drive or performance. These are not common side effects, and their incidence rate is not known.²⁰

Keep this medication in the container it came in, tightly closed and out of reach of children. Store it at room temperature and away from light, and excess heat and moisture (not in the bathroom).

Dispose of unneeded medications in a way so that pets, children and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

Keep all medication out of sight and reach of children, as many containers are not child resistant. Always lock safety caps. Place the medication in a safe location, out of their sight and reach. Learn more at www.upandaway.org.²¹

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• Irregular heartbeat

• Feeling agitated, confused or drowsy

• Trouble concentrating

• Seizures

• Muscle stiffness

• Vomiting

• Increase in pupil size

• Hallucination (seeing things or hearing voices that do not exist)

• Fever

• Cold body temperature

• Coma (loss of consciousness for a period of time)²²

No, doxepin is not considered addictive.²³

Doxepin typically does not cause rebound insomnia, but results may vary by patient.²⁴

Doxepin does not cause withdrawal symptoms.²⁵

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.²⁶

Doxepin is the generic version of the brand name Silenor®.²⁷

We also prescribe the following medication for insomnia:

• Trazodone (Generic Desyrel®)

• Mirtazapine (Generic Remeron®)

• Ramelteon (Generic Rozerem®)

• Amitriptyline (Generic Elavil®)

• Hydroxyzine (Generic Atarax®)

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