Doxepin

Details About Generic Salt ::  Doxepin 

Main Medicine Class:: Skin   Sub Medicine Class ::  Anti Pruritic Drugs

1D. ANTI-DEPRESSANTS in 1. NERVOUS SYSTEM
DOXEPIN
TCA(TERTIARY AMINE) | ANTI-DEPRESSANT, ANTI-PRURITIC
also comes under 15L. Anti-Pruritic Drugs in 15. Skin
PK: A: Well absorbed D: Extensive M: Hepatic E: Urine

Indications & Dose: ANXIETY PO Adult Initially 25-150mg/day HS or in 2-3 divided doses, may gradually increase up to 300mg/day, single dose should not exceed 150mg Elderly Initially 10-25mg HS; increase by 10-25mg q3days for inpatients and weekly for outpatients if tolerated, max 75mg/day, a single bedtime dose is recommended | DEPRESSION PO Adult Initially 25-150mg/day HS or in 2-3 divided doses; may gradually increase up to 300mg/day, single dose should not exceed 150mg Child 12-18 yr: Initially 75mg/day in divided doses or as a single dose at bedtime, MD 30-300mg/daily (doses >100mg given in 3 divided doses) Elderly Initially 10-25mg HS; increase by 10-25mg q3days for inpatients and wkly for outpatients if tolerated. max 75mg/day, a single HS dose is recommended | INSOMNIA PO Adult 3-6mg OD 30 min prior to HS, max 6mg/day Elderly 3mg OD; increase to 6mg OD if needed | PRURITUS Moderate-to-severe Short-term therapy TP Adult Cream (5%): Apply a thin film on affected areas QID, with an interval of atleast 3-4h between application 8 days

Contra: Hypersensitivity, narrow-angle glaucoma, urinary retention, use of MAOI within 14 days

Precautions: CVD, prostatic enlargement, seizures, elderly

ADR: Serious: Bone marrow depression, arrhythmias, MI, increased risk of suicide, paralytic ileus, seizures, blood disorders, hypoglycemia, heart block, HTN, tinnitus, gynecomastia, hypersensitivity reactions, orthostatic hypotension, ECG changes, tachycardia, palpitations, blurred vision, increased IOP, tinnitus, Others: constipation, fatigue, sedation, agitation, confusion, hallucinations, drowsiness, dizziness, nasal congestion, irritation, diaphoresis, flushing, photosensitivity, urticaria, testicular swelling, local burning, stinging, tingling, hyperglycemia, libido

DDI: Serious Rifampicin decreases drug level, Cimetidine increases drug level, SSRIs increases risk of drug toxicity, Thioridazine/Biperiden leads to severe constipation, MAOIs leads to tachycardia, seizures, potentially fatal reactions, Carbamazepine reduces drug level, Lithium results in neurotoxicity, serotonin syndrome & NMS

Diet: Do not take within 3h of food

Monitor: BP,pulse rate,mental status,suicidal ideation,weight,ECG

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