Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Drowsiness/reduced alertness: Since doxepin may cause drowsiness, avoid driving or engaging in activities requiring mental alertness and physical coordination until you determine that the medication does not affect you in this way.
Heart diseases: Tricyclic antidepressant medications such as doxepin, particularly when taken in high doses, can cause abnormal heart rhythms. People with a history of heart disease and seniors should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Mania or hypomania: Doxepin may cause activation of mania or hypomania. People with a history of bipolar disorder should be closely monitored by their doctor while using this medication.
Medical conditions: People with reduced liver function or seizures should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Suicidal or agitated behaviour: People taking antidepressants such as doxepin may feel agitated (restless, anxious, aggressive, emotional, trouble sleeping, and feeling not like themselves), or they may want to hurt themselves or others. If you notice any changes in mood, behaviours, thoughts, or feelings in yourself or someone who is taking this medication, contact a doctor immediately. Your doctor will monitor you closely for behaviour changes, especially at the start of treatment or when your dose is increased or decreased.
Surgery: Using doxepin before, during, and after surgery may increase the risk of developing abnormal heart rhythms. The risks and benefits of continuing doxepin during elective surgery should be discussed with your doctor. Your doctor may recommend to stop or reduce the dose of doxepin several days prior to the scheduled surgery.
Thyroid disease: Patients who have an overactive thyroid (hyperthyroidism) or are taking thyroid medication should be monitored closely by their doctor while taking doxepin.
Withdrawal: Stopping this medication abruptly after taking it for a long time may produce nausea, headache, and malaise. Experiencing these symptoms does not mean you are addicted. Do not suddenly stop taking this medication if you have been taking it for a while. If you are to stop taking this medication, contact your doctor, who will advise you on how to gradually stop taking this medication.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if doxepin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children.