Doxepin
Medication to treat depressive disorder, anxiety disorders, chronic hives, and trouble sleeping / From Wikipedia, the free encyclopedia
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Doxepin is a medication belonging to the tricyclic antidepressant (TCA)[10] class of drugs used to treat major depressive disorder, anxiety disorders, chronic hives, and insomnia.[10][11] For hives it is a less preferred alternative to antihistamines.[10] It has a mild to moderate benefit for sleeping problems.[12] It is used as a cream for itchiness due to atopic dermatitis or lichen simplex chronicus.[13]
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Trade names | Sinequan, Quitaxon, Aponal, others[1] |
Other names | NSC-108160[2] |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682390 |
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Routes of administration | By mouth, topical, intravenous, intramuscular injection[3] |
Drug class | Tricyclic antidepressant (TCA) |
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Bioavailability | 13–45% (mean 29%)[5][6] |
Protein binding | 76%[7] |
Metabolism | Liver (CYP2D6, CYP2C19)[8][5] |
Metabolites | Nordoxepin, glucuronide conjugates[8] |
Elimination half-life | Doxepin: 8–24 hours (mean 17 hours)[7] Nordoxepin: 28–31 hours[7][9] |
Excretion | Kidney: ~50%[8][5] Feces: minor[5] |
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Formula | C19H21NO |
Molar mass | 279.383 g·mol−1 |
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Common side effects include sleepiness, dry mouth, constipation, nausea, and blurry vision.[10] Serious side effects may include increased risk of suicide in those under the age of 25, mania, and urinary retention.[10] A withdrawal syndrome may occur if the dose is rapidly decreased.[10] Use during pregnancy and breastfeeding is not generally recommended.[14][15] Although how it works for treating depression remains an area of active inquiry, it may involve increasing the levels of norepinephrine, along with blocking histamine, acetylcholine, and serotonin.[10]
Doxepin was approved for medical use in the United States in 1969.[10] It is available as a generic medication.[14][16][17] In 2020, it was the 252nd most commonly prescribed medication in the United States, with more than 1 million prescriptions.[18][19]