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What is SILENOR ( Doxepin )?

Buy Silenor (doxepin) online is a tricyclic antidepressant. Silenor tablets are used to treat insomnia in people who have trouble staying asleep. This medication guide provides information about the Silenor brand of doxepin used to treat insomnia. Sinequan and other generic brands of doxepin used to treat depression or anxiety are not covered in this medication guide. Silenor tablets are not for use in treating depression.

Why is SILENOR ( Doxepin ) prescribed?

Uses of SILENOR ( Doxepin )

Doxepin (Silenor) is used to treat insomnia (difficulty falling asleep or staying asleep) in people who have trouble staying asleep. Doxepin (Silenor) is in a class of medications called tricyclic antidepressants. It works by slowing activity in the brain to allow sleep. Buy Silenor online

Doxepin is also available as a capsule and liquid to treat depression and anxiety. This monograph only gives information about doxepin (Silenor) for insomnia. If you are using this medication for depression or anxiety, read the monograph entitled doxepin (depression, anxiety).

How should SILENOR ( Doxepin ) be used?

Doxepin (Silenor) comes as a tablet to take by mouth. It is usually taken once a day, within 30 minutes of bedtime. Do not take doxepin (Silenor) within 3 hours of a meal. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take doxepin (Silenor) exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

You should begin to sleep better during the first few days of treatment with doxepin (Silenor). If your sleep does not improve within 7-10 days or gets worse call your doctor.

What are the side effects of SILENOR ( Doxepin )?

Doxepin’s side effects profile may differ from the list below in some countries where it is licensed to be used in much smaller doses (viz., 3 mg and 6 mg).

• Central nervous system: fatigue, dizziness, drowsiness, lightheadedness, confusion, nightmares, agitation, increased anxiety, difficulty sleeping, seizures (infrequently), temporary confusion (delirium), rarely induction of hypomania and schizophrenia (stop the medication immediately), extrapyramidal side effects (rarely), abuse in patients with polytoxicomania (rarely), ringing in the ears (tinnitus)
• Anticholinergic: dry mouth, constipation, even ileus (rarely), difficulties in urinating, sweating, precipitation of glaucoma
• Antiadrenergic: Low blood pressure, (if patient arises too fast from the lying/sitting position to standing—known as orthostatic hypotension), abnormal heart rhythms (e.g., sinus tachycardia, bradycardia, and atrioventricular block)
• Allergic/toxic: skin rash, photosensitivity, liver damage of the cholestatic type (rarely), hepatitis (extremely rare), leuko- or thrombocytopenia (rarely), agranulocytosis (very rarely), hypoplastic anemia (rarely)
• Others: frequently increased appetite and weight gain, rarely nausea, rarely high blood pressure. May increase or decrease liver function in some people.

What special precautions should I follow?

Before taking doxepin (Silenor),

• 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 if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. 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.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: cimetidine (Tagamet); medications for cough, cold, or allergies; quinidine (in Nuedexta); sedatives; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); other sleeping pills; tolazamide; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with doxepin (Silenor), so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• 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.

What special dietary instructions should I follow?

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

What should I do if I forget a dose?

Doxepin (Silenor) should only be taken at bedtime. If you did not take doxepin (Silenor) before you went to bed and you are having trouble sleeping, you may take doxepin (Silenor) if you will be able to stay in bed for at least 7 to 8 hours afterward. Do not take a double dose of doxepin (Silenor) to make up for a missed dose.

What should I know about the storage and disposal of this medication?

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). Buy SILENOR ( Doxepin ) online

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. Buy SILENOR ( Doxepin ) online

In case of emergency/overdose

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911. Buy SILENOR ( Doxepin ) online

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)

What other information should I know?

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.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Buy SILENOR ( Doxepin ) online

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Brand names

• Silenor^®