Sinequan

Generic Name: Doxepin
Brand Names: Adapin, Sinequan

Sinequan (Doxepin) is used for:

Treating depression or anxiety in certain patients. It may also be used for other conditions like gastrointestinal ulceration and other GI-problems (e.g. irritable bowel syndrome), whether part of depression or not.

Sinequan (Doxepin) is a tricyclic antidepressant. It is not known exactly how it works. It may increase the activity of certain chemicals in the brain, which help elevate mood.

Do NOT use Sinequan (Doxepin) if:

• you are allergic to any ingredient in Sinequan (Doxepin) or to other tricyclic antidepressants
• you have certain prostate problems (eg, asymptomatic prostatic hypertrophy), glaucoma, or trouble urinating
• you are taking cisapride, clonidine, dofetilide, H₁ antagonists (eg, astemizole, terfenadine), or ibutilide, or you have taken a monoamine oxidase (MAO) inhibitor (eg, furazolidone, phenelzine, isocarboxazid) within the past 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Sinequan (Doxepin) :

Some medical conditions may interact with Sinequan (Doxepin). Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of heart problems, seizures (eg, epilepsy), overactive thyroid, prostate problems (eg, benign prostatic hypertrophy [BPH]), blood problems (eg, porphyria), other mental or mood problems, suicidal thoughts or attempts, or alcohol abuse

Some MEDICINES MAY INTERACT with Sinequan (Doxepin). Tell your health care provider if you are taking any other medicines, especially any of the following:

• Antiarrhythmics (eg, quinidine, propafenone, flecainide), antifungal medicines (eg, fluconazole, terbinafine), carbamazepine, cimetidine, mibefradil, phenothiazines (eg, chlorpromazine, thioridazine), or selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine, sertraline) because side effects of Sinequan (Doxepin) may be increased
• Anticoagulants (eg, warfarin), cisapride, dofetilide, H₁ antagonists (eg, astemizole, terfenadine), ibutilide, sulfonylureas (eg, tolazamide, glipizide), sympathomimetics (eg, phenylephrine, pseudoephedrine), or tramadol because side effects may be increased by Sinequan (Doxepin)
• Clonidine, guanadrel, guanethidine, or guanfacine because the effectiveness of these medicines may be decreased
• MAO inhibitors (eg, furazolidone, phenelzine, isocarboxazid) because severe toxic effects may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Sinequan (Doxepin) may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Sinequan (Doxepin) :

Use Sinequan (Doxepin) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Sinequan (Doxepin) comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Sinequan (Doxepin) refilled.
• Sinequan (Doxepin) may be taken with or without food.
• Taking Sinequan (Doxepin) at bedtime may help reduce side effects (eg, daytime drowsiness). Discuss this possibility with your doctor.
• If you miss a dose of Sinequan (Doxepin) , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you take 1 dose daily at bedtime, do not take the missed dose the next morning.

Ask your health care provider any questions you may have about how to use Sinequan (Doxepin).

Important safety information:

• Sinequan (Doxepin) may cause drowsiness, dizziness, blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Sinequan (Doxepin). Using Sinequan (Doxepin) alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Sinequan (Doxepin) will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Sinequan (Doxepin) may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Limit your alcohol consumption while taking Sinequan (Doxepin).
• Antidepressants can increase suicidal thoughts and actions in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your health care provider right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
• Sinequan (Doxepin) may cause increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to Sinequan (Doxepin). Use a sunscreen or protective clothing if you must be outside for a prolonged period.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Sinequan (Doxepin).
• After you start taking Sinequan (Doxepin) , several weeks may pass before you feel the full benefit.
• LAB TESTS may be required to monitor your therapy or to check for side effects. Be sure to keep all doctor and lab appointments.
• Use Sinequan (Doxepin) with caution in the ELDERLY because they may be more sensitive to its effects.
• Sinequan (Doxepin) is not recommended for use in CHILDREN younger than 12 years of age. Safety and effectiveness in this age group have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Sinequan (Doxepin) during pregnancy. Sinequan (Doxepin) is excreted in breast milk. Do not breast-feed while taking Sinequan (Doxepin).

Possible side effects of Sinequan (Doxepin) :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Appetite loss; constipation; diarrhea; dizziness; drowsiness; dry mouth; excess sweating; headache; heartburn; increased appetite; indigestion; nausea; unpleasant taste; urinary retention; vomiting; weakness; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormal movements; aggressive or bizarre behavior; agitation; anxiety; blurred vision or other vision changes; chest pain; constipation; difficulty speaking and swallowing; disorientation; eye pain; fainting; fast, slow, or irregular heartbeat; hair loss; hallucinations; hostility; irritability; loss of balance; mood swings; nervousness or restlessness; panic attacks; ringing in the ears; seizures; shakiness; sore throat or fever; trouble sleeping; twitching of the face or tongue; unusual bleeding or bruising; yellowing of the skin or eyes.

Where to find the shelf life of the medicines?

• The expiration date can be found on each blister. It is different for different batches. The usual shelf life is 2 years from the date of manufacture but it may differ from batch to batch depending on date they were manufactured.