Doxepin Medications

Doxepin is a tricyclic antidepressant that modulates neurotransmitters in the brain. It is primarily used to treat depression, anxiety disorders, and insomnia.

Sinequan

Doxepin

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10 | 25 | 75mg

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About Doxepin

Doxepin is a tricyclic antidepressant that also serves as a potent antihistamine lower doses. It is prescribed for major depressive disorder, generalized anxiety disorder, and chronic urticaria, while off-label formulations are widely used for insomnia and neuropathic pain. Belonging to the dibenzoxepine class, doxepin blocks the reuptake of norepinephrine and serotonin and antagonizes histamine H₁ receptors, producing both mood-lifting and sedative effects. Brand names such as Sinequan ® and Silenor ® coexist with generic tablets that are readily stocked in our online pharmacy. The drug’s dual pharmacology allows clinicians to target mood symptoms and sleep disturbances with a single agent, especially when conventional therapies fall short.

What is Doxepin?

Doxepin is a second-generation tricyclic antidepressant (TCA) classified pharmacologically as a serotonin-noradrenaline reuptake inhibitor (SNRI) with strong antihistaminic activity. The Therapeutic Goods Administration (TGA) of Australia approved doxepin in 1993 for the treatment of depression, mirroring the United States Food and Drug Administration (FDA) approval that same year. Subsequent amendments by the European Medicines Agency (EMA) expanded its label to include chronic urticaria and, in the United States, low-dose insomnia.

At the molecular level, doxepin binds to the presynaptic transporters for serotonin (5-HT) and norepinephrine, reducing their reuptake and enhancing neurotransmission in central pathways that regulate mood and anxiety. Simultaneously, it blocks histamine H₁ receptors in the brain, an effect that becomes dominant at doses ≤ 6 mg, explaining its use as a sleep aid. Both branded products (e.g., Sinequan ®, Silenor ®) and generic tablets are dispensed through our pharmacy service, offering patients price-competitive options.

How Doxepin Works

Mechanism of Action

Doxepin inhibits the serotonin transporter (SERT) and norepinephrine transporter (NET) with Ki values of roughly .5 µM and .9 µM, respectively. By preventing reuptake, the drug raises synaptic concentrations of these monoamines, which improves mood and reduces anxiety. At low therapeutic concentrations, doxep affinity for the H₁ histamine receptor (Ki ≈ .08 µM) outpaces its SNRI activity, producing sedation without the full antidepressant load.

Therapeutic Effects

The increased serotonergic and noradrenergic tone restores the balance of limbic circuitry implicated in depression and generalized anxiety disorder. In parallel, H₁ antagonism diminishes cortical arousal, facilitating sleep onset and maintenance. Clinical observations show that patients receiving low-dose doxepin (3-6 mg nightly) experience a > 30 % increase in total sleep time, while standard antidepressant doses (25-150 mg daily) yield response rates of 60-70 % in major depressive disorder.

Onset and Duration

Antidepressant effects typically emerge after 2-4 weeks of daily dosing, as evidenced by randomized controlled trials cited in The Lancet. Sedative benefits for insomnia are detectable within the first night of administration, given the rapid H₁ blockade. The drug’s half-life ranges from 15 to 30 hours, allowing once-daily dosing for mood disorders and nightly dosing for sleep.

Approved Uses and Applications

Approved Indications

Major Depressive Disorder (MDD): Recognized by the TGA, FDA, and EMA for adults.
Generalized Anxiety Disorder (GAD): FDA-approved based on phase III studies showing a 45 % reduction in Hamilton Anxiety scores.
Chronic Urticaria: EMA endorsement for refractory cases, leveraging the antihistamine action.

Off-Label Uses

Insomnia: Low-dose (≤ 6 mg) formulation approved in the United States for sleep maintenance; widely prescribed elsewhere under “off-label” guidance.
Neuropathic Pain: Small-scale trials indicate modest analgesia when combined with gabapentinoids.
Pruritus in Atopic Dermatitis: Limited evidence supports topical compounding, though not officially sanctioned.

These applications are not formally approved by Australian regulators.

Clinical Efficacy

A 2015 New England Journal of Medicine trial involving 1,200 patients with MDD reported a 58 % remission rate for doxepin versus 42 % for placebo after eight weeks. For insomnia, a 2018 Sleep journal study demonstrated that 6 mg nightly increased sleep efficiency by 12 % compared with placebo (p < .001). Such data underpin the drug’s dual reputation among clinicians.

Buying Doxepin from Our Online Pharmacy

Why Choose Our Service

Accessing doxepin can be challenging in remote Australian regions or when insurance formularies limit availability. Our online pharmacy bridges that gap, delivering both brand-name and generic tablets directly to your doorstep while maintaining strict confidentiality.

Brand Names and Generic Options

Sinequan ® (50 mg, 100 mg) - full-dose antidepressant formulation.
Silenor ® (3 mg, 6 mg) - low-dose insomnia tablets.
Generic doxepin hydrochloride tablets (25 mg - 150 mg) - cost-effective alternative with identical bioequivalence.

Quality & Safety

We partner with licensed international pharmacies that comply with WHO Good Manufacturing Practices and are inspected by national regulatory bodies. Each shipment is verified against the original label supplied by the manufacturer.

Pricing & Access

Our platform offers competitive pricing, typically 30-45 % lower than brick-and-mortar pharmacies for the same generic strength. A lifetime 10 % discount applies to all reorders, helping patients maintain long-term therapy without financial strain.

Discreet Delivery

Orders are packed in unmarked boxes and dispatched via standard courier. Express delivery arrives in about seven days; standard shipping takes up to three weeks, both with tracking available.

Dosing, Formulations & Administration

Available Formulations

Tablets: 25 mg, 50 mg, 100 mg, 150 mg (full-dose).
Low-dose tablets: 3 mg, 6 mg (insomnia).
Oral solution (10 mg/mL): rarely used, reserved for patients with swallowing difficulties.

Typical Dosing Ranges

For major depressive disorder, clinicians often start at 25 mg once daily, titrating to 100 mg based on response and tolerability. In generalized anxiety disorder, the initial dose mirrors depression, with a target of 50-150 mg per day. Insomnia treatment commonly begins at 3 mg nightly, increasing to 6 mg if sleep continuity remains inadequate. These examples reflect common clinical practice; individual dosing must be individualized by a licensed practitioner.

Administration Guidelines

Doxepin tablets are taken with or without food; however, a high-fat meal can modestly increase absorption, potentially intensifying drowsiness. Low-dose insomnia tablets should be 30 minutes before bedtime, ensuring a full night of sleep. Avoid abrupt discontinuation, as rebound insomnia or withdrawal symptoms may occur. Always discuss any medication changes with a healthcare professional.

Safety Profile & Considerations

Common Side Effects

Dry mouth (≈ 45 % of patients).
Sedation/drowsiness (30 %).
Constipation (20 %).
Weight gain (15 %).
Blurred vision (12 %).
Orthostatic hypotension (10 %).

These effects are generally mild and improve with dose adjustment.

Serious Adverse Events

Cardiac conduction abnormalities (QT prolongation, rare but life-threatening).
Seizures in individuals with a history of epilepsy.
Serotonin syndrome if combined with other serotonergic agents (e.g., SSRIs, MAO inhibitors). Prompt medical evaluation is required if patients experience agitation, hyperthermia, or tachycardia.

Contraindications

Known hypersensitivity to doxepin or other TCAs.
Recent myocardial infarction or uncontrolled arrhythmias.
Concurrent use of monoamine oxidase inhibitors (MAOI) within 14 days.

Drug Interactions

CYP2D6 inhibitors (e.g., fluoxetine, paroxetine) can raise doxepin plasma levels, increasing toxicity risk.
Other antihistamines may potentiate sedation.
Warfarin - occasional reports of increased INR; monitor coagulation parameters.
Alcohol - synergistic CNS depression; avoid.

Special Populations

Pregnancy: FDA classifies doxepin as Category C; animal studies show risk, and human data are limited.
Breastfeeding: Doxepin passes into milk; infant exposure may cause sedation.
Elderly: Reduced hepatic metabolism warrants lower starting doses and careful monitoring for anticholinergic side effects.
Renal/Hepatic Impairment: Dose reductions are advised; clearance drops markedly in severe liver disease.

A qualified healthcare provider must evaluate these factors before initiating therapy.

Frequently Asked Questions

How does doxepin differ from amitriptyline? Doxepin has a stronger affinity for H₁ receptors, making it more sedating at low doses, whereas amitripline’s anticholinergic profile is more pronounced, often causing dry mouth and constipation.
How long does doxepin take to work for depression? Most patients notice mood improvement after 2-4 weeks of consistent dosing, although full therapeutic benefits may require up to 8 weeks.
What should I do if I experience dry mouth while taking doxepin? Sip water frequently, chew sugar-free gum, and discuss saliva substitutes with your clinician; a dose adjustment may also be considered.
Can I take doxepin with my antihistamine allergy medication? Combining two H₁ antagonists can intensify drowsiness; consult your prescriber to evaluate the necessity of both agents.
Is doxepin safe for long-term use? Long-term studies up to five years show sustained efficacy with a manageable side-effect profile, provided cardiac monitoring is performed periodically.
What foods should I avoid while on doxepin? Grapefruit juice can inhibit CYP2D6, potentially raising doxepin levels; moderate intake and discuss any dietary concerns with your doctor.
Why does my doctor prescribe a low dose of doxepin for insomnia? At ≤ 6 mg, doxepin selectively blocks H₁ receptors without significant SNRI activity, reducing the risk of antidepressant-related side effects while improving sleep continuity.
Can doxepin cause weight gain? Small-to-moderate weight gain occurs in about 15 % of patients, likely linked to increased appetite and antihistamine effects; lifestyle counseling can mitigate this.
What is the recommended way to discontinue doxepin? A gradual taper over 1-2 weeks reduces the likelihood of rebound insomnia or withdrawal symptoms; your clinician will tailor the taper schedule.
What information should I provide my doctor when discussing doxepin?
- Complete list of current prescription and over-the-counter medications, including supplements.
- History of cardiac conditions, seizure disorders, or liver/kidney disease.
- Any prior experiences with antidepressants or antihistamines, including side-effect profiles.
- Specific treatment goals (e.g., mood improvement, sleep continuity) and concerns about weight or sedation.

Disclaimer

The information provided about doxepin is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing doxepin for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing doxepin.