DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This drug should not be used with the following medications because very serious, possibly fatal interactions may occur: arbutamine, cisapride, disopyramide, halofantrine.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anticholinergics (e.g., atropine, belladonna alkaloids, scopolamine, drugs for Parkinson's disease such as benztropine), certain drugs for high blood pressure (e.g., clonidine, guanadrel, guanethidine, reserpine), digoxin, levodopa, lithium, thyroid medication, valproic acid, drugs affecting liver enzymes that remove doxepin from your body (e.g., alcohol, barbiturates such as phenobarbital, cimetidine, haloperidol, phenothiazines such as thioridazine, St. John's wort, terbinafine, certain drugs for heart rhythm such as flecainide/propafenone, certain HIV protease inhibitors such as fosamprenavir, certain anti-seizure drugs such as carbamazepine/phenytoin, antidepressants such as amitriptyline, duloxetine, fluvoxamine, paroxetine, sertraline, trazodone).Many drugs besides doxepin may affect the heart rhythm (QT prolongation), including amiodarone, dofetilide, pimozide, quinidine, procainamide, sotalol, macrolide antibiotics (such as erythromycin), sparfloxacin, among others. Therefore, before using doxepin, report all medications you are currently using to your doctor or pharmacist.Also report the use of drugs which might increase seizure risk when combined with this medication such as isoniazid (INH), theophylline, or tramadol, among others. Consult your doctor or pharmacist for details.Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., levetiracetam), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, nefazodone).Check the labels on all your medicines (e.g., antacids, cough-and-cold products, diet aids) because they may contain cimetidine, ingredients that cause drowsiness, or decongestants/stimulants that could increase your heart rate or blood pressure. Ask your pharmacist about using those products safely.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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