III. Adverse Effects

  1. See Tricyclic Antidepressant
  2. Significant Anticholinergic effects, including sedation

IV. Safety

  1. Unknown safety in pregnancy
  2. Avoid in Lactation

V. Mechanism

  1. See Tricyclic Antidepressant
  2. Primarily affects Norepinephrine reuptake

VI. Dosing (Adults and Age over 12 years)

  1. Mood Disorders (Major Depression, Anxiety Disorder)
    1. Start: 75 mg orally at bedtime
    2. Titrate to 50 to 150 mg/day as tolerated and to effect
    3. Max: 300 mg/day (divide higher doses, above 150 mg/day, twice daily)
  2. Insomnia
    1. Adult: 6 mg orally 30 min before bed
    2. Elderly (over age 65 years): 3 mg orally 30 min before bed
      1. May advance to 6 mg orally as needed
  3. Pruritus
    1. Start 10 to 25 mg orally at bedtime
    2. Titrate to 10 to 100 mg/day as tolerated and to effect

VIII. References

  1. (2023) Med Lett Drugs Ther 62(1592): 25-32
  2. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 38-9
  3. Hamilton (2020) Tarascon Pocket Pharmacopoeia

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Cost: Medications

doxepin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
DOXEPIN 10 MG CAPSULE Generic $0.12 each
DOXEPIN 10 MG/ML ORAL CONC Generic $0.31 per ml
DOXEPIN 100 MG CAPSULE Generic $0.48 each
DOXEPIN 150 MG CAPSULE Generic $0.61 each
DOXEPIN 25 MG CAPSULE Generic $0.21 each
DOXEPIN 50 MG CAPSULE Generic $0.29 each
DOXEPIN 75 MG CAPSULE Generic $0.39 each
DOXEPIN HCL 3 MG TABLET Generic $6.96 each
DOXEPIN HCL 6 MG TABLET Generic $8.43 each