Key takeaways

  • Doxepin oral capsule is used to treat depression and anxiety in certain adults and children ages 12 years and older.
  • Doxepin oral capsule is only available as a generic drug. It’s not available as a brand-name drug.
  • In addition to oral capsules, doxepin comes as oral tablets, an oral solution, and a topical cream.

Doxepin oral capsule is a prescription drug. Oral means that you take the drug by swallowing.

Doxepin oral capsule does not have a brand-name version. It’s only available as a generic drug. Generic drugs usually cost less than brand-name drugs.

Doxepin also comes as an oral tablet, oral solution, and topical cream (which you apply to your skin). This article focuses on the oral capsule form of doxepin. Your doctor or pharmacist can tell you more about the other forms of this drug.

Why it’s used

Doxepin oral capsule is used to treat mood disorders, specifically depression and anxiety. For these uses, doctors usually prescribe the drug to certain adults and children ages 12 years and older.

How it works

Doxepin belongs to a class of drugs called tricyclic antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It’s not known exactly how doxepin works to treat depression or anxiety. It may block your brain from reabsorbing norepinephrine, a chemical messenger that affects your mood. This action increases the levels of norepinephrine in your body, which helps improve your mood.

Doxepin oral capsule can cause mild or serious side effects. The following text contains some of the key side effects that may occur while taking doxepin. These are not all of the possible side effects doxepin may cause.

For more information on the possible side effects of doxepin, or tips on managing bothersome side effects, talk with your doctor or pharmacist.

Doxepin oral capsule may cause drowsiness. You should not drive, use machinery, or do other activities that require alertness after taking this drug until you know how it affects you.

More common side effects

Some of the more common side effects that can occur with use of doxepin include:

  • dizziness
  • dry mouth
  • blurred vision
  • constipation
  • nausea or vomiting
  • indigestion (upset stomach)
  • changes in how foods taste
  • weight gain
  • drowsiness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or do not go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Suicidal thoughts and behaviors and worsening depression. Symptoms can include:
    • thoughts about suicide or dying
    • suicide attempts
    • new or worsened symptoms of anxiety
    • feeling very agitated or restless
    • panic attacks
    • insomnia (difficulty sleeping)
    • new or worsened irritability
    • acting aggressive, angry, or violent
    • acting on dangerous impulses
    • mania (moments of extremely high excitement and energy)
    • other unusual changes in behavior or mood
  • Urinary retention (difficulty urinating). Symptoms include:
    • not being able to empty your bladder
    • painful or urgent need to urinate
    • pain or bloating in your lower abdomen
    • feeling like you cannot completely empty your bladder when you urinate

Doxepin oral capsule can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

This section gives examples of medications that can interact with doxepin. The text that follows does not list all drugs that may interact with doxepin.

Before taking doxepin, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs for digestive system problems

Taking doxepin with certain drugs used to treat digestive system problems can increase the amount of doxepin in your body. This can raise your risk of side effects. If you take these drugs together, your doctor may lower your dosage of doxepin or monitor you for side effects.

Examples of these drugs used to treat digestive system problems include:

  • cimetidine (Tagamet HB)
  • famotidine (Pepcid)
  • nizatidine

Antidepressant drugs

Taking doxepin with antidepressants called monoamine oxidase inhibitors (MAOIs) may lead to serious side effects and even death. You should not take doxepin if you’re taking a MAOI or if you have used a MAOI within the past 14 days.

Examples of MAOIs include:

  • isocarboxazid (Marplan)
  • selegiline (Zelapar)
  • phenelzine (Nardil)
  • tranylcypromine (Parnate)

Also, taking doxepin with other drugs used to treat depression and anxiety can increase the amount of doxepin in your body. This can raise your risk of side effects. Examples of these drugs include:

Antifungal drugs

Taking doxepin with certain antifungals (drugs used to treat fungal infections) can increase the amount of doxepin in your body. This can raise your risk of side effects. Examples of these drugs include:

Heart rhythm drugs

Taking doxepin with certain drugs used to treat heart rhythm problems can increase your risk of dangerous heart rhythm problems. Examples of these drugs include:

Kidney disease drug

Taking cinacalcet with doxepin can increase the amount of doxepin in your body. This can raise your risk of side effects.

The doxepin oral capsule dosage your doctor prescribes will depend on several factors. These include:

  • your age
  • the condition being treated
  • the severity of your condition
  • other medical conditions you have
  • how you react to the first dose

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended for doxepin oral capsule. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Drug form and strengths

Generic: doxepin

  • Form: oral capsule
  • Strengths: 10 milligrams (mg), 25 mg, 50 mg, 75 mg, 100 mg, 150 mg

Dosage for depression

Adult dosage (ages 18 to 64 years)

  • Typical starting dosage: 75 mg per day. Your doctor may tell you to take the entire dose at once or divide it into smaller doses throughout the day.
  • Dosage adjustments: Your doctor will adjust your dosage depending on how your body responds to the drug. The usual dosage range is 75 to 150 mg per day. For severe depression, your doctor may increase your dosage to 300 mg per day. For very mild depression, they may recommend a dosage as low as 25 to 50 mg per day.
  • Maximum dosage: 300 mg per day. If taken once daily, the maximum dosage is 150 mg per day, which you may take at bedtime.

Child dosage (ages 12 to 17 years)

  • Typical starting dosage: 75 mg per day. Your child’s doctor may recommend that your child take the entire dose at once or divide it into smaller doses throughout the day.
  • Dosage adjustments: Your child’s doctor will adjust the doxepin dosage depending on how your child’s body responds to the drug. The usual dosage range is 75 to 150 mg per day. For severe depression, the doctor may increase your child’s dosage to 300 mg per day. For very mild depression, the doctor may suggest a dosage as low as 25 to 50 mg per day.
  • Maximum dosage: 300 mg per day. If given once daily, the maximum dosage is 150 mg per day, which your child may take at bedtime.

Child dosage (ages 0 to 11 years)

It’s not known whether doxepin is safe and effective for children younger than age 12 years.

Older adult dosage (ages 65 years and older)

The liver and kidneys of an older adult may not work as well as they used to. This can cause the body to process drugs more slowly. As a result, a higher amount of a drug may stay in the body for a longer time. This increases the risk of side effects.

If you’re an older adult, your doctor may start you on a lower dosage or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for anxiety

Adult dosage (ages 18 to 64 years)

  • Typical starting dosage: 75 mg per day. Your doctor may tell you to take the entire dose at once or divide it into smaller doses throughout the day.
  • Dosage adjustments: Your doctor will adjust your dosage depending on how your body responds to the drug. The usual dosage range is 75 to 150 mg per day. For severe anxiety, your doctor may increase your dosage to 300 mg per day. For very mild anxiety, they may recommend a dosage as low as 25 to 50 mg per day.
  • Maximum dosage: 300 mg per day. If taken once daily, the maximum dosage is 150 mg per day, which you may take at bedtime.

Child dosage (ages 12 to 17 years)

  • Typical starting dosage: 75 mg per day. Your child’s doctor may recommend that your child take the entire dose at once or divide it into smaller doses throughout the day.
  • Dosage adjustments: Your child’s doctor will adjust the doxepin dosage depending on how your child’s body responds to the drug. The usual dosage range is 75 to 150 mg per day. For severe anxiety, the doctor may increase your child’s dosage to 300 mg per day. For very mild anxiety, the doctor may suggest a dosage as low as 25 to 50 mg per day.
  • Maximum dosage: 300 mg per day. If given once daily, the maximum dosage is 150 mg per day, which your child may take at bedtime.

Child dosage (ages 0 to 11 years)

It’s not known whether doxepin is safe and effective for children younger than age 12 years.

Older adult dosage (ages 65 years and older)

The liver and kidneys of an older adult may not work as well as they used to. This can cause the body to process drugs more slowly. As a result, a higher amount of a drug may stay in the body for a longer time. This increases the risk of side effects.

If you’re an older adult, your doctor may start you on a lower dosage or a different medication schedule. This can help keep levels of this drug from building up too much in your body.

Your symptoms of depression should start to improve after you’ve been taking doxepin oral capsule for 2 to 3 weeks. Your symptoms of anxiety should start to improve sooner than that.

This drug comes with several warnings.

FDA warning: Suicide risk

This drug has a boxed warning for suicide risk. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

Antidepressant drugs, such as doxepin, may increase the risk of suicidal thoughts or behaviors. This risk may be especially high during the first few months of treatment or when changing doses. Children, teenagers, and young adults have even more of a risk of this side effect.

You and your family members, caregivers, and doctor should pay attention to changes in your mood, behaviors, thoughts, or feelings while you take this drug.

Drowsiness warning

You should not drive, use machinery, or do other activities that require alertness until you know how this drug affects you.

Dementia warning

Research has indicated that this type of medication can cause effects similar to those caused by drugs called anticholinergics. This can raise the risk of dementia.

Allergy warning

Doxepin can cause a severe allergic reaction. Symptoms can include:

  • difficulty breathing
  • swelling of your throat or tongue
  • itching
  • hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

You should not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

Alcohol interaction warning

Consuming drinks that contain alcohol while taking doxepin can increase the drowsiness you feel from the drug. If you drink alcohol, talk with your doctor about how much is safe to consume, if any, while taking this drug.

Warnings for people with certain health conditions

For people with glaucoma: You should not take this drug if you have glaucoma, a condition that affects the eyes. Taking doxepin may worsen your glaucoma.

For people with problems urinating: You should not take this drug if you have urinary problems, such as difficulty urinating. It can worsen your condition.

Warnings for other groups

For pregnant women: It is not known whether doxepin is safe for use in pregnant women.

Tell your doctor if you’re pregnant or plan to become pregnant. Doxepin should be used during pregnancy only if the potential benefit justifies the potential risk.

For women who are breastfeeding: Doxepin may pass into breast milk and may cause side effects in a child who is breastfed. These effects include drowsiness and breathing problems.

Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For older adults: Older adults may be more sensitive to doxepin. This may make them more likely to feel confused or drowsy while taking the drug.

For children: Doxepin has not been established as safe or effective for use in children younger than age 12 years. It should not be used in children in this age range.

Doxepin oral capsule is used for short- or long-term treatment. It comes with risks if you do not take it as prescribed.

If you stop taking the drug or do not take it at all: You may still have symptoms of depression or anxiety. If you’ve been taking this drug for a long time, you should not stop taking it suddenly. Stopping it suddenly may cause side effects. These include nausea, headache, and tiredness.

If you miss doses or do not take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. You may have the following symptoms:

  • atypical heart rhythms
  • low blood pressure
  • sudden involuntary body movements
  • overactive reflexes
  • muscle stiffness
  • confusion
  • difficulty concentrating
  • drowsiness
  • hallucinations (seeing things that are not real)
  • dilated pupils
  • agitation
  • vomiting
  • very low body temperature or very high fever
  • seizures

If you think you’ve taken too much of this drug, call your doctor or seek guidance from America’s Poison Centers at 800-222-1222 or through its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should have fewer symptoms of depression or anxiety. You may be in a better mood. It may take 2 to 3 weeks of treatment with this drug for your symptoms of depression to improve. Your symptoms of anxiety should improve sooner than that.

Whether you have health insurance or not, cost may be a factor when you’re considering doxepin. What you’ll pay for doxepin may depend on several things, such as your treatment plan and the pharmacy you use.

  • Comparing pharmacies: The price of doxepin may vary depending on which pharmacy you use. As a result, it can help to compare prices across pharmacies to find the lowest cost.
  • Drug coupons: You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits. However, the discounted price may be lower than what you would pay through insurance.
  • Financial assistance: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Keep these considerations in mind if your doctor prescribes doxepin for you.

General

  • You can take doxepin with or without food. Taking it with food may help to reduce your risk of upset stomach.
  • Doxepin oral capsule can be opened, and the powder can be mixed with water.

Storage

  • Store doxepin at room temperature between 68°F and 77°F (20°C and 25°C).
  • Protect this drug from light.
  • Keep this drug in the container it came in, with the lid tightly closed.
  • Do not store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • You do not need to worry about airport X-ray machines. They cannot harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • You should not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Mood: Pay close attention to sudden changes in your mood, behaviors, thoughts, or feelings. If you have any unusual changes, call your doctor right away.
  • Vision: This drug may cause vision problems. Your doctor may examine your eyes.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Doxepin, oral capsule images