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Sinequan (Doxepin)
Patient Information
Pronounced: SIN-uh-kwan
Generic name: Doxepin hydrochloride
Why is Sinequan prescribed?
Sinequan is used in the treatment of depression and anxiety. It helps
relieve tension, improve sleep, elevate mood, increase energy, and generally
ease the feelings of fear, guilt, apprehension, and worry most people
experience. It is effective in treating people whose depression and/or
anxiety is psychological, associated with alcoholism, or a result of another
disease (cancer, for example) or psychotic depressive disorders (severe
mental illness). It is in the family of drugs called tricyclic
antidepressants.
Most important fact about Sinequan
Serious, sometimes fatal, reactions have occurred when Sinequan is used
in combination with drugs known as MAO inhibitors, including the
antidepressants Nardil and Parnate. Any drug of this type should be
discontinued at least 2 weeks prior to starting treatment with Sinequan, and
you should be carefully monitored by your doctor.
If you are taking any prescription or nonprescription drugs, consult your
doctor before taking Sinequan.
How should you take Sinequan?
Take this medication exactly as prescribed. It may take several weeks for
you to feel better.
--If you miss a dose...
If you are taking several doses a day, take the missed dose as soon as
you remember, then take any remaining doses for that day at evenly spaced
intervals. If it is almost time for your next dose, skip the one you missed
and go back to your regular schedule. Never take 2 doses at the same time.
If you are taking a single dose at bedtime and do not remember until the
next morning, skip the dose. Do not take a double dose to make up for a
missed one.
--Storage instructions...
Store at room temperature.
What side effects may occur using Sinequan?
Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor can
determine if it is safe for you to continue taking Sinequan.
The most common side effect is drowsiness.
- Less common or rare side effects may include: Blurred vision,
breast development in males, bruises, buzzing or ringing in the ears,
changes in sex drive, chills, confusion, constipation, diarrhea,
difficulty urinating, disorientation, dizziness, dry mouth, enlarged
breasts, fatigue, fluid retention, flushing, fragmented or incomplete
movements, hair loss, hallucinations, headache, high fever, high or low
blood sugar, inappropriate breast milk secretion, indigestion,
inflammation of the mouth, itching and skin rash, lack of muscle
control, loss of appetite, loss of coordination, low blood pressure,
nausea, nervousness, numbness, poor bladder control, rapid heartbeat,
red or brownish spots on the skin, seizures, sensitivity to light,
severe muscle stiffness, sore throat, sweating, swelling of the
testicles, taste disturbances, tingling sensation, tremors, vomiting,
weakness, weight gain, yellow eyes and skin
Why should this drug not be prescribed?
If you are sensitive to or have ever had an allergic reaction to Sinequan
or similar antidepressants, you should not take this medication. Make sure
that your doctor is aware of any drug reactions that you have experienced.
Unless you are directed to do so by your doctor, do not take this
medication if you have the eye condition known as glaucoma or difficulty
urinating.
Special warnings about Sinequan
Sinequan may cause you to become drowsy or less alert; driving or
operating dangerous machinery or participating in any hazardous activity
that requires full mental alertness is not recommended.
Notify your doctor or dentist that you are taking Sinequan if you have a
medical emergency, and before you have surgery or dental treatment.
Possible food and drug interactions when taking Sinequan
Alcohol increases the danger in a Sinequan overdose. Do not drink alcohol
while taking this medication.
Never combine Sinequan with drugs known as MAO inhibitors. Medications in
this category include the antidepressants Nardil and Parnate.
If you are switching from Prozac, wait at least 5 weeks after your last
dose of Prozac before starting Sinequan.
If Sinequan is taken with certain other drugs, the effects of either
could be increased, decreased, or altered. It is especially important to
check with your doctor before combining Sinequan with the following:
Antidepressants that act on serotonin, such as Prozac, Zoloft, and Paxil
Other antidepressants such as Elavil and Serzone
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Clonidine (Catapres)
Flecainide (Tambocor)
Guanethidine (Ismelin)
Major tranquilizers such as Compazine, Mellaril, and Thorazine
Propafenone (Rythmol)
Quinidine (Quinidex)
Tolazamide (Tolinase)
Special information if you are pregnant or breastfeeding
The effects of Sinequan during pregnancy have not been adequately
studied. If you are pregnant or planning to become pregnant, inform your
doctor immediately. Sinequan may appear in breast milk and could affect a
nursing infant. If this medication is essential to your health, your doctor
may advise you to discontinue breastfeeding your baby until your treatment
is finished.
Recommended
dosage
ADULTS
The starting dose for mild to moderate illness is usually 75 milligrams
per day. This dose can be increased or decreased by your doctor according to
individual need. The usual ideal dose ranges from 75 milligrams per day to
150 milligrams per day, although it can be as low as 25 to 50 milligrams per
day. The total daily dose can be given once a day or divided into smaller
doses. If you are taking this drug once a day, the recommended dose is 150
milligrams at bedtime.
The 150-milligram capsule strength is intended for long-term therapy only
and is not recommended as a starting dose.
For more severe illness, gradually increased doses of up to 300
milligrams may be required as determined by your doctor.
CHILDREN
Safety and effectiveness have not been established for use in children
under 12 years of age.
OLDER ADULTS
Due to a greater risk of drowsiness and confusion, older people are
usually started on a low dose.
Overdosage
- Symptoms of Sinequan overdose may include: Agitation, coma,
confusion, convulsions, dilated pupils, disturbed concentration,
drowsiness, hallucinations, high or low body temperature, irregular
heartbeat, overactive reflexes, rigid muscles, severely low blood
pressure, stupor, vomiting
If you experience any of these symptoms, seek medical attention
immediately. An overdose of this drug can be fatal.
Full Sinequan prescribing information
Last updated 11/2005
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