Generic Name and Formulations:
Doxepin (as HCl) 3mg, 6mg; tabs.
Indications for SILENOR:
Treatment of insomnia characterized by difficulty with sleep maintenance.
Individualize. Take within 30mins of bedtime. Do not take within 3 hours of a meal. Initially 6mg once daily. Max: 6mg/day. Elderly, hepatic impairment, tendency to urinary retention: initially 3mg once daily.
During or within 14 days of MAOIs. Untreated narrow angle glaucoma. Severe urinary retention.
Evaluate for co-morbid diagnoses (eg, physical or psychiatric disorders) prior to treatment. Reevaluate if insomnia persists after 7–10 days of use. Monitor for new onset behavioral changes, worsening of depression, or suicidal thinking. Hepatic impairment. Respiratory dysfunction. Severe sleep apnea: not recommended. Poor metabolizers (those with reduced CYP2D6/2C19 activity). Reevaluate periodically. Elderly. Pregnancy (Cat.C). Nursing mothers.
H1 receptor antagonist.
Additive effects with concomitant CNS depressants, antihistamines, or alcohol (avoid); reduce dose. Potentiated by cimetidine. Possible hypoglycemia with tolazamide.
Somnolence, sedation, nausea, upper respiratory tract infection, dizziness, photosensitivity, skin rash; abnormal thinking, behavioral changes, complex behaviors, sleep-driving (discontinue if occurs), amnesia, anxiety, other neuro-psychiatric symptoms.
Tabs—30, 100, 500
Clinical Pain Advisor Articles
- History of Migraine May Be Associated With Higher Risk for Cochlear Disorders
- Radiofrequency Denervation Efficacious in Treating Thoracic Zygapophyseal Joint Pain
- Symptom Severity, Sensory Sensitivity May Indicate Pain Centralization in Chronic Overlapping Pain Conditions
- Stat Consult: Chronic Low Back Pain
- Opioid Misuse May Help Predict Alcohol Dependence Treatment Outcomes
- Consensus Guidelines for the Use of Intravenous Ketamine for Chronic Pain
- Pain Societies Issue Guidelines on Use of Ketamine for the Management of Acute Pain
- Labor Epidural Analgesia Linked to Reduced Likelihood of Successful Breastfeeding
- Novel Oral Treatment Safe, Effective for Migraine Headache Relief
- DFN-02 Nasal Spray Safe, Effective for Acute Treatment of Episodic Migraine
- OnabotulinumtoxinA May Be Effective for Chronic Migraine With Medication Overuse
- FDA Outlines Plan for Increasing Nonprescription Drug Availability
- Prescribed Opioids Difficulties Scale Effective for Assessing Concerns of Patients With Chronic Pain
- Hypoesthesia for Touch and Joint Position Linked to Chronic Pain in MS
- New Laws Are Needed to Protect Health Data Shared Online