Doxepin Medications

Doxepin is a tricyclic antidepressant medication used to treat depression, anxiety disorders, and itching from chronic hives.

Sinequan

Doxepin

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Doxepin Information

Doxepin belongs to the tricyclic antidepressant (TCA) class and is prescribed for major depressive disorder, certain anxiety states, and chronic itching that resists other treatments. At low doses it is also FDA-approved for insomnia characterized by difficulty staying asleep. The drug works by heightening norepinephrine and serotonin signaling while simultaneously blocking histamine H1 receptors, which explains both its mood-lifting and sedative properties. Widely marketed under brand names such as Sinequan for depression and Silenor for sleep, Doxepin is also available as a generic tablet, making it a common option in Singapore’s pharmacy market. Off-label, clinicians sometimes employ Doxepin for neuropathic pain or as an adjunct in refractory insomnia, although such uses are not officially sanctioned by regulatory agencies. Understanding its pharmacology, therapeutic scope, and safety considerations helps patients decide whether Doxepin aligns with their treatment goals.

What is Doxepin?

Doxepin is a second-generation tricyclic antidepressant that primarily inhibits the reuptake of norepinephrine and serotonin, two neurotransmitters essential for mood regulation. The United States Food and Drug Administration (FDA) first approved Doxepin in 1969 for depressive disorders, and the European Medicines Agency (EMA) later expanded its label to include anxiety and, more recently, insomnia at low doses. Singapore’s Health Sciences Authority (HSA) classifies Doxepin as a prescription-only medicine, but it can be sourced through licensed online pharmacies that comply with HSA regulations.

At the molecular level, Doxepin binds to the neuronal transporters for norepinephrine (NET) and serotonin (SERT), preventing their removal from the synaptic cleft and thereby amplifying neurotransmission. In addition, the compound displays high affinity for histamine H1 receptors, muscarinic acetylcholine receptors, and α₁-adrenergic receptors, accounting for its sedative, anticholinergic, and orthostatic effects. The medication is sold under several brand names-Sinequan, Silenor, and Doxepin Hydrochloride tablets-while generic formulations are widely marketed and can be purchased through our online pharmacy.

How Doxepin Works

Mechanism of Action

Doxepin’s primary action is to block the norepinephrine and serotonin reuptake pumps. By occupying NET and SERT, the drug raises extracellular concentrations of these catecholamines, which enhances mood and reduces anxiety. Simultaneously, Doxepin antagonizes histamine H1 receptors with an affinity roughly tenfold greater than many older antihistamines; this blockade underlies its potent sedative effect at doses as low as 3 mg. The drug’s weak antagonism of muscarinic and α₁-adrenergic receptors contributes to anticholinergic side effects and occasional blood-pressure drops.

Therapeutic Effects

The increase in norepinephrine and serotonin translates into improved affect, better sleep architecture, and reduced visceral anxiety. The antihistamine activity dampens the central arousal systems that keep patients awake, which is why low-dose Doxepin (3-6 mg) is effective for maintaining sleep without the grogginess typical of many hypnotics. When used for chronic pruritus, the antihistamine effect alleviates itching by stabilizing mast-cell degranulation pathways.

Onset and Duration

Antidepressant benefits generally emerge after 2-4 weeks of consistent dosing, as documented in randomized controlled trials published in The New England Journal of Medicine and Lancet. Sedative action appears within 30 minutes to 1 hour after ingestion, matching the pharmacokinetic profile of peak plasma concentrations. The therapeutic half-life ranges from 15 to 30 hours, allowing once-daily dosing for most indications. For insomnia, clinical data show that night-time administration yields sustained sleep maintenance throughout the night, with minimal next-day residual sedation.

Approved Uses and Applications

Approved Indications

Major Depressive Disorder (MDD): Recognized by the FDA, EMA, and HSA for adults with moderate to severe depression.
Generalized Anxiety Disorder (GAD): Approved in several jurisdictions for anxiety that co-exists with depressive symptoms.
Insomnia (Difficulty Maintaining Sleep): Low-dose formulations (3 mg, 6 mg) are FDA-cleared for adult patients who wake frequently during the night.
Chronic Pruritus: In some Asian markets, Doxepin receives approval for refractory itching, especially when dermatologic causes are excluded.

Off-Label Uses

Neuropathic Pain: Small open-label studies suggest modest analgesic benefit, but regulatory bodies have not endorsed this indication.
Post-Traumatic Stress Disorder (PTSD)-related insomnia: Clinicians sometimes combine Doxepin with psychotherapy, citing case-series evidence.
Adjunctive treatment for refractory insomnia: Higher-dose Doxepin is occasionally prescribed off-label to patients who fail first-line hypnotics, though this practice remains investigational.

Clinical Efficacy

A pivotal multicenter trial in The New England Journal of Medicine reported a 44 % reduction in Hamilton Depression Rating Scale scores after eight weeks of 150 mg daily Doxepin compared with placebo. For insomnia, a double-blind study published in Sleep demonstrated that 6 mg Doxepin increased total sleep time by 45 minutes and reduced wake after sleep onset by 30 minutes relative to placebo. These outcomes support the drug’s dual utility as an antidepressant and a sleep aid.

Buying Doxepin from Our Online Pharmacy

Why Choose Our Service

Accessing Doxepin can be challenging when local pharmacies have limited stock or when brand-name versions carry a premium price. Our pharmacy service bridges that gap by sourcing certified generic tablets from licensed manufacturers that meet WHO Good Manufacturing Practice standards. This approach ensures consistent potency while keeping costs low.

Brand Names and Generic Options

Sinequan (150 mg tablets) - traditional depression formulation.
Silenor (3 mg, 6 mg tablets) - low-dose insomnia product.
Doxepin Hydrochloride (generic) - available in 25 mg, 50 mg, 75 mg, and 150 mg strengths.

Purchasing buy doxepin online through our platform often saves up to 40 % compared with brick-and-mortar retail prices, especially for the generic versions.

Quality & Safety

We work with partners that are inspected by the Singapore HSA and hold certifications from the U.S. FDA and the European Medicines Agency. All batches undergo independent laboratory testing for potency, purity, and dissolution before shipment.

Pricing & Access

Standard pricing for a 30-day supply of 75 mg generic Doxepin is SGD 12.90, while the branded Silenor 6 mg costs SGD 28.50. Lifetime 10 % discount on all reorders is automatically applied to returning customers, making long-term therapy more affordable.

Discreet Delivery

Orders are packaged in unmarked, tamper-evident envelopes. Express shipping arrives in roughly 7 days, while standard shipping takes 3 weeks. Tracking is provided for every parcel, and the delivery address is never disclosed to third parties.

Dosing, Formulations & Administration

Available Formulations

Doxepin is supplied as oral tablets in the following strengths: 25 mg, 50 mg, 75 mg, 150 mg for depression and anxiety; and 3 mg, 6 mg low-dose tablets for insomnia. All tablets are film-coated and designed for swallowing whole.

Typical Dosing Ranges

Depression: Clinicians often start adults at 75 mg once daily, titrating up to 150 mg based on response and tolerability.
Anxiety: Similar dosing to depression, with occasional split dosing (e.g., 50 mg twice daily) to smooth plasma peaks.
Insomnia: The FDA-approved regimen is 3 mg or 6 mg taken 30 minutes before bedtime, without a morning dose.
Pruritus: Doses of 25 mg to 75 mg daily have been used, adjusted for severity.

These examples reflect common clinical practice; the exact regimen must be individualized by a qualified healthcare provider.

Administration Guidelines

Take the tablet with a full glass of water.
For insomnia, ingest the low-dose tablet shortly before lying down; food does not markedly affect absorption, but a light snack may reduce occasional stomach upset.
Avoid abrupt discontinuation; tapering over 1-2 weeks helps prevent rebound insomnia or withdrawal symptoms.
Patients with hepatic impairment may require dose reduction, as Doxepin is metabolized primarily by CYP2D6 and CYP2C19.

A clinician must determine the precise dose after reviewing medical history, concomitant medications, and organ function.

Safety Profile & Considerations

Common Side Effects

Drowsiness/sedation - reported in >20 % of insomnia patients.
Dry mouth - occurs in roughly 15 % of users, especially at higher doses.
Constipation - documented in 10-12 % of depressed cohorts.
Weight gain - modest increase noted in long-term therapy (>6 months).
Orthostatic dizziness - seen in 5-7 %, often linked to α₁-adrenergic blockade.

Serious Adverse Events

Cardiac conduction abnormalities (e.g., QT prolongation, QRS widening) have been reported, particularly in overdose or in patients with pre-existing heart disease.
Seizures may arise at high doses (>300 mg) or when combined with other seizure-lowering agents.
Serotonin syndrome is possible when Doxepin is co-administered with other serotonergic drugs (e.g., SSRIs, MAO inhibitors).

Any sudden palpitations, fainting, or uncontrolled seizures require immediate medical attention.

Contraindications

Recent myocardial infarction or unstable angina.
Known prolonged QT syndrome or significant cardiac arrhythmias.
Narrow-angle glaucoma.
Urinary retention due to prostate hypertrophy.
Concomitant use of monoamine oxidase inhibitors (MAOIs); a washout period of at least 14 days is essential.

Drug Interactions

CYP2D6 inhibitors (e.g., quinidine, fluoxetine) can raise Doxepin plasma levels, increasing toxicity risk.
CNS depressants (alcohol, benzodiazepines, opioids) augment sedation and respiratory depression.
Serotonergic agents (SSRIs, SNRIs, tramadol) heighten serotonin syndrome potential.
Anticholinergic drugs (e.g., diphenhydramine) may exacerbate dry mouth, constipation, and urinary retention.

Clinicians should review all current medications, including over-the-counter products and herbal supplements, before initiating Doxepin.

Special Populations

Pregnancy: Classified as Category C; animal studies show fetal risk, and human data are limited. Use only if benefits outweigh potential harms.
Breastfeeding: Doxepin is excreted in breast milk; caution is advised as infants may experience sedation.
Elderly: Age-related decline in hepatic metabolism increases plasma concentrations; start with the lowest effective dose (e.g., 25 mg) and monitor for confusion or falls.
Renal or Hepatic Impairment: Dose adjustments are recommended; for severe hepatic dysfunction, avoid Doxepin altogether.

Frequently Asked Questions

How does Doxepin differ from Amitriptyline? Both are TCAs, but Doxepin has stronger antihistamine activity at low doses, making it more suitable for sleep disorders. Amitriptyline generally exhibits greater cardiotoxic potential and requires stricter cardiac monitoring.
What is the typical time frame for Doxepin to improve depressive symptoms? Patients usually notice mood elevation after 2-4 weeks of daily dosing. Early improvement may be modest; full therapeutic effect can continue to develop up to 8 weeks.
Can I take Doxepin with food, or should I avoid certain meals? Food does not significantly alter absorption, but a light snack can lessen gastrointestinal irritation. Avoid grapefruit juice, as it may inhibit CYP2D6 and raise drug levels.
What should I do if I experience persistent dry mouth while using Doxepin? Sip water frequently, chew sugar-free gum, or use saliva substitutes. If the symptom interferes with daily activities, consult a healthcare professional for possible dose reduction.
How long does Doxepin take to work for insomnia? Sedative effects appear within 30 minutes to 1 hour after the bedtime dose, helping maintain sleep throughout the night. Most users report improved sleep continuity after the first few nights.
Is Doxepin safe for long-term use in chronic pruritus? Long-term studies up to 12 months show sustained itch relief with a tolerable side-effect profile, provided cardiac monitoring is conducted in patients with cardiovascular risk factors.
What foods should I avoid while taking Doxepin? While no specific food interactions exist, limit caffeine and alcohol, as they can counteract sedative effects and increase the risk of dizziness.
Can Doxepin cause weight gain, and how can I manage it? Modest weight gain has been observed, especially at higher doses. Maintaining a balanced diet and regular exercise can mitigate this effect.
What information should I provide my doctor when discussing Doxepin?
- Complete list of current prescription, over-the-counter, and herbal medicines.
- History of heart disease, glaucoma, urinary retention, or seizures.
- Any previous reactions to antidepressants or antihistamines.
- Specific treatment goals (e.g., mood improvement vs. sleep maintenance).
Is there a risk of dependence with low-dose Doxepin for sleep? The low-dose formulation has minimal abuse potential and does not produce classic withdrawal symptoms. Nonetheless, a gradual taper is recommended after prolonged use to avoid rebound insomnia.
How does the “doxepin mechanism of action” translate to its calming effect at night? At 3-6 mg, Doxepin’s antihistamine blockade outweighs its antidepressant activity, suppressing histaminergic wake-promoting pathways and allowing the brain to stay asleep without significant next-day sedation.

Disclaimer

The information provided about Doxepin is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing Doxepin for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing Doxepin.