Doxepin - Revision history

MDElliottMD: parser-claude: Doxepin MedTemplate refill, Top 300 stub upgrade

2026-05-23T07:10:41Z

parser-claude: Doxepin MedTemplate refill, Top 300 stub upgrade

← Older revision		Revision as of 07:10, 23 May 2026
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	{{MedTemplate		{{MedTemplate
	\| generic = Doxepin		\| generic = Doxepin (hydrochloride)
	\| brand = Sinequan		\| brand = Sinequan (oral antidepressant, US brand discontinued), Silenor (low-dose for insomnia), Prudoxin / Zonalon (topical cream)
	\| structure =		\| structure =
	\| classes = TCA, Antidepressant		\| classes = [[:Category:Tricyclic antidepressants\|Tricyclic antidepressant (TCA)]], [[:Category:Antidepressants\|Antidepressant]], [[:Category:Sleep aids\|Sleep aid (Silenor low-dose)]], [[:Category:Antihistamines\|Antihistamine (potent H1)]]
	\| ~~mechanism~~ = ~~Serotonin~~ and ~~norepinephrine reuptake inhibitor;~~ H1 ~~antagonist~~		\| uses = <vote slug="major-depressive-disorder-use">Major depressive disorder (FDA, oral antidepressant dose)</vote>, <vote slug="anxiety-doxepin-use">Anxiety disorders (FDA)</vote>, <vote slug="insomnia-sleep-maintenance-use">Insomnia, sleep maintenance type (Silenor 3-6 mg, FDA)</vote>, <vote slug="chronic-urticaria-pruritus-use">Chronic urticaria and pruritus (off-label, leveraging H1 antihistamine activity)</vote>, <vote slug="topical-pruritus-use">Topical treatment of localized pruritus (Prudoxin 5% cream, FDA)</vote>
	\| ~~uses~~ =		\| starting_dose = Depression: 25-75 mg/day to start, titrate to 75-150 mg/day at bedtime. Insomnia (Silenor): 3 mg PO 30 minutes before bedtime, max 6 mg. Topical (Prudoxin): apply to affected area every 3-4 hours
	\| ~~starting_dose~~ =		\| preparations = Capsules 10, 25, 50, 75, 100, 150 mg; oral concentrate 10 mg/mL; Silenor tablets 3, 6 mg; topical cream 5% (Prudoxin, Zonalon)
	\| ~~preparations~~ =		\| fda_max = 300 mg/day (depression, hospitalized); 150 mg/day outpatient; 6 mg/day for insomnia
	\| ~~fda_max~~ =		\| pill_id =
	\| routes =		\| routes = Oral, topical
	\| onset =		\| onset = Sleep effect from first dose; antidepressant effect over 1-4 weeks
	\| duration =		\| duration = 24 hours (HS dosing)
	\| halflife =		\| halflife = ~15 hours (parent); nordoxepin active metabolite ~30 hours<ref name="silenor-label">FDA Prescribing Information, Silenor (doxepin tablets), Pernix/Currax, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022036lbl.pdf</ref>
	~~\| bioavailability =~~		\| bioavailability = ~30% (oral)<ref name="silenor-label" />
	~~\| pregnancy~~ =		\| pregnancy = TCA class signal; limited human data specific to doxepin.{{citation needed}}
	~~\| legal~~ =		\| legal = [[USLegal:Prescription only\|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults<ref name="silenor-label" />
	\| ~~intro =~~		\| mechanism = <vote slug="doxepin-mech-claim">Tricyclic antidepressant with the '''strongest H1 antihistamine activity of any TCA''', actually the most potent H1 antihistamine in clinical use, exceeding diphenhydramine on a molar basis. This is why '''low-dose doxepin (Silenor 3-6 mg) is uniquely sedating without anticholinergic burden''' at low doses: the H1 effect saturates at very low concentrations, while the muscarinic and α-adrenergic effects do not contribute meaningfully until higher antidepressant doses (75-300 mg).</vote> At antidepressant doses, the standard TCA mechanisms apply: serotonin and norepinephrine reuptake inhibition, anticholinergic, antihistaminergic, and α1-adrenergic antagonism. CYP2D6 and CYP2C19 substrate; CPIC TCA dosing guidance applies<ref name="cpic-tca">CPIC Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Tricyclic Antidepressants, 2016. https://cpicpgx.org/guidelines/guideline-for-tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/</ref>.
	~~\| pharmacokinetics~~ =
	~~\| pharmacodynamics~~ =
	\| ~~indications~~ =
	\| ~~dosing~~ =
	\| ~~effects~~ =
	~~\| interactions = <pharmaInteractions~~/>
	\| ~~pregnancy_details =~~
	~~\| monitoring~~ =
	~~\| counseling~~ =
	~~\| anecdotes =~~
	~~\| seealso =~~
	~~\| references~~ =
	}}		}}

			== References ==
			<references />

	[[Category:Tricyclic ~~Antidepressants (TCAs)~~]]		[[Category:Tricyclic antidepressants]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]
			[[Category:Sleep aids]]
	[[Category:Antihistamines]]		[[Category:Antihistamines]]
	~~[[Category:First-generation antihistamines]]~~

MDElliottMD: Comprehensive categorization: +Antihistamines, First-generation antihistamines

2026-05-15T18:42:07Z

Comprehensive categorization: +Antihistamines, First-generation antihistamines

← Older revision		Revision as of 18:42, 15 May 2026
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	[[Category:Tricyclic Antidepressants (TCAs)]]		[[Category:Tricyclic Antidepressants (TCAs)]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]
			[[Category:Antihistamines]]
			[[Category:First-generation antihistamines]]

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:06:49Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:06, 14 May 2026
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	}}		}}


			[[Category:Tricyclic Antidepressants (TCAs)]]
	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Pharmacopedia: add

2026-05-14T03:30:50Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:30, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	\| interactions =		\| interactions = <pharmaInteractions/>
	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring =		\| monitoring =

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:31Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	\| dosing =		\| dosing =
	\| effects =		\| effects =
	~~\| contraindications =~~
	\| interactions =		\| interactions =
	\| pregnancy_details =		\| pregnancy_details =

MDElliottMD: Added empty fda_max parameter to MedTemplate call

2026-05-13T02:32:37Z

Added empty fda_max parameter to MedTemplate call

← Older revision		Revision as of 02:32, 13 May 2026
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	\| starting_dose =		\| starting_dose =
	\| preparations =		\| preparations =
			\| fda_max =
	\| routes =		\| routes =
	\| onset =		\| onset =
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	[[Category:Antidepressants]]		[[Category:Antidepressants]]

MDElliottMD: Expand stub to full MedTemplate parameter set

2026-05-13T01:00:00Z

Expand stub to full MedTemplate parameter set

@@ Line 1: / Line 1: @@
 {{MedTemplate
-| generic           = Doxepin
+| generic            = Doxepin
-| brand             = Sinequan
+| brand              = Sinequan
-| classes           = TCA, Antidepressant
+| structure          =
-| mechanism         = Serotonin and norepinephrine reuptake inhibitor; H1 antagonist
+| classes            = TCA, Antidepressant
 }}
 [[Category:Antidepressants]]

MDElliottMD: Auto-created stub

2026-05-13T00:00:00Z

Auto-created stub

New page

{{MedTemplate
| generic = Doxepin
| brand = Sinequan
| classes = TCA, Antidepressant
| mechanism = Serotonin and norepinephrine reuptake inhibitor; H1 antagonist
}}
[[Category:Antidepressants]]