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Generic Sinequan(Generic name: Doxepin Hydrochloride)
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Sinequan Overview |
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Sinequan (generic name Doxepin Hydrochloride) is anti-depressant medicine.
Information about Sinequan such as Sinequan usage, Sinequan side effects, detailed Sinequan description and other you may find on our online pharmacy.
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| Sinequan Description |
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brand names: Adapin, Sinequan
generic names: Doxepin hydrochloride, Doxepin
How does it work? Sinepin capsules contain the active ingredient doxepin, which is a type of medicine called a tricyclic antidepressant (TCA) . This type of medicine acts on nerve cells in the brain.
In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells. Serotonin and noradrenaline are neurotransmitters and they have various functions that we know of.
When serotonin and noradrenaline are released from nerve cells in the brain they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood. It is thought that when depression occurs, there may be a decreased amount of serotonin and noradrenaline released from nerve cells in the brain.
Doxepin works by preventing serotonin and noradrenaline from being reabsorbed back into the nerve cells in the brain. This helps prolong the mood lightening effect of any released noradrenaline and serotonin. In this way, doxepin helps relieve depression.
Doxepin can cause side effects such as drowsiness. This means it may be particularly useful in treating depression in people who are also anxious and agitated, or who have trouble sleeping.
It may take between two to four weeks for the benefits of this medicine to appear, so it is very important that you keep taking it, even if it doesn't seem to make much difference at first. If you feel your depression has got worse, or if you have any distressing thoughts or feelings in these first few weeks, then you should talk to your doctor.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
•If you frequently drink alcohol-containing beverages
•asthma or breathing difficulties
•diabetes
•difficulty passing urine
•glaucoma
•heart disease, including a previous heart attack or abnormal heart beat/rhythm
•liver disease
•thyroid disease, including increased or decreased thyroid activity
•over 65 years old
•Parkinson's disease
•prostate trouble
•schizophrenia
•seizure disorder
•stomach disease, reflux or digestive disorders
•surgery scheduled
•an unusual or allergic reaction to Doxepin (Sinequan), sulfites, tartrazine dye, other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding
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 is the most important information I should know about Doxepin (Sinequan)? Do not use this medication if you are allergic to Doxepin, or if you have glaucoma or problems with urination. Do not use Doxepin if you have used an MAO inhibitor such as Emsam), selegiline (Eldepryl, rasagiline (Azilect), phenelzine (Nardil), isocarboxazid (Marplan), or tranylcypromine (Parnate) within the past 14 days. You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or if you feel impulsive, trouble sleeping, panic attacks, anxiety.
How can this medicine affect other medicines? It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe .
Doxepin should not be taken in combination with a monoamine oxidase inhibitor antidepressant (MAOI), isocarboxazid, tranylcypromine, eg phenelzine, or moclobemide. Treatment with Doxepin (Sinequan) should not be started until at least two weeks after stopping an MAOI. Conversely, an MAOI should not be started until two weeks after stopping Doxepin. Moclobemide should not be started until at least a week after stopping Doxepin (Sinequan).
If Doxepin is taken with other medicines that enhance serotonin activity in the brain, there may be an increased risk of side effects such as increased heart rate and diarrhoea, shivering, tremor, agitation, known collectively as the 'serotonin syndrome'. Other medicines that increase serotonin activity include the following:
There may be an increased risk of drowsiness if Doxepin (Sinequan) is taken in combination with other medicines that can cause drowsiness, such as the following:
- strong opioid painkillers, such as morphine, codeine.
- sleeping tablets, eg zopiclone
- sedating antihistamines, eg chlorphenamine, promethazine
- benzodiazepines, eg diazepam, temazepam
There may be an increased risk of side effects such as difficulty passing urine and blurred vision if Doxepin (Sinequan) is taken with other medicines that have anticholinergic effects, dry mouth, constipation, - antisickness medicines, eg meclozine, cyclizine.
- muscle relaxants, eg baclofen
- certain other antidepressants
- antiarrhythmics, eg disopyramide, propafenone
- antipsychotics, eg chlorpromazine, clozapine (some antipsychotics may also increase the blood level of Doxepin (Sinequan))
- antispasmodics, eg hyoscine, atropine
- antihistamines, eg promethazine, chlorphenamine
- anticholinergics for Parkinson's disease, eg procyclidine, trihexyphenidyl
- anticholinergics for urinary incontinence, eg tolterodine, oxybutynin
There may be an increased risk of side effects on the heart if Doxepin (Sinequan) is taken in combination with the following medicines; these medicines should be avoided in people taking Doxepin:
- pentamidine.
- moxifloxacin
- certain antipsychotics, eg thioridazine, haloperidol, pimozide
- the antimalarials halofantrine, chloroquine or quinine
- the antihistamines astemizole, terfenadine or mizolastine
- certain medicines to treat abnormal heart rhythms (antiarrhythmics), eg amiodarone, procainamide, quinidine, disopyramide, sotalol
- atomoxetine
Doxepin may alter the anti-blood-clotting effect of anticoagulant medicines such as warfarin. Your blood clotting time (INR) should be carefully monitored if you are taking these two medicines together.
Doxepin (Sinequan) may antagonise the blood pressure lowering effect of clonidine and guanethidine.
There may be a sudden and marked increase in blood pressure and heart rate if adrenaline, noradrenaline or phenylephrine are given by injection to people taking Doxepin. These medicines should be avoided in people taking Doxepin (Sinequan).
The following medicines may increase the blood level of Doxepin and could increase the risk of its side effects:
- SSRI antidepressants such as fluvoxamine and fluoxetine.
- ritonavir
- oestrogen-containing contraceptives (these may also decrease the antidepressant effect of Doxepin (Sinequan))
- methylphenidate
- cimetidine
- calcium channel blockers such as diltiazem or verapamil
The level of Doxepin (Sinequan) in the blood may be decreased by the following medicines, and these could make it less effective:
- rifampicin.
- barbiturates such as phenobarbital
If you experience a dry mouth as a side effect of this medicine you may find that medicines that are designed to dissolve and be absorbed from under the tongue, eg sublingual glyceryl trinitrate (GTN) tablets for angina, become less effective. This is because the tablets do not dissolve properly in a dry mouth. To resolve this, drink a mouthful of water before taking sublingual tablets.
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