Doxepin - Revision history

ClaireLewis at 18:18, 22 September 2019

2019-09-22T18:18:27Z

← Older revision		Revision as of 18:18, 22 September 2019
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	==Administration==		==Administration==
	*Type: Insomnia; Tricyclic ~~Antidepressants~~ (TCAs)		*Type: Insomnia; [[Tricyclic antidepressant]] (TCAs)
	*Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL		*Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL
	*Routes of Administration: PO		*Routes of Administration: PO
Line 98:		Line 98:
	==References==		==References==
	<references/>		<references/>
	[[Category:Pharmacology]]		[[Category:Pharmacology]] [[Category:Psychiatry]]

Dteoli: /* Depression and/or anxiety */

2018-04-20T22:33:16Z

Depression and/or anxiety

← Older revision		Revision as of 22:33, 20 April 2018
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	==Pediatric Dosing==		==Pediatric Dosing==

	===[[Depression ~~and/or anxiety~~]]===		===[[Depression]]===

	*PO:		*PO:

Dteoli: /* Pediatric Dosing */

2018-04-20T22:32:44Z

Pediatric Dosing

← Older revision		Revision as of 22:32, 20 April 2018
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	==Pediatric Dosing==		==Pediatric Dosing==

	Depression and/or anxiety:		===[[Depression and/or anxiety]]===

	*PO:		*PO:

Dteoli: /* Pediatric Dosing */

2018-04-20T22:31:43Z

Pediatric Dosing

← Older revision		Revision as of 22:31, 20 April 2018
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	==Pediatric Dosing==		==Pediatric Dosing==

	Depression and/or anxiety: ~~Oral: Note~~: ~~Controlled clinical trials have not shown TCAs to be superior to placebo for the treatment of depression in children and adolescents~~		Depression and/or anxiety:
	* Not recommended as first line medication
	* May be beneficial for patients with comorbid conditions		*PO:
			* Not recommended as first line medication; however some studies indicate it might be beneficial for patients with comorbid conditions.

	*Children 7 to 11 years: Limited data available; efficacy results variable: 1 to 3 mg/kg/day in single or divided doses.		*Children 7 to 11 years: Limited data available; efficacy results variable: 1 to 3 mg/kg/day in single or divided doses.

	*Children ≥12 years and Adolescents: Initial: 25 to 75 mg/day at bedtime or in 2 to 3 divided doses; begin at the low end of range and gradually titrate; select patients may respond to 25 to 50 mg/day; maximum single dose: 150 mg; maximum daily dose: 300 mg/day.		*Children ≥12 years and Adolescents: Initial: 25 to 75 mg/day at bedtime or in 2 to 3 divided doses; begin at the low end of range and gradually titrate; select patients may respond to 25 to 50 mg/day; maximum single dose: 150 mg; maximum daily dose: 300 mg/day.

			** Note: Controlled clinical trials have not shown TCAs to be superior to placebo for the treatment of depression in children and adolescents

	==Special Populations==		==Special Populations==

Dteoli: /* Pediatric Dosing */

2018-04-20T22:30:28Z

Pediatric Dosing

← Older revision		Revision as of 22:30, 20 April 2018
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	==Pediatric Dosing==		==Pediatric Dosing==
	NA
			Depression and/or anxiety: Oral: Note: Controlled clinical trials have not shown TCAs to be superior to placebo for the treatment of depression in children and adolescents
			* Not recommended as first line medication
			* May be beneficial for patients with comorbid conditions

			*Children 7 to 11 years: Limited data available; efficacy results variable: 1 to 3 mg/kg/day in single or divided doses.

			*Children ≥12 years and Adolescents: Initial: 25 to 75 mg/day at bedtime or in 2 to 3 divided doses; begin at the low end of range and gradually titrate; select patients may respond to 25 to 50 mg/day; maximum single dose: 150 mg; maximum daily dose: 300 mg/day.

	==Special Populations==		==Special Populations==

Neil.m.young: Text replacement - "* " to "*"

2016-10-27T15:39:31Z

Text replacement - "* " to "*"

← Older revision		Revision as of 15:39, 27 October 2016
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	===Common===		===Common===
	*drowsiness, dizziness, confusion, weakness, tremor, paresthesias		*drowsiness, dizziness, confusion, weakness, tremor, paresthesias
	* nausea/vomiting, constipation, xerostomia		*nausea/vomiting, constipation, xerostomia
	*blurred vision		*blurred vision
	*palpitations, tachycardia, diaphoresis, restlessness, insomnia, anxiety		*palpitations, tachycardia, diaphoresis, restlessness, insomnia, anxiety

ClaireLewis: /* Adverse Reactions */

2016-09-29T02:58:06Z

Adverse Reactions

← Older revision		Revision as of 02:58, 29 September 2016
Line 50:		Line 50:
	==Adverse Reactions==		==Adverse Reactions==
	===Serious===		===Serious===
	*~~hypotension~~, orthostatic		*syncope, orthostatic hypotension
	*HTN		*ventricular arrhythmias, AV block, QT prolongation, torsades de pointes
	*syncope		*seizures
	*ventricular arrhythmias		*MI, HTN
	*QT prolongation
	*torsades de pointes
	*~~AV block~~
	*MI
	*stroke		*stroke
	*seizures		*extrapyramidal symptoms, tardive dyskinesia
	*extrapyramidal sx
	*ataxia		*ataxia
	*tardive dyskinesia
	*paralytic ileus		*paralytic ileus
	*IOP elevation		*IOP elevation
	*agranulocytosis		*agranulocytosis, leukopenia, thrombocytopenia
	*leukopenia		*hallucinations, psychosis, worsening depression, hypomania/mania, suicidality
	*thrombocytopenia
	*hallucinations
	*psychosis ~~exacerbation~~
	*hypomania/mania
	*depression exacerbation
	*suicidality
	*SIADH		*SIADH
	*hepatitis		*hepatitis
	*angioedema		*angioedema
	*~~psychosis~~, ~~anticholinergic~~		*hyperthermia, heat stroke
	*hyperthermia		*withdrawal symptoms if abruptly discontinued
	*heat stroke
	*withdrawal sx if ~~abrupt dc~~

	===Common===		===Common===
	*drowsiness		*drowsiness, dizziness, confusion, weakness, tremor, paresthesias
	*xerostomia		* nausea/vomiting, constipation, xerostomia
	*dizziness
	*constipation
	*blurred vision		*blurred vision
	*palpitations		*palpitations, tachycardia, diaphoresis, restlessness, insomnia, anxiety
	*tachycardia		*urinary frequency, incontinence, retention
	*incontinence		*increased appetite, weight gain
	*appetite incr		*libido changes, impotence, gynecomastia, galactorrhea
	*nausea/vomiting
	*diaphoresis
	*weakness
	*disorientation
	*confusion
	*restlessness
	*insomnia
	*anxiety~~/agitation~~
	*urinary retention
	*~~urinary frequency~~
	*rash/urticaria
	*pruritis
	*weight gain
	*libido changes
	*impotence
	*gynecomastia
	*galactorrhea
	*tremor
	*hypo/hyperglycemia		*hypo/hyperglycemia
	*~~paresthesia~~		*rash/urticarial, pruritus, photosensitivity
	*photosensitivity

	==Pharmacology==		==Pharmacology==

ClaireLewis: /* Contraindications */

2016-09-29T02:52:12Z

Contraindications

← Older revision		Revision as of 02:52, 29 September 2016
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	*Allergy to class/drug		*Allergy to class/drug
	*MI, acute recovery		*MI, acute recovery
	*glaucoma		*glaucoma, increased IOP
	*IOP ~~increased~~		*urinary retention, prostatic hypertrophy, GI/GU obstruction
	*urinary retention
	*prostatic hypertrophy
	*GI/GU obstruction
	*avoid abrupt withdrawal		*avoid abrupt withdrawal
	*caution ~~in its <25yo~~		*caution if:
	*~~caution in~~ elderly ~~pts~~		**age <25 years, elderly
	*~~caution if~~ cardiovascular dz		**cardiovascular disease
	*~~caution if~~ seizure disorder		**seizure disorder, parkinsons
	*~~caution if~~ thyroid dz		**thyroid disease, diabetes
	*~~caution if diabetes mellitus~~		**asthma
	*~~caution if~~ asthma		**hepatic impairment
	*~~caution if Parkinson dz~~		**schizophrenia, bipolar disorder, alcohol abuse, electroconvulsive therapy, suicide risk
	*~~caution if~~ hepatic impairment		**high environmental temperature
	*~~caution if~~ schizophrenia
	*caution if bipolar disorder
	*caution if electroconvulsive tx
	*caution if alcohol abuse
	*caution if suicide risk
	*~~caution if~~ high environmental temperature

	==Adverse Reactions==		==Adverse Reactions==

Rossdonaldson1: /* Adult Dosing */

2016-09-24T05:22:38Z

Adult Dosing

← Older revision		Revision as of 05:22, 24 September 2016
Line 6:		Line 6:

	==Adult Dosing==		==Adult Dosing==
	Depression		===[[Depression]]===
	*150-300mg PO QHS		*150-300mg PO QHS
	*start 25-75mg PO QHS; max 300mg/day		*start 25-75mg PO QHS; max 300mg/day
	*taper gradually to dc		*taper gradually to discontinue

	Anxiety		===[[Anxiety]]===
	*150-300mg PO QHS		*150-300mg PO QHS
	*start 25-75mg PO QHS; max 300mg/day		*start 25-75mg PO QHS; max 300mg/day
	*taper gradually to dc		*taper gradually to discontinue

	Insomnia		===[[Insomnia]]===
	*10-50mg PO QHS		*10-50mg PO QHS

Kaoru: Created page with "==Administration== Type: Insomnia; Tricyclic Antidepressants (TCAs) Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL Routes of Administration: PO Common Trade Names: Silenor,..."

2016-09-23T21:40:19Z

Created page with "==Administration== *Type: Insomnia; Tricyclic Antidepressants (TCAs) *Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL *Routes of Administration: PO *Common Trade Names: Silenor,..."

New page

==Administration==
*Type: Insomnia; Tricyclic Antidepressants (TCAs)
*Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL
*Routes of Administration: PO
*Common Trade Names: Silenor, Zonalon, Prudoxin

==Adult Dosing==
Depression
*150-300mg PO QHS
*start 25-75mg PO QHS; max 300mg/day
*taper gradually to dc

Anxiety
*150-300mg PO QHS
*start 25-75mg PO QHS; max 300mg/day
*taper gradually to dc

Insomnia
*10-50mg PO QHS

==Pediatric Dosing==
NA

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C
*[[Lactation risk categories|Lactation risk]]: unsafe

===Renal Dosing===
*Adult: no adjustment

===Hepatic Dosing===
*Adult: not defined, caution advised

==Contraindications==
*Allergy to class/drug
*MI, acute recovery
*glaucoma
*IOP increased
*urinary retention
*prostatic hypertrophy
*GI/GU obstruction
*avoid abrupt withdrawal
*caution in its <25yo
*caution in elderly pts
*caution if cardiovascular dz
*caution if seizure disorder
*caution if thyroid dz
*caution if diabetes mellitus
*caution if asthma
*caution if Parkinson dz
*caution if hepatic impairment
*caution if schizophrenia
*caution if bipolar disorder
*caution if electroconvulsive tx
*caution if alcohol abuse
*caution if suicide risk
*caution if high environmental temperature

==Adverse Reactions==
===Serious===
*hypotension, orthostatic
*HTN
*syncope
*ventricular arrhythmias
*QT prolongation
*torsades de pointes
*AV block
*MI
*stroke
*seizures
*extrapyramidal sx
*ataxia
*tardive dyskinesia
*paralytic ileus
*IOP elevation
*agranulocytosis
*leukopenia
*thrombocytopenia
*hallucinations
*psychosis exacerbation
*hypomania/mania
*depression exacerbation
*suicidality
*SIADH
*hepatitis
*angioedema
*psychosis, anticholinergic
*hyperthermia
*heat stroke
*withdrawal sx if abrupt dc

===Common===
*drowsiness
*xerostomia
*dizziness
*constipation
*blurred vision
*palpitations
*tachycardia
*incontinence
*appetite incr
*nausea/vomiting
*diaphoresis
*weakness
*disorientation
*confusion
*restlessness
*insomnia
*anxiety/agitation
*urinary retention
*urinary frequency
*rash/urticaria
*pruritis
*weight gain
*libido changes
*impotence
*gynecomastia
*galactorrhea
*tremor
*hypo/hyperglycemia
*paresthesia
*photosensitivity

==Pharmacology==
*Half-life: 15.3 hours (doxepin); 31 hours (metabolite)
*Metabolism: liver; CYP450 (1A2, 2C9/19, 2D6 substrate)
*Excretion: urine
*Mechanism of Action: exact MOA unknown; inhibits norepinephrine and serotonin reuptake; antagonizes central H1 receptors

==See Also==

==References==
<references/>
[[Category:Pharmacology]]

Doxepin - Revision history

ClaireLewis at 18:18, 22 September 2019

Dteoli: /* Depression and/or anxiety */

Dteoli: /* Pediatric Dosing */

Dteoli: /* Pediatric Dosing */

Dteoli: /* Pediatric Dosing */

Neil.m.young: Text replacement - "* " to "*"

ClaireLewis: /* Adverse Reactions */

ClaireLewis: /* Contraindications */

Rossdonaldson1: /* Adult Dosing */

Kaoru: Created page with "==Administration== *Type: Insomnia; Tricyclic Antidepressants (TCAs) *Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL *Routes of Administration: PO *Common Trade Names: Silenor,..."

Kaoru: Created page with "==Administration== Type: Insomnia; Tricyclic Antidepressants (TCAs) Dosage Forms: 10, 25, 50, 75, 100, 150; 10/mL Routes of Administration: PO Common Trade Names: Silenor,..."