Sinequan (Doxepin Hydrochloride)

(dox' e pin)

Doxepin topical is used to relieve itching of the skin caused by eczema. Doxepin is in a class of medications called topical antipruritics. It may work by blocking histamine, a substance in the body that causes certain symptoms, such as itching.

Doxepin comes as a cream to apply to the skin. It is usually applied four times a day, at least 3 to 4 hours apart, for up to 8 days. Use doxepin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use doxepin topical exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor. To use the cream, follow these steps:

• Wash the affected skin with water and a mild soap or soapless cleansing lotion and pat dry with a soft towel.
• Apply a thin layer of cream to the affected skin. Gently and thoroughly massage it into the skin. Be careful not to get the medication in your eyes or mouth. If you do get doxepin in your eyes, wash with plenty of water and call your doctor if your eyes are irritated.
• Do not cover the affected area with any bandages, dressings, or wrappings.
• Wash your hands with soap and water after you finish handling the medication.

Before using doxepin cream,
• tell your doctor and pharmacist if you are allergic to doxepin (Adapin, Sinequan) or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants (mood elevators); antihistamines; carbamazepine (Tegretol); cimetidine (Tagamet); medications for irregular heartbeat, including encainide (Enkaid), flecainide (Tambocor), propafenone (Rythmol), and quinidine (Quinaglute, Quinidex); and medications for mental illness and nausea. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past 2 weeks: monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had glaucoma, benign prostatic hypertrophy (enlargement of the prostate), or urinary retention (inability to empty your bladder completely or at all).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using doxepin, call your doctor. You should not use doxepin if you are breast-feeding.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using doxepin.
• you should know that doxepin may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If you become very drowsy from doxepin, talk to your doctor.
• remember that alcohol can add to the drowsiness caused by this medication.

Unless your doctor tells you otherwise, continue your normal diet.

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra cream to make up for a missed dose.

Doxepin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• dry mouth
• dry lips
• thirst
• headache
• extreme tiredness
• dizziness
• mood changes
• taste changes
• burning or stinging at affected area
• worsened itching
• dryness and tightness of skin at affected area
• tingling of the fingers or toes
• swelling of the affected area

Doxepin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.