Doxepin interactions
Doxepin (Silenor, Sinequan), a tricyclic antidepressant has 219 documented interactions across the FDA labels and fact sheets we index: 83 major, 123 moderate, 12 minor, and 1 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (83)
Avoid administrations of TUDORZA PRESSAIR with other anticholinergic-containing drugs. (Aclidinium label, Drug interactions)
Do not use with alcohol. (Doxepin label, Warnings and precautions)
• Effects on Driving and Operating Machinery: Patients receiving • alprazolam XR should be cautioned against operating machinery or driving a motor vehicle, as well as avoiding concomitant use of alcohol and other central nervous system (CNS) depressant drugs. (Alprazolam label, Warnings and precautions)
Anyone considering the use of amitriptyline hydrochloride tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Amitriptyline label, Boxed warning)
Serotonin Syndrome: Increased risk when coadministered with serotonergic agents (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans), but also during overdosage situations. (Amphetamine and dextroamphetamine label, Warnings and precautions)
Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Buprenorphine label, Boxed warning)
Serotonergic Drugs: Concomitant use may result in serotonin syndrome. (Buprenorphine and naloxone label, Drug interactions)
Serotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs SSRIs, and other serotonergic drugs, including buspirone, alone but particularly with concomitant use of other serotonergic drugs (including triptans), with drugs that impair metabolism of serotonin (in particular, MAOIs, including reversible MAOIs… (Buspirone label, Warnings)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Butorphanol label, Boxed warning)
Known hypersensitivity to any of the tricyclic compounds (e.g., amitriptyline, desipramine, imipramine, protriptyline, and nortriptyline.) Hypersensitivity reactions include anaphylaxis and serious rash. (Carbamazepine label, Contraindications)
Avoid concurrent use of QUZYTTIR with alcohol or other CNS depressants because additional reduction in alertness and additional impairment of CNS performance may occur. (Cetirizine label, Warnings and precautions)
Table 8: Drugs That are Affected by and Affecting Ciprofloxacin Drugs That are Affected by Ciprofloxacin Drug(s) Recommendation Comments Tizanidine Contraindicated Concomitant administration of tizanidine and ciprofloxacin is contraindicated due to the potentiation of hypotensive and sedative effects of tizanidine [see Contraindications ( 4.2 )]. (Ciprofloxacin label, Drug interactions)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Citalopram label, Warnings and precautions)
Avoid use with other central nervous system (CNS) depressants ( 5.3 ) (Clonidine label, Warnings and precautions)
When possible, avoid concomitant use, with other anticholinergic medications because the risk for anticholinergic toxicity or severe gastrointestinal adverse reactions is increased [see Warnings and Precautions ( 5.7 ), Drug Interactions ( 7.1 )]. (Clozapine label, Warnings and precautions)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Codeine label, Boxed warning)
Hyperpyretic crisis seizures and deaths have occurred in patients who received cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitors drugs. (Cyclobenzaprine label, Contraindications)
• Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Desvenlafaxine label, Warnings and precautions)
…Pharmacology (12.3) ] • Concomitant use of drugs or herbal products that prolong the QT interval and might increase the risk of torsade de pointes, such as phenothiazine antipsychotics, tricyclic antidepressants, certain oral macrolide antibiotics, and Class I and III antiarrhythmics • Liver or lung toxicity related to the previous use of amiodarone • QTc interval… (Dronedarone label, Contraindications)
Serotonin Syndrome : Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Duloxetine label, Warnings and precautions)
Selective Serotonin Reuptake Inhibitors/Serotonin and Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during co-administration of triptans and SSRIs, SNRIs, TCAs and MAO inhibitors [see Warnings and Precautions (5.7) ]. (Eletriptan label, Drug interactions)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents but also when taken alone. (Escitalopram label, Warnings and precautions)
The use of LUNESTA with other sedative-hypnotics at bedtime or the middle of the night is not recommended. (Eszopiclone label, Warnings and precautions)
• Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Fentanyl label, Boxed warning)
If concomitant use of PROZAC with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases ( 5.2 ) (Fluoxetine label, Warnings and precautions)
Anyone considering the use of Fluvoxamine Maleate Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Fluvoxamine label, Boxed warning)
- GlucagonMajor
Intervention Concomitant use of anticholinergic drugs with GVOKE VialDx is not recommended. (Glucagon label, Drug interactions)
• Other Conditions Exacerbated by Anticholinergic Adverse Reactions : Use is not recommended in patients with autonomic neuropathy, hyperthyroidism, cardiac disease, hiatal hernia, etc. (Glycopyrrolate label, Warnings and precautions)
Serotonin syndrome has been reported with granisetron products, alone but particularly with concomitant use of serotonergic drugs. (Granisetron label, Warnings and precautions)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Hydrocodone and acetaminophen label, Boxed warning)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death . (Hydromorphone label, Boxed warning)
Rarely, cardiac arrests and death have been reported in association with the combined use of hydroxyzine hydrochloride intramuscularly and other CNS depressants. (Hydroxyzine label, Precautions)
Avoid administration of ATROVENT HFA with other anticholinergic-containing drugs ( 7.1 ) (Ipratropium label, Drug interactions)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
Benzodiazepines, Opioid Analgesics, or other CNS Depressants : Concomitant use may result in profound sedation, respiratory depression, coma, or death. (Ketamine label, Drug interactions)
This may potentiate and prolong hypnotic and sedative effects, especially with repeated dosing or chronic administration of these agents. (Ketoconazole label, Contraindications)
Avoid concurrent use of alcohol or other central nervous system depressants with XYZAL. (Levocetirizine label, Warnings and precautions)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Levomilnacipran label, Warnings and precautions)
Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Levorphanol label, Boxed warning)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
• Serotonin Syndrome: Increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. (Lisdexamfetamine label, Warnings and precautions)
If concomitant use of lithium with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms. (Lithium label, Warnings and precautions)
Caution patients receiving LOREEV XR against operating machinery or driving a motor vehicle as well to avoid the concomitant use of alcohol and other CNS depressant drugs during treatment ( 5.4 , 7 ) (Lorazepam label, Warnings and precautions)
Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Meperidine label, Boxed warning)
Managing Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, is a risk factor for respiratory depression and death [see Warnings and Precautions ( 5.2 )]. (Methadone label, Boxed warning)
Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, malignant hyperthermia, drug fever, serotonin syndrome, and primary central nervous system pathology. (Metoclopramide label, Warnings and precautions)
WARNING: PERSONNEL AND EQUIPMENT FOR MONITORING AND RESUSCITATION, AND RISKS FROM CONCOMITANT USE WITH OPIOID ANALGESICS AND OTHER SEDATIVE-HYPNOTICS Personnel and Equipment for Monitoring and ResuscitationOnly personnel trained in the administration of procedural sedation, and not involved in the conduct of the diagnostic or therapeutic procedure, should administer… (Midazolam label, Boxed warning)
Serotonin Syndrome : Increased risk when co-administered with other serotonergic drugs (e.g., SSRI, SNRI, triptans), but also when taken alone. (Mirtazapine label, Warnings and precautions)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Morphine label, Boxed warning)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Nalbuphine label, Boxed warning)
Anyone considering the use of nortriptyline hydrochloride or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Nortriptyline label, Boxed warning)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oliceridine label, Boxed warning)
Avoid concurrent use of alcohol or other central nervous system depressants with olopatadine hydrochloride nasal spray ( 5.2 ). (Olopatadine label, Warnings and precautions)
S e ro t o ni n Syndrome: Serotonin syndrome has been reported with 5-HT 3 receptor antagonists alone but particularly with concomitant use of serotonergic drugs. (Ondansetron label, Warnings and precautions)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oxycodone label, Boxed warning)
…LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; CYTOCHROME P450 3A4 INTERACTION; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Oxycodone hydrochloride tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to… (Oxycodone and acetaminophen label, Boxed warning)
Risks From Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Oxymorphone label, Boxed warning)
Serotonin Syndrome: BRISDELLE can cause serotonin syndrome with increased risk when co-administered with other serotonergic agents, but also when taken alone. (Paroxetine label, Warnings and precautions)
…MITIGATION STRATEGY (REMS); LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL INGESTION; NEONATAL OPIOID WITHDRAWAL SYNDROME; and RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS Addiction, Abuse, and Misuse Pentazocine and Naloxone Tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to… (Pentazocine and naloxone label, Boxed warning)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Sertraline label, Warnings and precautions)
Abuse or misuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death [see Warnings and Precautions ( 5.2 )]. (Sodium oxybate label, Boxed warning)
Combining St. John's wort with antidepressants and other serotonergic drugs increases the risk of serotonin syndrome. (NCCIH, St. John's Wort)
Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions (5.7)] . (Sumatriptan label, Drug interactions)
Selective Serotonin Reuptake Inhibitors/Serotonin Norepinephrine Reuptake Inhibitors and Serotonin Syndrome Clinical Impact: Cases of serotonin syndrome have been reported during coadministration of triptans and SSRIs, SNRIs, TCAs, and MAO inhibitors [see Warnings and Precautions (5.11)] . (Sumatriptan and naproxen label, Drug interactions)
Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Tapentadol label, Boxed warning)
Avoid administration of SPIRIVA RESPIMAT with other anticholinergic-containing drugs. (Tiotropium label, Drug interactions)
Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. (Tramadol label, Boxed warning)
Co-administration with Monoamine Oxidase Inhibitors (MAOIs): Do not administer if patient is taking MAOIs or has used MAOIs within the past two weeks. (Doxepin label, Contraindications)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents (e.g., SSRI, SNRI, triptans), but also when taken alone. (Trazodone label, Warnings and precautions)
• Effects on Driving and Operating Heavy Machinery : Patients receiving triazolam should be cautioned against driving or operating heavy machinery, as well as avoiding concomitant use with alcohol and other CNS depressant drugs. (Triazolam label, Warnings and precautions)
Avoid administration of Umeclidinium and Vilanterol ELLIPTA with other anticholinergic-containing drugs. (Umeclidinium and vilanterol label, Drug interactions)
Anyone considering the use of Venlafaxine Extended Release Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. (Venlafaxine label, Boxed warning)
Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Vilazodone label, Warnings and precautions)
• Serotonin Syndrome : Increased risk when coadministered with other serotonergic agents, but also when taken alone. (Vortioxetine label, Warnings and precautions)
The use of zaleplon with other sedative-hypnotics at bedtime or the middle of the night is not recommended (see ). (Zaleplon label, Warnings)
• Serotonin Syndrome: Increased risk when co-administered with other serotonergic agents, but also when taken alone. (Ziprasidone label, Warnings and precautions)
The use of Zolpidem Tartrate with other sedative-hypnotics (including other zolpidem products) at bedtime or the middle of the night is not recommended. (Zolpidem label, Warnings and precautions)
Moderate interactions (123)
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Albuterol label, Drug interactions)
Inform patients also that the central nervous system depressant effects of allopurinol tablets may be additive to those of alcohol and other CNS depressants. (Allopurinol label, Warnings and precautions)
Other Anticholinergic Drugs: Doses should be reduced if atropine-like effects occur ( 7.1 ) (Amantadine label, Drug interactions)
Table 5: Amiodarone Drug Interactions Concomitant Drug Class/Name Examples Clinical Comment QT Prolonging Drugs class I and III antiarrhythmics, lithium, certain phenothiazines, tricyclic antidepressants, certain fluoroquinolone and macrolide antibiotics, azole antifungals, halogenated inhalation anesthetic agents Increased risk of Torsade de Pointes. (Amiodarone label, Drug interactions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- AsenapineantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- AzelastineantihistamineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Bictegravir, emtricitabine, and tenofovir alafenamideantiretroviralModerate
Sedatives/Hypnotics: midazolam (oral) triazolam ↑ midazolam (oral) ↑ triazolam Use caution when midazolam or triazolam is concomitantly administered with BIXLENVO. (Bictegravir, emtricitabine, and tenofovir alafenamide label, Drug interactions)
- BrexpiprazoleantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Use with CNS depressants may result in an additive or potentiating effect. (Brimonidine label, Drug interactions)
- BrivaracetamanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Budesonide and formoterolcorticosteroidModerate
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Budesonide and formoterol label, Drug interactions)
…following conditions can also increase the risk of seizure: concomitant use of other medications that lower the seizure threshold (e.g., other bupropion products, antipsychotics, tricyclic antidepressants, theophylline, and systemic corticosteroids), metabolic disorders (e.g., hypoglycemia, hyponatremia, severe hepatic impairment, and hypoxia), or use of illicit… (Bupropion label, Warnings and precautions)
- Butalbital, acetaminophen, and caffeinebarbiturateModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Cannabidiol (prescription)anticonvulsantModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- CariprazineantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- CenobamateanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- ChlordiazepoxidebenzodiazepineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- ChlorpheniramineantihistamineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- ChlorpromazineantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- CimetidineH2 blockerModerate
Cimetidine: Increases exposure to doxepin. (Doxepin label, Drug interactions)
- ClobazambenzodiazepineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Dantrolenemuscle relaxantModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Daridorexantsedative-hypnoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- DarifenacinanticholinergicModerate
Darifenacin extended-release tablets, like other anticholinergic drugs, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as severe constipation, ulcerative colitis, and myasthenia gravis. (Darifenacin label, Warnings and precautions)
- DesmopressinModerate
Other Drugs that may Increase Risk of Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide,… (Desmopressin label, Drug interactions)
- DeutetrabenazineVMAT2 inhibitorModerate
Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Deutetrabenazine label, Warnings and precautions)
- Dexmedetomidinealpha-adrenergic agonistModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Anticholinergic agents: may affect the gastrointestinal absorption of various drugs; may also increase certain actions or side effects of other anticholinergic drugs (7) (Dicyclomine label, Drug interactions)
- DimenhydrinateantihistamineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- DoxylamineantihistamineModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- DronabinolcannabinoidModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- EluxadolineopioidModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- EpinephrinesympathomimeticModerate
• Drugs that potentiate the effects of epinephrine include sympathomimetics, beta blockers, tricyclic antidepressants, MAO inhibitors, COMT inhibitors, clonidine, doxapram, oxytocin, levothyroxine sodium, and certain antihistamines. (Epinephrine label, Drug interactions)
- EslicarbazepineanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- EthosuximideanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- FelbamateanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- FesoterodineanticholinergicModerate
Urinary Retention in Adult Patients With Bladder Outlet Obstruction The use of Toviaz, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction, including patients with urinary retention, may result in further urinary retention and kidney injury. (Fesoterodine label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- FlibanserinCNS depressantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Fluticasone and salmeterol label, Drug interactions)
- Formoterolbeta-adrenergic agonistModerate
• MAO inhibitors, tricyclic antidepressants and drugs that prolong QTc interval may potentiate effect on the cardiovascular system. (Formoterol label, Drug interactions)
- FosfomycinantibioticModerate
Avoid co-administration of CONTEPO with drugs known to prolong the QT interval, such as class IA or class III antiarrhythmic medications, tricyclic antidepressants, macrolides, and antipsychotics [see Warnings and Precautions ( 5.2 )] . (Fosfomycin label, Drug interactions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- IloperidoneantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
SSRIs, Tricyclics and Related Antidepressants Venlafaxine Monitor for adverse reactions. (Itraconazole label, Drug interactions)
- LacosamideanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Lemborexantsedative-hypnoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Levalbuterolbeta-adrenergic agonistModerate
Monoamine oxidase inhibitors (MAOs) or tricyclic antidepressants : May potentiate effect of albuterol on the cardiovascular system. (Levalbuterol label, Drug interactions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Levothyroxine label, Drug interactions)
- Lidocainelocal anestheticModerate
Clinically Significant Drug Interactions The administration of local anesthetic solutions containing epinephrine or norepinephrine to patients receiving monoamine oxidase inhibitors or tricyclic antidepressants may produce severe, prolonged hypertension. (Lidocaine label, Drug interactions)
- Liothyroninethyroid hormoneModerate
Antidepressant Therapy Concurrent use of tricyclic (e.g., amitriptyline) or tetracyclic (e.g., maprotiline) antidepressants and liothyronine sodium may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. (Liothyronine label, Drug interactions)
- Lofexidinealpha-adrenergic agonistModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- LumateperoneantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Mirabegronbeta-adrenergic agonistModerate
• Urinary Retention in Patients With Bladder Outlet Obstruction and in Patients Taking Muscarinic Antagonist Drugs for Overactive Bladder : Administer with caution in these patients because of risk of urinary retention. (Mirabegron label, Warnings and precautions)
In individuals deficient in the CYP2D6 enzyme, the levels of CYP2D6 substrates which have ancillary routes of elimination through CYP2C19, such as tricyclic antidepressants and selective serotonin reuptake inhibitors, may be increased by co-administration of PROVIGIL. (Modafinil label, Drug interactions)
- MoxifloxacinfluoroquinoloneModerate
Pharmacokinetic studies between moxifloxacin and other drugs that prolong the QT interval such as cisapride, erythromycin, antipsychotics, and tricyclic antidepressants have not been performed. (Moxifloxacin label, Warnings and precautions)
- Naloxoneopioid antagonistModerate
WARNINGS AND PRECAUTIONS Risk of Recurrent Respiratory and CNS Depression : Due to the duration of action of naloxone relative to the opioid, respiratory and CNS depression may recur after the first dose of naloxone. (Naloxone label, Warnings and precautions)
- Naltrexone and bupropionopioid antagonistModerate
…(sulfonylureas and meglitinides) that may cause hypoglycemia concomitant administration of medications that may lower the seizure threshold, including other bupropion products, antipsychotics, tricyclic antidepressants, theophylline, systemic steroids Recommendations for Reducing the Risk of Seizure: Clinical experience with bupropion suggests that the risk of seizure may… (Naltrexone and bupropion label, Warnings and precautions)
…diverticulosis, and inflammatory bowel disease), hypomotility disorders (e.g., constipation, gastroesophageal reflux disease, ileus, obesity, hypothyroidism, and diabetes) and concomitant medications (e.g., H 2 -histamine blockers, opiates, nonsteroidal anti-inflammatory drugs, laxatives, anticholinergic agents, levothyroxine, and neuromuscular blocking agents). (Nifedipine label, Warnings)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- OnabotulinumtoxinAneuromuscular blockerModerate
Anticholinergic Drugs Use of anticholinergic drugs after administration of BOTOX may potentiate systemic anticholinergic effects. (OnabotulinumtoxinA label, Drug interactions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Oxybutynin chloride extended-release tablets, like other anticholinergic drugs, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis and intestinal atony. (Oxybutynin label, Warnings and precautions)
- PaliperidoneantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- PerampanelanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Phentermine and topiramateCNS stimulantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- PhenylephrinedecongestantModerate
Agonistic Effects (increase in BIORPHEN blood pressure effect) can occur with monoamine oxidase inhibitors (MAOI), oxytocin and oxytocic drugs, tricyclic antidepressants, angiotensin and aldosterone, atropine, steroids, norepinephrine transporter inhibitors, ergot alkaloids. (Phenylephrine label, Drug interactions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Pilocarpinecholinergic agonistModerate
These effects should be considered when anticholinergic properties may be contributing to the therapeutic effect of concomitant medication (e.g., atropine, inhaled ipratropium). (Pilocarpine label, Drug interactions)
- PimavanserinantipsychoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Posaconazoleazole antifungalModerate
Concomitant Use with Midazolam : Noxafil can prolong hypnotic/sedative effects. (Posaconazole label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- PropofolCNS depressantModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Pyridostigminecholinesterase inhibitorModerate
Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Ramelteonsedative-hypnoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Drugs transported by P-gp (e.g., digoxin), or drugs metabolized by CYP2D6 (e.g., tricyclic antidepressants) may need reduced doses when used with ASPRUZYO Sprinkle. (Ranolazine label, Drug interactions)
…Selective 5-HT3 Receptor Antagonists Ondansetron Decrease exposure Statins Metabolized by CYP3A4 Simvastatin Decrease exposure Thiazolidinediones Rosiglitazone Decrease AUC by 66% Tricyclic Antidepressants Nortriptyline A tuberculosis treatment regimen including rifampin (600 mg/day), isoniazid (300 mg/day), pyrazinamide (500 mg 3× per day), and pyridoxine (25… (Rifampin label, Drug interactions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
The onset of symptoms can occur within minutes to hours of receiving a new or a greater dose of a serotonergic medication. (Rizatriptan label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- RufinamideanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Salmeterolbeta-adrenergic agonistModerate
• Monoamine oxidase inhibitors and tricyclic antidepressants: Use with extreme caution. (Salmeterol label, Drug interactions)
- ScopolamineanticholinergicModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Urinary Retention The use of Solifenacin succinate tablets, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction including patients with urinary retention, may result in further urinary retention and kidney injury. (Solifenacin label, Warnings and precautions)
The efficacy of tricyclic antidepressants can decrease when coadministered with sulfamethoxazole and trimethoprim. (Sulfamethoxazole and trimethoprim label, Drug interactions)
- Suvorexantsedative-hypnoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Tasimelteonsedative-hypnoticModerate
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
- Terbutalinebeta-adrenergic agonistModerate
Monoamine Oxidase Inhibitors and Tricyclic Antidepressants Terbutaline sulfate should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, since the action of terbutaline sulfate on the vascular system may be potentiated. (Terbutaline label, Precautions)
- TetrabenazineVMAT2 inhibitorModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
25% increase Diazepam Benzodiazepines increase CNS concentrations of adenosine, a potent CNS depressant, while theophylline blocks adenosine receptors. (Theophylline label, Drug interactions)
- TiagabineanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Potential additive effects when used in combination with CNS depressants or sedating antihistamines. (Doxepin label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- TrihexyphenidylanticholinergicModerate
Concurrent use of alcohol or other CNS depressants with trihexyphenidyl HCl may cause increased sedative effects. (Trihexyphenidyl label, Drug interactions)
- TrospiumanticholinergicModerate
Trospium chloride extended-release capsules, like other antimuscarinic agents, may decrease gastrointestinal motility and should be used with caution in patients with conditions such as ulcerative colitis, intestinal atony and myasthenia gravis. (Trospium label, Warnings and precautions)
- ValbenazineVMAT2 inhibitorModerate
Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever, and primary central nervous system pathology. (Valbenazine label, Warnings and precautions)
- Valproic acidanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Vibegronbeta-adrenergic agonistModerate
Urinary Retention : Monitor for urinary retention, especially in patients with bladder outlet obstruction and also in patients taking muscarinic antagonist medications for OAB, in whom the risk of urinary retention may be greater. (Vibegron label, Warnings and precautions)
- VigabatrinanticonvulsantModerate
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
- Voriconazoleazole antifungalModerate
Eszopiclone (CYP3A4 Inhibition) Not Studied In Vivo or In Vitro , but Drug Plasma Exposure Likely to be Increased which may Increase the Sedative Effect of Eszopiclone Dose reduction of eszopiclone is recommended. (Voriconazole label, Drug interactions)
- ZolmitriptantriptanModerate
The onset of symptoms usually rapidly occurs within minutes to hours of receiving a new or a greater dose of a serotonergic medication. (Zolmitriptan label, Warnings and precautions)
Although behaviors such as "sleep-driving" may occur with hypnotics alone at therapeutic doses, the use of alcohol and other CNS depressants with hypnotics appears to increase the risk of such behaviors, as does the use of hypnotics at doses exceeding the maximum recommended dose. (Doxepin label, Warnings and precautions)
Minor mentions (12)
When benztropine mesylate is given concomitantly with phenothiazines, haloperidol, or other drugs with anticholinergic or antidopaminergic activity, patients should be advised to report gastrointestinal complaints, fever or heat intolerance promptly. (Benztropine label, Warnings)
- Cevimelinecholinergic agonistMinor
Cevimeline might interfere with desirable antimuscarinic effects of drugs used concomitantly. (Cevimeline label, Drug interactions)
- DofetilideantiarrhythmicMinor
Such drugs include phenothiazines, cisapride, bepridil, tricyclic antidepressants, certain oral macrolides, and certain fluoroquinolones. (Dofetilide label, Warnings)
Cholinesterase inhibitors have the potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Donepezil label, Drug interactions)
- Epoetin alfaMinor
The “gasping syndrome” is characterized by central nervous system (CNS) depression, metabolic acidosis, and gasping respirations. (Epoetin alfa label, Warnings and precautions)
- Galantaminecholinesterase inhibitorMinor
Potential to interfere with the activity of anticholinergic medications ( 7.1 ) (Galantamine label, Drug interactions)
These include itraconazole, ketoconazole, posaconazole, voriconazole, the macrolide antibiotics erythromycin and clarithromycin, the ketolide antibiotic telithromycin, HIV protease inhibitors, boceprevir, telaprevir, the antidepressant nefazodone, or cobicistat-containing products. (Lovastatin label, Warnings)
The safety and efficacy of combination therapy with phentermine and any other drug products for weight loss including prescribed drugs, over-the-counter preparations, and herbal products, or serotonergic agents such as selective serotonin reuptake inhibitors (e.g., fluoxetine, sertraline, fluvoxamine, paroxetine), have not been established. (Phentermine label, Warnings and precautions)
…to date with the following: (1) cardiac glycosides– digitalis and digoxin; (2) hypoglycemics–insulin, chlorpropamide, phenformin, tolazamide, and tolbutamide; (3) tranquilizers and sedatives–chlordiazepoxide, diazepam, and phenobarbital; (4) antigout–allopurinol, colchicine, and probenecid; (5) antiarrhythmics–procainamide, propranolol (see WARNINGS however),… (Prazosin label, Drug interactions)
- PropafenoneantiarrhythmicMinor
Such drugs may include many antiarrhythmics, some phenothiazines, tricyclic antidepressants, and oral macrolides. (Propafenone label, Warnings and precautions)
Antidepressants: The hypotensive effect of MAO inhibitors or tricyclic antidepressants may be exacerbated when administered with beta-blockers. (Propranolol label, Drug interactions)
Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. (Terbinafine label, Drug interactions)
No significant interaction reported (1)
…adjustment is needed when SINGULAIR is co-administered with theophylline, prednisone, prednisolone, oral contraceptives, fexofenadine, digoxin, warfarin, gemfibrozil, itraconazole, thyroid hormones, sedative hypnotics, non-steroidal anti-inflammatory agents, benzodiazepines, decongestants, and Cytochrome P450 (CYP) enzyme inducers [see Clinical Pharmacology (12.3) ]. (Montelukast label, Drug interactions)
Check Doxepin against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.