Medication Guide App

amoxapine

Generic Name: amoxapine (a MOX a peen)
Brand Name: Asendin

What is amoxapine?

Amoxapine is a tricyclic antidepressants. Amoxapine affects chemicals in the brain that may become unbalanced.

Amoxapine is used to treat symptoms of depression, anxiety, or agitation.

Amoxapine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about amoxapine?

Never take amoxapine in larger amounts, or for longer than recommended by your doctor. High doses or long-term use of amoxapine can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include tremors or other uncontrollable muscle movements.

You should not use amoxapine if you are allergic to it, or if you have recently had a heart attack.

Slideshow: Depression, the Risk of Suicide, and Treatment Options

Do not use amoxapine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Avoid drinking alcohol. It can cause dangerous side effects when taken together with amoxapine.

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.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking amoxapine?

You should not use amoxapine if you are allergic to it, or if you have recently had a heart attack.

Do not use amoxapine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

To make sure amoxapine is safe for you, tell your doctor if you have any of these conditions:

  • heart disease;

  • a history of heart attack, stroke, or seizures;

  • kidney disease;

  • schizophrenia or other mental illness;

  • diabetes (amoxapine may raise or lower blood sugar);

  • bipolar disorder (manic depression);

  • glaucoma; or

  • problems with urination.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

FDA pregnancy category C. It is not known whether amoxapine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Amoxapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medicine.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take amoxapine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 3 weeks of treatment.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amoxapine can be fatal.

Overdose symptoms may include seizure (convulsions) or coma.

What should I avoid while taking amoxapine?

Avoid drinking alcohol. It can cause dangerous side effects when taken together with amoxapine.

Grapefruit and grapefruit juice may interact with amoxapine and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Amoxapine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Stop taking amoxapine and call your doctor at once if you have a serious side effect such as:

  • very stiff (rigid) muscles, high fever, sweating, confusion, tremors, feeling like you might pass out;

  • pounding heartbeats or fluttering in your chest;

  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

  • sudden numbness or weakness, especially on one side of the body; or

  • sudden severe headache, confusion, problems with vision, speech, or balance.

Less serious side effects may include:

  • drowsiness, dizziness, headache, tired feeling;

  • feeling restless or nervous;

  • dry mouth, blurred vision;

  • mild nausea, constipation;

  • increased appetite, weight changes;

  • increased sweating; or

  • sleep problems (insomnia), night mares.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Amoxapine dosing information

Usual Adult Dose for Depression:

For the relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions:

Initial dose: 50 mg 2 or 3 times daily. Depending on tolerance, the dosage may be increased to 100 mg 2 or 3 times daily by the end of the first week. An initial dosage of 300 mg daily may be given, but notable sedation may occur in some patients during the first few days of therapy at this level. Increases above 300 mg daily should be made only if 300 mg daily has been ineffective during a trial period of at least two weeks. When an effective dosage is established, the drug may be given in a single dose (not to exceed 300 mg) at bedtime.

Maintenance: 200 to 300 mg daily.
Three weeks is an adequate trial period providing the dosage has reached 300 mg daily (or the lower level of tolerance) for at least two weeks. If no response is seen at 300 mg, the dosage may be increased (depending on tolerance) up to 400 mg daily. Hospitalized patients who have been refractory to antidepressant therapy and who have no history of convulsive seizures may have their dosage cautiously raised up to 600 mg daily in divided doses.

Amoxapine may be given in a single daily dose up to 300 mg, preferably at bedtime. If the total daily dosage exceeds 300 mg, it should be given in divided doses.

Usual Geriatric Dose for Depression:

For the relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions:

Initial dose: 25 mg 2 or 3 times daily. If no intolerance is observed, the dosage may be increased by the end of the first week to 50 mg 2 or 3 times daily. Although 100 to 150 mg daily may be adequate for many elderly patients, some may require a higher dosage. Careful increases up to 300 mg daily may be appropriate for such individuals.

Once an effective dose has been established, amoxapine may be given as a single bedtime dose, not to exceed 300 mg.

What other drugs will affect amoxapine?

Cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and seizure medication can add to sleepiness caused by amoxapine. Tell your doctor if you regularly use any of these medicines, or any other antidepressants.

Before taking amoxapine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Tell your doctor about all other medicines you use, especially:

  • bupropion (Wellbutrin, Zyban);

  • cimetidine (Tagamet);

  • duloxetine (Cymbalta);

  • St. John's wort;

  • terbinafine (Lamisil); or

  • heart rhythm medications such as flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quin-G).

This list is not complete and other drugs may interact with amoxapine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about amoxapine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 9.01. Revision Date: 2012-10-23, 1:07:47 PM.

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