Generic Name: doxepin (DOX e pin)
Brand Names: Silenor

What is Silenor?

Silenor (doxepin) belongs to a group of drugs called hypnotics.

Silenor is used to treat insomnia in people who have trouble staying asleep.

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

Important information

You should not use Silenor if you have untreated narrow-angle glaucoma or severe problems with urination. Do not use Silenor if you are allergic to doxepin or to similar medications such as amitriptyline, amoxapine, clomipramine, desipramine, imipramine, nortriptyline, protriptyline, or trimipramine.

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Do not use Silenor if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking Silenor and talk with your doctor.

Before taking this medicine

You should not use Silenor if you have untreated narrow-angle glaucoma or severe problems with urination. Do not use Silenor if you are allergic to doxepin or to similar medications such as amitriptyline, amoxapine, clomipramine, desipramine, imipramine, nortriptyline, protriptyline, or trimipramine.

Some people using this medicine have engaged in activity such as driving, eating, or making phone calls and later having no memory of the activity. If this happens to you, stop taking Silenor and talk with your doctor.

Do not use Silenor if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

To make sure Silenor is safe for you, tell your doctor if you have:

  • sleep apnea (breathing stops during sleep);

  • a history of depression, mental illness, or addiction to drugs or alcohol;

  • kidney or liver disease;

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

  • if you have ever had glaucoma, or urination problems.

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

See also: Pregnancy and breastfeeding warnings (in more detail)

Doxepin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to a child without medical advice.

How should I take Silenor?

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

Take Silenor within 30 minutes before bedtime. Do not take within 3 hours after eating.

It may take 7 to 10 days before your insomnia symptoms improve. Keep using as directed and tell your doctor if your symptoms do not improve after 10 days of treatment.

Store Silenor at room temperature away from moisture, heat, and light.

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.

Do not take Silenor if you do not have time for a full night's sleep before being active again.

What happens if I overdose?

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

What should I avoid?

Do not drink alcohol. Silenor can increase the effects of alcohol, which could be dangerous.

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

Avoid taking this medicine within 3 hours after eating a meal.

Silenor side effects

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

Call your doctor at once if you have a side effect such as:

  • fast, pounding, or uneven heart rate;

  • confusion, hallucinations, unusual thoughts or behavior, seizure (convulsions);

  • new or worsening symptoms of depression (mood or behavior changes, anxiety, trouble sleeping, feeling agitated, thoughts about suicide or hurting yourself.

  • easy bruising or bleeding, unusual weakness;

  • feeling light-headed, fainting;

  • restless muscle movements in your eyes, tongue, jaw, or neck;

  • tremors or uncontrollable shaking;

  • urinating less than usual or not at all; or

  • extreme thirst with headache, nausea, vomiting, and weakness.

Other common Silenor side effects may include:

  • drowsiness, dizziness;

  • cold symptoms such as stuffy nose, sneezing, sore throat;

  • nausea, vomiting, diarrhea, constipation, loss of appetite;

  • dry mouth;

  • weight changes;

  • lack of coordination;

  • numbness or tingly feeling;

  • strange dreams;

  • blurred vision, headache, ringing in your ears;

  • increased sweating;

  • breast swelling (in men or women); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

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)

What other drugs will affect Silenor?

Taking Silenor with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking Silenor with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking Silenor, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with this medicine, especially:

  • cimetidine (Tagamet);

  • St. John's wort; or

  • tolazamide (Tolinase).

This list is not complete. Other drugs may interact with Silenor, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about Silenor.
  • 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 1996-2014 Cerner Multum, Inc. Version: 2.01. Revision Date: 2012-12-13, 3:20:12 PM.

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