Drug Interaction Report

The medication in doxepin topical is absorbed through the skin into the bloodstream and may cause interactions with other medications such as methylene blue. When used together, this combination may produce a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. In general, you should wait at least 14 days after stopping methylene blue before you start treatment with doxepin topical, and vice versa. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.