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amoxapine

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

What is amoxapine?

Amoxapine is a tricyclic antidepressant. Amoxapine affects chemicals in the brain that may be unbalanced in people with certain conditions.

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?

You should not use amoxapine if you have recently had a heart attack.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

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 in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

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

  • 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.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while taking amoxapine.

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

Amoxapine is not approved for use by anyone younger than 18 years old.

How should I take 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.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

If you take this medicine once daily, take your dose at bedtime.

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.

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?

Drinking alcohol with this medicine can cause side effects.

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 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.

Call your doctor at once if you have:

  • skin rash with fever;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

  • pounding heartbeats or fluttering in your chest;

  • little or no urination;

  • chest pain or pressure, pain spreading to your jaw or shoulder;

  • sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Side effects may be more likely in older adults.

Common side effects may include:

  • drowsiness;

  • constipation;

  • dry mouth; or

  • blurred vision.

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:

Initial dose: 50 mg orally two or three times a day
Maintenance dose: 100 mg orally two or three times a day
Maximum dose: 600 mg orally per day

Comments:
-Increases above 300 mg per day should be made only if 300 mg per day has been ineffective during at least two weeks.
-Hospitalized patients who have been refractory to antidepressant treatment and who have no history of convulsive seizures may have dosage increased cautiously up to 600 mg per day in divided doses.
-This drug may be given in a single daily dose, not to exceed 300 mg, preferably at bedtime.
-Doses above 300 mg should be given in divided doses.

Use:
-Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions

Usual Geriatric Dose for Depression:

Initial dose: 25 mg orally two or three times a day
Maintenance dose: 50 mg orally two or three times a day
Maximum dose: 300 mg orally per day

Comments:
-Once an effective dosage is established, this drug may be administered in a single bedtime dose, not to exceed 300 mg.
-Recommended maintenance dosage is the lowest dose that will maintain remission.
-If symptoms reappear, the dosage should be increased to previous level until symptoms are under control.

Use:
-Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions

What other drugs will affect amoxapine?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking amoxapine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

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

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • other antidepressants such as bupropion;

  • heart rhythm medications such as flecainide, propafenone, or quinidine;

  • bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;

  • bronchodilators such as aclidinium, ipratropium, tiotropium, or umeclidinium;

  • cold or allergy medicine that contains an antihistamine;

  • medication for Parkinson's disease; or

  • medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome.

This list is not complete. Other drugs may interact with amoxapine, 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 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: 10.02. Revision Date: 2016-07-22, 8:36:46 AM.

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