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The main factors affecting doxepin dose are the condition for which it is being used, response to treatment and tolerance. Doxepin is available as both an oral preparation and topical preparation, each of which is used to treat a different clinical condition. It may be known by different trade names in different countries according to manufacturer and, in most countries, is available only by doctor’s prescription.
Doxepin belongs to the class of drugs called tricyclic antidepressants. The oral preparation is used to treat anxiety and depression and works by preventing the resorption of serotonin and noradrenalin which allows the mood to improve. The topical preparation, which is used to treat itching associated with conditions such as atopic dermatitis, eczema and lichen simplex, works by blocking histamine receptors.
The optimal doxepin dose will be established by the treating doctor, who will monitor the patient’s response. Initially, a low doxepin dose may be prescribed which can be increased over a number of weeks until the desired effect is obtained. The full antidepressant effect may take some weeks to be obtained, although the effect on anxiety may be seen earlier.
As with any medication, doxepin may cause unwanted side effects. These may include drowsiness, dry mouth and constipation. Driving and the operation of heavy machinery should be avoided due to the possibility of drowsiness, especially during the initial stage of treatment and adjustment of doxepin dose. Should side effects prove to be intolerable, they should be discussed with the prescribing doctor, who may adjust the dose of the drug.
When starting treatment with doxepin it is important that any other medication that is being taken, including homeopathic, complementary and over-the-counter preparations should be disclosed to the doctor, as interactions may occur. Any underlying clinical conditions, pregnancy, desired pregnancy and lactation should be discussed. Doxepin may be contraindicated in patients with some clinical conditions.
The doxepin dose may be taken as a once daily dose at night or divided doses during the day. The prescribed dose and dosage regimen should not be altered without consultation with the prescribing doctor. All medications, including doxepin should be stored in a locked cupboard, out of reach of children, to prevent accidental overdose.
Doxepin cream is used short-term to treat itching associated with skin conditions such as atopic dermatitis. It is usually applied to the skin three to four times daily for a short period. Again, the prescribed dose should never be exceeded to avoid unwanted systemic effects.