Doxepin — What It Does, How to Take It, and What to Watch For

Think doxepin is just an old antidepressant? It’s more than that. Doxepin is a tricyclic antidepressant often used for depression and anxiety, but at much lower doses it’s also prescribed for sleep trouble and severe itching. That mix of uses makes it useful, but also means you should know how it behaves and when to be careful.

Oral doxepin comes in a range of doses. For depression and anxiety doctors usually start around 25–75 mg a day and may go up to 150–300 mg depending on response and tolerance. For insomnia, approved low doses are typically 3 mg or 6 mg at bedtime. Topical doxepin creams are also available for itchy skin conditions. Always follow your prescriber’s plan — doses vary a lot by reason for treatment.

Common Side Effects and Red Flags

Doxepin has noticeable anticholinergic effects: expect dry mouth, constipation, blurred vision, and sometimes urinary difficulty. Sedation and weight gain are common, especially at higher doses. It can lower blood pressure when you stand up, so get up slowly to avoid dizziness. Less common but serious issues include fast or irregular heartbeat, severe confusion, and signs of an allergic reaction — contact a doctor right away if these happen.

Because it’s a tricyclic, doxepin can be dangerous in overdose. If you or someone else takes too much, seek emergency care immediately. Also watch for worsening mood or suicidal thoughts, particularly when starting or changing the dose. Don’t stop suddenly; your prescriber will advise a gradual taper to avoid withdrawal symptoms.

Interactions, Warning Signs, and Who Should Be Careful

Avoid combining doxepin with MAO inhibitors and be cautious with other drugs that slow the heart or affect heart rhythm. Many common medicines — certain antibiotics, antifungals, and antidepressants — can raise doxepin levels or increase side effects. Alcohol and sedatives amplify drowsiness. People with heart disease, glaucoma, urinary retention, or severe constipation should talk to their doctor before using doxepin.

Pregnancy and breastfeeding require a specific risk–benefit discussion with your provider. Older adults are often more sensitive to dizziness, confusion, and falls, so doctors usually start low and move slowly.

Want to buy doxepin online? Get a prescription first. Use licensed pharmacies that list a physical address and pharmacist contact, and avoid sites selling without prescriptions or offering suspiciously low prices. Check shipping, packaging, and expiration dates when your order arrives. If something feels off, contact the pharmacy and your prescriber before taking the medicine.

Have questions about switching from another antidepressant or combining therapies? Ask your prescriber for clear steps and monitoring plans. Doxepin works well for many people, but it works best when you and your healthcare team pay attention to dose, interactions, and safety signals.