Doxepindosage

Prior to initiating treatment with doxepin hydrochloride, screen patients for a personal or family history of bipolar disorder, mania, or hypomania. Recommended starting oral dosage is 25 mg three times daily or 75 mg once daily. Recommended target total dosage range is between 75 mg/day and 150 mg/day (may be given once daily or in divided doses). Maximum recommended dosage is 100 mg three times daily. Wait at least 14 days after discontinuation of a monoamine oxidase inhibitor (MAOI) before initiating therapy with doxepin hydrochloride. See the Full Prescribing Information for dosage modifications intended to reduce the risk of anticholinergic effects, for strong CYP2D6 inhibitors, and in known CYP2D6 and CYP2C19 poor metabolizers. When discontinuing doxepin hydrochloride, gradually reduce the dosage until discontinued. See Full Prescribing Information for recommended preparation instructions for the oral solution.

2.1 Screen for

Bipolar Disorder Prior to Starting Doxepin Hydrochloride Prior to initiating treatment with doxepin hydrochloride, screen patients for a personal or family history of bipolar disorder, mania, or hypomania.

2.2 Recommended

Dosage The recommended starting oral dosage for doxepin hydrochloride is 25 mg three times daily or 75 mg once daily. The recommended target total oral dosage range for doxepin hydrochloride is between 75 mg/day and 150 mg/day (may be given once daily or in divided doses). The maximum recommended oral dosage for doxepin hydrochloride is 100 mg three times daily.

2.3 Switching

Patients to or from a Monoamine Oxidase Inhibitor Wait at least 14 days after discontinuation of a monoamine oxidase inhibitor (MAOI) before initiating therapy with doxepin hydrochloride. Wait at least 14 days after discontinuation of doxepin hydrochloride before initiating therapy with an MAOI.

2.4 Dosage Modifications

Intended to Reduce the Risk of Anticholinergic Effects If anticholinergic effects (e.g., dry mouth, blurred vision, constipation) develop, reduce the doxepin hydrochloride dosage.

2.5 Dosage Modifications for

Strong CYP2D6 Inhibitors Reduce the doxepin hydrochloride dosage based on doxepin plasma concentrations when used concomitantly with strong CYP2D6 inhibitors.

2.6 Dosage Modifications in

Known CYP2D6 and CYP2C19 Poor Metabolizers Reduce the doxepin hydrochloride dosage based on doxepin plasma concentrations in patients who are known CYP2D6 and CYP2C19 poor metabolizers.

2.7 Discontinuation of

Doxepin Hydrochloride Treatment When discontinuing doxepin hydrochloride, gradually reduce the dosage until discontinued.

2.8 Preparation of

Doxepin Hydrochloride Oral Solution Recommended preparation instructions for the Doxepin Hydrochloride Oral Solution are as follows: Use the supplied calibrated dropper to measure the amount of Doxepin Hydrochloride Oral Solution needed. The calibrated dropper has markings at 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg. Just prior to administration, mix doxepin hydrochloride with 120 mL of water, whole or skimmed milk, or orange, grapefruit, tomato, prune, or pineapple juice. Do not mix with other liquids. Administer the dose immediately after mixing.