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Before taking Sinequan, tell your doctor if you have used an “SSRI” antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking Sinequan, tell your doctor if you are currently using any of the following drugs:

* cimetidine (Tagamet) or;
* heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

There are many other medicines that can interact with Sinequan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms 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 any of these serious side effects:

* fast, pounding, or uneven heart rate;
* confusion, hallucinations, or seizure (convulsions);
* easy bruising or bleeding, unusual weakness;
* feeling light-headed, fainting;
* restless muscle movements in your eyes, tongue, jaw, or neck;
* tremors or uncontrollable shaking;
* urinating less than usual or not at all; or
* extreme thirst with headache, nausea, vomiting, and weakness.

Less serious side effects may include:

* nausea, vomiting, constipation, loss of appetite;
* dry mouth;
* weight changes;
* weakness, lack of coordination;
* numbness or tingly feeling;
* feeling dizzy, drowsy, or tired;
* sleep problems (insomnia), nightmares;
* blurred vision, headache, ringing in your ears;
* increased sweating;
* breast swelling (in men or women); or
* decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Avoid drinking alcohol. It can cause dangerous side effects when taken together with Sinequan. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety can add to sleepiness caused by Sinequan. Tell your doctor if you regularly use any of these medicines, or any other antidepressant. Sinequan can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

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Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Sinequan can be fatal.

Overdose symptoms may include uneven heartbeats, extreme drowsiness, agitation, vomiting, blurred vision, confusion, hallucinations, feeling hot or cold, muscle stiffness, feeling light-headed, fainting, seizure (convulsions), or coma.

Sinequan missed dose

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

Measure Sinequan oral concentrate (liquid) with the special dose-measuring dropper provided. Do not use a regular table spoon. If you do not have a dose-measuring dropper, ask your pharmacist for one.

Empty the measured dose from the medicine dropper into a small glass (4 ounces) of water, milk, orange juice, grapefruit juice, tomato juice, prune juice, or pineapple juice. Do not use grape juice or a carbonated soft drink to mix Sinequan oral concentrate. Stir the mixture and drink all of it right away. Do not save it for later use.

It may take a few weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve during treatment.

Store Sinequan at room temperature away from moisture and heat.

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Do not use this medication if you are allergic to Sinequan, or if you have glaucoma or problems with urination. Do not use Sinequan if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Sinequan before the MAO inhibitor has cleared from your body.

Before taking Sinequan, tell your doctor if you are allergic to any drugs, or if you have:

* bipolar disorder (manic-depression); or
* diabetes (Sinequan may raise or lower blood sugar).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

You may have thoughts about suicide while taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Sinequan passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give Sinequan to anyone younger than 18 years old without the advice of a doctor.

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Do not use this medication if you are allergic to Sinequan, or if you have glaucoma or problems with urination. Do not use Sinequan if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Sinequan before the MAO inhibitor has cleared from your body.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms 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.

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Generic Name: doxepin hydrochloride (DOX e pin)
Brand Names: Adapin, Sinequan

What is Sinequan?

Sinequan is in a group of drugs called tricyclic antidepressants. Sinequan affects chemicals in the brain that may become unbalanced.

Sinequan is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions.

Sinequan may also be used for other purposes not listed in this medication guide.

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Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Paxil may cause you to bruise or bleed easily.

Before taking Paxil, tell your doctor if you are using any of the following medicines:

* atomoxetine (Strattera), cimetidine (Tagamet), fosamprenavir (Lexiva), lithium (Lithobid, Eskalith), risperidone (Risperdal), ritonavir (Norvir), St. John’s wort, tramadol (Ultram), or tryptophan (also called L-tryptophan);
* heart rhythm medication such as flecainide (Tambocor) or propafenone (Rhythmol);
* a blood thinner such as warfarin (Coumadin);
* any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or sertraline (Zoloft);
* a phenothiazine such as prochlorperazine (Compazine), chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), and others; or
* almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig).

This list is not complete and there may be other drugs that can interact with Paxil. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/or physical hyperactivity), thoughts of suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

* seizure (convulsions);
* tremors, shivering, muscle stiffness or twitching;
* problems with balance or coordination;
* agitation, confusion, sweating, fast heartbeat; or
* easy bruising or bleeding (such as a nosebleed).

Less serious side effects may include:

* feeling nervous, restless, or unable to sit still;
* drowsiness, dizziness, weakness;
* sleep problems (insomnia);
* nausea, constipation, loss of appetite;
*  weight changes;
* decreased sex drive, impotence, or difficulty having an orgasm; or
* dry mouth, yawning, or ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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