Patient/caregiver was educated on precautions to be exercised while taking doxepin as follows:

  1. Follow closely on the expiration date of the medication. If using a pillbox, check the expiration date on the medication container every time you fill the pillbox. If you are taking this medication for longer periods of time, set enough reminders on your phone for medication pick-up. You can have a reminder 10 days ahead, the next a week ahead, and then, every day, before you run out of the medication. This helps with securing the refill in time and making arrangements for pick-up at the pharmacy. Also, you can avoid the unpleasant withdrawal response from sudden discontinuation of medication due to running out on the medication.
  2. Doxepin use can result in common general constitutional symptoms such as, nausea and vomiting. Taking dose of doxepin with a glass of water, after having some food or a snack can help avoid having unpleasant gastrointestinal symptoms with the medication.
  3. Doxepin intake can induce extreme dry mouth and constipation. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with relief from constipation. If you experience any further bothersome constipation, report it to your physician for a recommendation on laxative/stool softener use. Observing compliance with fiber intake recommendations in the diet can also help with preventing episodes of constipation with the medication.
  4. Doxepin intake carries the risk of lowering the blood pressure. Hypotension, secondary to doxepin intake, can lead to episodes of confusion and dizziness. Avoid sudden changes in position, until you are used to the side-effects of doxepin intake. Sudden change of positions can make the confusion and dizzy episodes even worse and precipitate accidents and falls. Observing compliance with use of assistive and supportive devices, such as, walker and cane, can help fall prevention. Report any episodes of increased dizziness, syncope, and loss of consciousness while taking doxepin. Discuss with your physician regarding all your medications and their risk of causing hypotensive episodes.