Patient/caregiver was educated on precautions to be exercised while taking dothiepin as follows:
- Dothiepin intake can induce some dizziness and make one drowsy. Starting the medication at a low dose, watching for the response, and gradually changing the dose, to help optimum control of your symptoms, can contribute to controlling/reducing the risk for drowsiness and dizziness due to the medication. If the dizziness becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until you are used to the side effects caused by dothiepin intake.
- Do not take dothiepin with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the dizziness and confusion caused by dothiepin, and contribute to falls and accidents. A number of OTC cough medications and antihistamines, muscle relaxant medications, and antianxiety medications, can potentiate the confusion caused by dothiepin and so, must be avoided taking along with dothiepin. Avoid taking any other medications with potential to cause drowsiness along with dothiepin at the same time.
- Dothiepin use can result in pupillary dilation and obstruction to the drainage of fluid (aqueous humor) inside the eye. This blockage of fluid in the eye can result in increase in the intraocular pressure, leading to glaucoma. Individuals with glaucoma can present with eye pain, headache, and blurred vision with haloes around light. Observe compliance with any periodical vision exams recommended. Report any eye pain and changes with vision, while taking dothiepin, to your physician immediately, so that, an alternative plan of care could be considered.
- Dothiepin can reduce the effects of anti-seizure medications and increase the likelihood for seizures in individuals with seizure history. Dothiepin is best avoided for other alternative medications or cautiously used with periodical monitoring in individuals with seizure history.
- Dothiepin can also induce a life-threatening reaction called neuroleptic malignant syndrome. Individuals taking dothiepin can present with high fever, episodes of confusion, muscle rigidity, elevated blood pressure, and rapid heart rate. Severe cases can present with muscle breakdown, elevated potassium levels in the blood due to muscle destruction, life-threatening cardiac arrhythmias due to the elevated blood potassium, and seizures. Any of these findings, while taking dothiepin, should be immediately reported to the physician, for necessary changes to be considered. Also, discuss with your physician regarding your history of seizures, if any, if you are newly started on dothiepin. If you are newly diagnosed with seizure complaint, discuss with your physician regarding your safety with continuing on dothiepin, if you have been using dothiepin for long.
