Patient/caregiver was educated on precautions to be exercised while taking doxepin as follows:
- Doxepin 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 doxepin, to your physician immediately, so that, an alternative plan of care could be considered.
- Doxepin intake has the potential to increase the likelihood of seizures. Doxepin must be very cautiously administered in individuals with seizure history, compliance with recommended anti-seizure therapy observed, and response closely monitored. Doxepin can also induce a life-threatening reaction called neuroleptic malignant syndrome. Individuals taking doxepin 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 doxepin, 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 doxepin. If you are newly diagnosed with seizure complaint, discuss with your physician regarding your safety with continuing on doxepin, if you have been using doxepin for long.
- Doxepin carries the risk of causing and/or aggravating cardiac arrhythmias. Doxepin can also interact with many antibacterial and antifungal antibiotics, antiarrhythmic medications, antidepressants, and antipsychotic medications, resulting in development or aggravation of underlying cardiac arrhythmias, leading to debility and sudden cardiac death. Avoid taking doxepin along with medications belonging to the above-mentioned groups, to prevent any dangerous arrhythmias from developing. Discuss with your physician regarding your history of cardiac arrhythmias, if any, if you are newly started on doxepin. If you are newly diagnosed with any cardiac arrhythmias or started on any antiarrhythmic medications, discuss with your physician regarding your safety with continuing on doxepin, if you have been using the medication for long.
