Doxepin (Topical) interactions
Checked as Doxepin (topical) in this data source.
Full monograph for Doxepin (Topical)Check it against another medicine
Medicines
368 documented
Mechanism
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Almotriptan | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 99 sources — open the full entry |
| Amiodarone Hydrochloride | Major | Synergy | Class IA (e.g., disopyramide, quinidine, procainamide) and class III (e.g., amiodarone, dofetilide, sotalol) antiarrhythmic agents can cause dose-related… | 45 sources — open the full entry |
| Amisulpride | Major | Synergy | Amisulpride can cause dose- and concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the… | 3 sources — open the full entry |
| Arsenic Trioxide | Major | Synergy | Arsenic trioxide can cause QT interval prolongation and complete atrioventricular block. Theoretically, coadministration with other agents that can prolong the… | 4 sources — open the full entry |
| Artemether + Lumefantrine | Major | Synergy | Artemether-lumefantrine may cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…2 documented mechanisms | 16 sources — open the full entry |
| Bupropion Hydrochloride | Major | Metabolism | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with other agents that can… | 23 sources — open the full entry |
| Cabozantinib | Major | Synergy | Cabozantinib can cause prolongation of the QT interval. | 7 sources — open the full entry |
| Ceritinib | Major | Synergy | Ceritinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval… | 9 sources — open the full entry |
| Chloroquine Phosphate | Major | Synergy | Chloroquine and hydroxychloroquine can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong… | 22 sources — open the full entry |
| Citalopram Hydrobromide | Major | Synergy | Citalopram can cause dose-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval… | 22 sources — open the full entry |
| Clonidine Hydrochloride | Major | Synergy | Potentially life-threatening elevations in blood pressure have been observed when tricyclic antidepressants (TCAs) and clonidine have been administered… | 6 sources — open the full entry |
| Crizotinib | Major | Synergy | Crizotinib can cause concentration-dependent prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT… | 6 sources — open the full entry |
| Cyclobenzaprine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Desvenlafaxine Succinate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Dextromethorphan + Bupropion | Major | Metabolism · Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 122 sources — open the full entry |
| Dextromethorphan + Phenylephrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 118 sources — open the full entry |
| Dextromethorphan + Pseudoephedrine + Triprolidine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 118 sources — open the full entry |
| Dextromethorphan Hydrobromide | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 99 sources — open the full entry |
| Dextromethorphan Hydrobromide + Guaifenesin | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 99 sources — open the full entry |
| Dextromethorphan Polistirex | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 99 sources — open the full entry |
| Diphenhydramine + Dextromethorphan + Levomenthol | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1…2 documented mechanisms | 118 sources — open the full entry |
| Duloxetine Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Efavirenz | Major | Metabolism | Efavirenz can cause significant QT interval prolongation in patients with the CYP450 2B6 *6/*6 genotype due to reduced metabolic clearance of the drug stemming… | 6 sources — open the full entry |
| Escitalopram Oxalate | Major | Synergy | Concomitant use of agents with serotonergic activity including selective serotonin reuptake inhibitors, tricyclic antidepressants, and other antidepressants… | 39 sources — open the full entry |
| Fentanyl Citrate | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Flumazenil | Major | Synergy | Severe adverse effects, including fatalities, have been reported following the administration of flumazenil to multiple-drug-overdose patients who have taken… | 6 sources — open the full entry |
| Fluoxetine Hydrochloride | Major | Metabolism | Coadministration with fluoxetine may significantly increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is… | 68 sources — open the full entry |
| Fluvoxamine Maleate | Major | Metabolism | Coadministration with fluvoxamine may significantly increase the plasma concentrations of some tricyclic antidepressants (TCAs). The proposed mechanism is… | 25 sources — open the full entry |
| Gatifloxacin | Major | Synergy | Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically… | 28 sources — open the full entry |
| Gatifloxacin + Dexamethasone | Major | Synergy | Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically… | 28 sources — open the full entry |
| Granisetron | Major | Synergy | Concomitant use of 5-HT3 receptor antagonists with agents that possess or enhance serotonergic activity such as selective serotonin reuptake inhibitors… | 7 sources — open the full entry |
| Guaifenesin + Dextromethorphan + Menthol | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 99 sources — open the full entry |
| Haloperidol | Major | Metabolism | Haloperidol can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may… | 14 sources — open the full entry |
| Hydroxychloroquine Sulphate | Major | Synergy | Chloroquine and hydroxychloroquine can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong… | 22 sources — open the full entry |
| Iloperidone | Major | Synergy | Iloperidone may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may… | 9 sources — open the full entry |
| Iohexol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Iopamidol | Major | Synergy | Intrathecal administration of iodinated contrast media may induce seizures. Although clinical data are generally lacking, there may be a theoretical risk of… | 5 sources — open the full entry |
| Ivabradine | Major | Synergy | Due to its bradycardic effects, the risk of QT prolongation and torsade de pointes arrhythmia may be increased when ivabradine is used with drugs that prolong… | 10 sources — open the full entry |
| Ivosidenib | Major | Synergy | Ivosidenib can cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive… | 6 sources — open the full entry |
| Lasmiditan Hemisuccinate | Major | Synergy | Coadministration of lasmiditan and serotonergic agents may increase the risk of serotonin syndrome. Lasmiditan binds to the 5-HT(1F) receptor, where it… | 5 sources — open the full entry |
| Lefamulin Acetate | Major | Synergy | Lefamulin may cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result… | 6 sources — open the full entry |
| Levomilnacipran Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Linezolid | Major | Synergy | Coadministration of linezolid with serotonergic agents may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal… | 52 sources — open the full entry |
| Loteprednol Etabonate + Gatifloxacin | Major | Synergy | Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically… | 28 sources — open the full entry |
| Mifepristone | Major | Synergy | Mifepristone may prolong the QTc interval in a dose-related manner. Theoretically, coadministration with other agents that can prolong the QT interval may… | 10 sources — open the full entry |
| Mifepristone + Misoprostol | Major | Synergy | Mifepristone may prolong the QTc interval in a dose-related manner. Theoretically, coadministration with other agents that can prolong the QT interval may… | 10 sources — open the full entry |
| Milnacipran Hydrochloride | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 102 sources — open the full entry |
| Mirtazapine | Major | Synergy | Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1… | 100 sources — open the full entry |
| Moxifloxacin HydrochlorideInjectionOphthalmicTablet | Major | Synergy | Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically… | 28 sources — open the full entry |
| Moxifloxacin Hydrochloride + Dexamethasone | Major | Synergy | Certain quinolones, including gatifloxacin and moxifloxacin, may cause dose-related prolongation of the QT interval in some patients. Theoretically… | 28 sources — open the full entry |
Food & lifestyle
alcohol
ModerateMetabolism
Concomitant use of ethanol and a tricyclic antidepressant (TCA) may result altered TCA plasma levels and efficacy, and additive impairment of motor skills, especially driving skills. Acute ethanol ingestion may inhibit TCA metabolism, while chronic ingestion of large amounts of ethanol may induce hepatic TCA metabolism.
What to do: Patients should be advised to avoid alcohol during TCA therapy. Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy. Dosage adjustments may be required.
7 sources
- Dorian P, Sellers EM, Reed KL, et al. "Amitriptyline and ethanol: pharmacokinetic and pharmacodynamic interaction." Eur J Clin Pharmacol 25 (1983): 325-31
- Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
- Sandoz M, Vandel S, Vandel B, Bonin B, Allers G, Volmat R "Biotransformation of amitriptyline in alcoholic depressive patients." Eur J Clin Pharmacol 24 (1983): 615-21
- Ciraulo DA, Barnhill JG, Jaffe JH "Clinical pharmacokinetics of imipramine and desipramine in alcoholics and normal volunteers." Clin Pharmacol Ther 43 (1988): 509-18
- Seppala T, Linnoila M, Elonen E, Mattila MJ, Makl M "Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving." Clin Pharmacol Ther 17 (1975): 515-22
- Ciraulo DA, Barnhill JG, Jaffe JH, Ciraulo AM, Tarmey MF "Intravenous pharmacokinetics of 2-hydroxyimipramine in alcoholics and normal controls." J Stud Alcohol 51 (1990): 366-72
- Ciraulo DA, Alderson LM, Chapron DJ, Jaffe JH, Subbarao B, Kramer PA "Imipramine disposition in alcoholics." J Clin Psychopharmacol 2 (1982): 2-7
Conditions
Conditions in which Doxepin (Topical) needs care, as documented in this source.
Anticholinergic Syndrome
ModerateDoxepin possesses anticholinergic activity and is systemically absorbed when applied topically. Therapy with doxepin should be administered cautiously in patients with conditions adversely affected by anticholinergic activity, such as urinary retention, angle-closure glaucoma or elevated intraocular pressure, gastrointestinal obstructive disorders, or dementia.
2 sources
- "Product Information. Zonalon (doxepin topical)." Bioglan Pharmaceutical Inc (2001):
- Jones MI, Skaufle ML "Systemic adverse effects from topical doxepin cream." Ann Pharmacother 35 (2001): 505-6
Liver Failure
ModerateDoxepin topical is systemically absorbed and metabolized by the liver to an active form. Parent drug and metabolites are eliminated by the kidney. Renal and hepatic impairment alter the metabolism and elimination of doxepin and/or its metabolites.
4 sources
- Faulkner RD, Senekjian HO, Lee CS "Hemodialysis of doxepin and desmethyldoxepin in uremic patients." Artif Organs 8 (1984): 151-5
- Ziegler VE, Biggs JT, Wylie LT, Rosen SH, Hawf DJ, Coryell WH "Doxepin kinetics." Clin Pharmacol Ther 23 (1978): 573-9
- "Product Information. Zonalon (doxepin topical)." Bioglan Pharmaceutical Inc (2001):
- Jones MI, Skaufle ML "Systemic adverse effects from topical doxepin cream." Ann Pharmacother 35 (2001): 505-6