amoxapine
Amoxapine is an antidepressant that's used for people who have both depression and anxiety. But, it's not a first-choice option because it has a higher risk of side effects. Drowsiness, dry mouth, constipation, and blurry vision are the most common side effects of amoxapine. The brand name Asendin is no longer sold in the United States, but it's still available as a lower-cost generic tablet.
What is Amoxapine?
What is Amoxapine used for?
- Depression that comes along with anxiety or agitation
How Amoxapine works
Amoxapine is a tricyclic antidepressant (TCA). It's not exactly clear how the medication treats depression, but it appears to boost certain chemicals in the brain (serotonin and norepinephrine). These chemicals play a role in affecting your mood.
Drug facts
Side effects of Amoxapine
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Drowsiness (14%)
- Dry mouth (14%)
- Constipation (12%)
- Blurred vision (7%)
Less Common Side Effects
- Restlessness
- Nervousness
- Headache
- Dizziness
- Tiredness
- Weakness
- Trouble sleeping (insomnia)
- Tremors
- Nausea
- Large appetite
- Irregular heartbeat
- More sweating than usual
- Rash
Amoxapine serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behavior
- Neuroleptic malignant syndrome (NMS): high fever, fast heart rate, full body stiffness, confusion
The following Amoxapine side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Excitement
fast, irregular, pounding, or racing heartbeat or pulse
fear or nervousness
mood or mental changes
nightmares
restlessness
shakiness and unsteady walk
shakiness in legs, arms, hands, or feet
swelling
trouble sleeping
unable to sleep
unsteadiness, trembling, or other problems with muscle control or coordination
Rare
Abdominal or stomach pain
actions that are out of control
black, tarry stools
bleeding gums
blood in urine or stools
blurred vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chest pain or discomfort
chills
clay-colored stools
confusion
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in ears
convulsions
cough or hoarseness
dark urine
decrease in frequency of urination
decrease in urine volume
difficulty in breathing
difficulty in passing urine (dribbling)
difficulty in speaking
disturbed concentration
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
double vision
extremely high fever or body temperature
false beliefs that cannot be changed by facts
fast, weak heartbeat
fever with or without chills
general feeling of tiredness or weakness
headache
hearing loss
high fever
high or low blood pressure
hives or welts
inability to move arms, legs, or facial muscles
inability to speak
increased need to urinate
increased sweating
indigestion
irritability
lack of coordination
light-colored stools
lip smacking or puckering
loss of appetite
loss of bladder control
lower back or side pain
muscle cramps
muscle spasm or jerking of all extremities
muscle trembling, jerking, or stiffness
nervousness
numbness
pain or discomfort in arms, jaw, back, or neck
painful or difficult urination
pains in stomach, side, or abdomen, possibly radiating to the back
pale, clammy skin
passing urine more often
pinpoint red spots on skin
pounding in the ears
puffing of cheeks
rapid or worm-like movements of tongue
redness of skin
seeing, hearing, or feeling things that are not there
severe muscle stiffness
shortness of breath
shuffling walk
skin rash
slow speech
sores, ulcers, or white spots on lips or in mouth
stiffness of limbs
sudden loss of consciousness
sweating
swollen glands
talking, feeling, and acting with excitement
testicular swelling
thirst
trouble in holding or releasing urine
twisting movements of body
uncontrolled chewing movements
uncontrolled movements, especially of face, neck, and back
unpleasant breath odor
unusual bleeding or bruising
unusually pale skin
upper right abdominal pain
vomiting of blood
yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Change in consciousness
drowsiness
epileptic seizure that will not stop
increased blood pressure
increased thirst
loss of consciousness
swelling of face, fingers, or lower legs
total body jerking
troubled breathing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Increased appetite
increased flow of breast milk
Rare
Agitation
breast enlargement
change in taste bad unusual or unpleasant (after)taste
decreased interest in sexual intercourse
excess air or gas in stomach or intestines
full feeling
hair loss, thinning of hair
inability to have or keep an erection
increased in sexual ability, desire, drive, or performance
increased interest in sexual intercourse
increased sensitivity of skin to sunlight
loss in sexual ability, desire, drive, or performance
menstrual changes
nasal stuffiness
painful ejaculation
passing gas
rapid weight gain
redness or other discoloration of skin
seizures
severe sunburn
stupor
swollen, painful, or tender lymph glands on side of face or neck
tearing of the eyes
unexpected or excess milk flow from breasts
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Amoxapine
Pros
- Doses up to 300 mg can be taken once a day.
- Might work faster than similar medications like amitriptyline or imipramine
- Available as a lower-cost generic
Cons
- Causes a lot of side effects
- Higher risk of side effects in older adults
- Not a good option for people with a history of seizures
Pharmacist tips for Amoxapine
- When you first start treatment, you might take smaller doses of amoxapine multiple times a day. This lets your body get used to the medication. If it's easier for you to take the medication one time a day, ask your provider if it's appropriate to adjust your dosing schedule.
- Make sure to regularly follow up with your provider to discuss how well amoxapine is working for your symptoms. If you continue to feel depressed and aren't bothered by side effects, your provider might raise your dose.
- It's common to feel dizzy and drowsy while you're taking amoxapine. Drinking alcohol can make these effects worse. It's best to avoid alcohol while you're taking this medication. Also don't drive or do anything that requires a lot of focus until you know how the medication affects you.
- Don't stop taking amoxapine without speaking to your provider first. Stopping it too suddenly could cause withdrawal symptoms. If you'd like to stop taking the medication, your provider can come up with a plan so you can do so safely.
- Keep amoxapine in a safe place. Get medical help right away if you or someone else takes more than the recommended amount. An overdose can lead to serious heart and kidney problems.
Common questions about Amoxapine
No, amoxapine isn't an antipsychotic. It's a tricyclic antidepressant. While both groups of medications affect chemicals in the brain, they work differently and are generally used for different mental health conditions. Tricyclic antidepressants like amoxapine are mainly used for depression, whereas antipsychotics can help treat schizophrenia as well.
Most people will start to feel the effects of amoxapine within 2 weeks. Some people might feel the effects as soon as 4 to 7 days after starting this medication. Make sure to keep your follow-up appointments with your provider since they might need to adjust your dose when you first start taking this medication.
After taking a dose of amoxapine, the medication can stay in your body for a long time (up to about a week). This means that even when you stop taking amoxapine, you could still experience side effects for several days after stopping. If you experience any side effects that are bothering you during and after treatment with amoxapine, speak with your provider.
In clinical studies, less than 1% of people who took amoxapine reported weight gain. Amoxapine can raise your appetite. As a result, you might end up eating more than usual during treatment, which can possibly lead to weight gain. If you have concerns about your weight while you're taking amoxapine, speak to your provider.
Drowsiness is a common side effect of amoxapine. In clinical studies, 14% of people reported feeling sleepy while taking this medication. Make sure to avoid driving or performing activities that require you to be alert until you know how this medication affects you.
You can take amoxapine at any time of the day that's easy for you to remember. When you first start taking this medication, your provider will probably recommend that you take it two or three times a day. This helps you get used to the medication. Once you're on a consistent maintenance dose, they might switch your dosing schedule to once daily at night. This might be helpful for people who get sleepy from taking amoxapine. If you're feeling sleepy during the day, talk to your provider about the best time to take your medication.
Both amoxapine and sertraline (Zoloft) are antidepressants. However, sertraline (Zoloft) is used for many other mental health conditions besides depression. Amoxapine and sertraline (Zoloft) belong to different classes of medications and work a little differently. Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI), while amoxapine is a tricyclic antidepressant (TCA). In studies, TCAs like amoxapine have proven to work just as well as other antidepressants (including SSRIs) for treating depression. But, sertraline (Zoloft) is the first-choice medication for the treatment of depression because it has less side effects than amoxapine. Speak with your provider to learn more about the similarities and differences that these two medications have.
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Risks and warnings for Amoxapine
Amoxapine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Suicidal thoughts and behavior
- Risk factors: Age 24 or younger
Amoxapine can raise the risk of suicidal thoughts or behavior. Watch for new or worsening depression, suicidal thoughts or behavior, especially during the first few months of treatment or when the dose changes. Let your healthcare provider know right away if you notice any unusual changes in your mood or behavior while taking amoxapine.
Possible bipolar disorder
Sometimes, depression can be the first sign of a bipolar disorder. Unfortunately, amoxapine doesn't treat bipolar disorder and can set off a manic phase (high energy). Your provider will screen you for bipolar disorder before you start amoxapine. Let them know about your full medical history and if anyone in your family has a history of bipolar disorder.
Eye problems
- Risk factors: Narrow-angle glaucoma
Many antidepressants, including amoxapine, can cause eye-related side effects. This can cause eye pain in people who already have eye conditions, such as glaucoma. Let your provider know if you have a history of eye problems and if amoxapine starts causing vision changes or discomfort.
Difficulty controlling movements
- Risk factors: Older adults (especially women) | Taking amoxapine for a long time
Amoxapine can cause a movement condition called tardive dyskinesia (TD). Common symptoms of TD include uncontrollable facial movements, such as blinking or sticking out your tongue. It happens more often to older adults, especially older women, but it can happen to anyone. Let your provider know if this starts to happen to you or a loved one if you're a caregiver. Sometimes TD will go away if the medication is stopped or the dose is lowered.
Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a rare, but life-threatening condition that's associated with amoxapine use. Symptoms include high fever, fast heart rate, full body stiffness, and confusion. Get medical attention right away if you notice any of these symptoms. Your healthcare provider will probably find another medication that'll work better for you.
Amoxapine dosage
Interactions between Amoxapine and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bromopride
- Clorgyline
- Grepafloxacin
- Isocarboxazid
- Levomethadyl
- Linezolid
- Methylene Blue
- Metoclopramide
- Moclobemide
- Phenelzine
- Ranolazine
- Safinamide
- Selegiline
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acecainide
- Aceclofenac
- Acemetacin
- Albuterol
- Alfentanil
- Alfuzosin
- Almotriptan
- Amifampridine
- Amitriptyline
- Amphetamine
- Amtolmetin Guacil
- Apomorphine
- Aprindine
- Arsenic Trioxide
- Asenapine
- Aspirin
- Astemizole
- Azimilide
- Azithromycin
- Benzhydrocodone
- Benzphetamine
- Bretylium
- Bromfenac
- Bromocriptine
- Brompheniramine
- Bufexamac
- Buprenorphine
- Bupropion
- Buspirone
- Butorphanol
- Celecoxib
- Chloral Hydrate
- Chloroquine
- Chlorpheniramine
- Chlorpromazine
- Choline Salicylate
- Ciprofloxacin
- Citalopram
- Clomipramine
- Clonidine
- Clonixin
- Clozapine
- Cocaine
- Codeine
- Cyclobenzaprine
- Darunavir
- Desipramine
- Desmopressin
- Desvenlafaxine
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Dextromethorphan
- Diclofenac
- Diflunisal
- Dihydrocodeine
- Dipyrone
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Doxepin
- Droperidol
- Droxicam
- Eletriptan
- Enflurane
- Epinephrine
- Erythromycin
- Escitalopram
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenfluramine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Fingolimod
- Flecainide
- Floctafenine
- Fluconazole
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Foscarnet
- Frovatriptan
- Gatifloxacin
- Gemifloxacin
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Granisetron
- Halofantrine
- Halothane
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Ibuprofen
- Ibutilide
- Iloperidone
- Imipramine
- Indomethacin
- Iobenguane I 123
- Iobenguane I 131
- Iproniazid
- Isoflurane
- Isradipine
- Ketoprofen
- Ketorolac
- Lapatinib
- Lasmiditan
- Levalbuterol
- Levomilnacipran
- Levorphanol
- Lidoflazine
- Lisdexamfetamine
- Lithium
- Lopinavir
- Lorcainide
- Lorcaserin
- Lornoxicam
- Loxapine
- Loxoprofen
- Lumefantrine
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Meperidine
- Metaxalone
- Methacholine
- Methadone
- Methamphetamine
- Milnacipran
- Mirtazapine
- Moricizine
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Nabumetone
- Nalbuphine
- Naproxen
- Naratriptan
- Nefazodone
- Nefopam
- Nepafenac
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Norepinephrine
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Ondansetron
- Oxaprozin
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Oxyphenbutazone
- Ozanimod
- Paliperidone
- Palonosetron
- Parecoxib
- Pargyline
- Paroxetine
- Pazopanib
- Pentamidine
- Pentazocine
- Phenylbutazone
- Piketoprofen
- Piroxicam
- Pranoprofen
- Procainamide
- Procarbazine
- Prochlorperazine
- Proglumetacin
- Promethazine
- Propafenone
- Propyphenazone
- Proquazone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Rasagiline
- Remifentanil
- Revefenacin
- Rofecoxib
- Salicylic Acid
- Salsalate
- Scopolamine
- Secretin Human
- Sematilide
- Sertraline
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Sodium Salicylate
- Solifenacin
- Sorafenib
- Sotalol
- Spiramycin
- Sufentanil
- Sulfamethoxazole
- Sulindac
- Sumatriptan
- Sunitinib
- Tapentadol
- Tedisamil
- Telavancin
- Telithromycin
- Tenoxicam
- Tetrabenazine
- Tiaprofenic Acid
- Tiotropium
- Tolfenamic Acid
- Tolmetin
- Toremifene
- Tramadol
- Trazodone
- Trifluoperazine
- Trimethoprim
- Trimipramine
- Tryptophan
- Valdecoxib
- Vardenafil
- Venlafaxine
- Vilanterol
- Vilazodone
- Voriconazole
- Vortioxetine
- Ziprasidone
- Zolmitriptan
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Arbutamine
- Atomoxetine
- Cannabis
- Carbamazepine
- Dicumarol
- Phenprocoumon
- S-Adenosylmethionine
How much does Amoxapine cost?
$12.21
Amoxapine contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Amoxapine will not be safe for you to take.
- Currently or recently taking (within 14 days) a monoamine oxidase inhibitor (MAOI) medication
- Recent heart attack and still in recovery
What are alternatives to Amoxapine?
News about Amoxapine
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