Doxepin Dosages for Adults: Your GoodRx Guide

Doxepin (Silenor, Zonalon) is a prescription medication with a variety of uses. It belongs to a class of medications called tricyclic antidepressants (TCAs). And it’s FDA approved to treat insomnia (trouble sleeping), depression, and anxiety. Doxepin also comes in a topical cream that treats itchy skin.

It’s helpful to know the typical doxepin dosages for the different conditions it treats. But be sure to follow your healthcare provider’s instructions. They may recommend a different dose based on your specific needs. Here we’ll cover usual doxepin dosages and more tips that can help you get the most out of this medication.

What dosage forms does doxepin come in?

Doxepin is available as an oral tablet, oral capsule, and oral solution. It also comes in a topical cream. Each form of doxepin is approved for a different medical use, so you can’t switch between them — except for the oral capsule and the oral solution. The various doses and approved use of each form of doxepin are detailed in the table below.

You can take doxepin capsules or solution with or without food. But you should take doxepin tablets on an empty stomach.

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You should use the dropper that comes with doxepin oral solution to measure your dose. Each dose needs to be mixed with about 4 oz of liquid before you take it. You shouldn’t mix doxepin solution with carbonated drinks. The suggested liquids are:

• Water

• Whole or skim milk

• Orange, grapefruit, or pineapple juice

• Tomato juice

• Prune juice 

What’s the typical doxepin dosage for adults?

The typical doxepin dosage depends on what you’re taking it for. Below are the suggested dosages for adults, as doxepin isn’t approved for children under the age of 12. For adolescents ages 12 to 17 years old, their healthcare provider will determine the right doxepin dosage. Doses for this age group aren't provided in the prescribing information.

Depression or anxiety

The recommended doxepin dosage for anxiety or depression is based on how severe your symptoms are. Keep in mind that it may take 2 to 3 weeks for the antidepressant effect of doxepin to kick in.

For mild to moderate symptoms of depression or anxiety, the recommended doxepin dosage is 75 mg per day. Your provider may then raise or lower the dose based on your response. Most adults take between 75 mg to 150 mg of doxepin daily for anxiety or depression symptoms. 

Very mild symptoms may respond to a lower dosage of 25 mg to 50 mg of doxepin daily. More severe symptoms may need up to 300 mg of doxepin daily. Doses over 300 mg per day aren’t recommended.

You can take doxepin doses of 150 mg or less as a single daily dose. It’s best to take once-daily doxepin at bedtime, since it’s likely to make you drowsy. 

Doxepin doses over 150 mg daily should be divided into smaller doses taken throughout the day. You can divide smaller doses of doxepin and take them throughout the day too, if needed.

Insomnia

The recommended doxepin dosage for insomnia is 6 mg once daily. A lower dosage of 3 mg once daily is also available, if needed. 

You should take doxepin tablets for insomnia within 30 minutes of your bedtime. And avoid taking it within 3 hours of a meal. Taking doxepin tablets with food raises the risk that you’ll still feel drowsy the day after taking it.

Itchy skin

Doxepin cream can be used to treat certain types of itchy skin. If your itching is caused by eczema or lichen simplex chronicus (a type of itching that involves nerves beneath the skin), doxepin may help.

The topical doxepin dosage for itchy skin is to apply a thin film of cream to the affected area 4 times a day. You should wait at least 3 to 4 hours between applications. And it’s only meant for short-term use (8 days or less).

Good to know: Doxepin cream can make you drowsy — especially if you apply it to a large area of your skin. So avoid driving or other activities that require your full attention after using doxepin cream until you know how it affects you. 

Are there any dosage adjustments for certain people?

A lower doxepin dosage may be recommended for certain people, based on age or other health conditions.

Dosage for people ages 65 years and over

For insomnia, the recommended doxepin dosage for people age 65 and over is 3 mg at bedtime. This is because doxepin may cause confusion or be too sedating for older people at higher doses.

For anxiety or depression, it’s best to start at the low end of the doxepin dosage range and slowly increase if needed. This helps lower the chance of side effects.

Dosage for people with liver problems

The recommended dosage of doxepin for insomnia in people with liver problems is 3 mg at bedtime. Liver problems can raise doxepin levels in the body, which could increase the risk of side effects at higher doses.

What happens if you miss a dose of doxepin?

If you’re taking doxepin capsules or liquid and you miss a dose, take it as soon as you remember. But, if it’s almost time for your next dose, skip the missed dose. Don’t take a double dose to make up for one you missed.

If you’re taking doxepin tablets for insomnia and miss your dose, it’s fine to take it if you’re already in bed. Just be sure you can stay in bed for at least 7 to 8 hours after taking it. You may be drowsy and have a higher chance of falling if you get up sooner than that.

If you forget to apply doxepin cream, it’s fine to use it when you remember. Just be sure to wait 3 to 4 hours before you apply it again. 

What should you do if you take too much doxepin?

If you take an extra dose of doxepin by mistake, it’s not likely to cause a major problem. You might have more side effects, such as drowsiness and dry mouth. If you’re concerned, reach out to your healthcare provider or call Poison Control at 1-800-222-1222 for instructions.

A large amount of doxepin, however, can be dangerous. Symptoms of a doxepin overdose can include confusion, hallucinations, or seizures. Abnormal heart rhythms, coma, and even death are also possible. If you or someone you know takes a large amount of doxepin, call 911 or get emergency medical care right away.

How to save on doxepin

There are many ways to save on doxepin, which is available as both a brand-name and generic medication.GoodRx can help you save over 90% off the average retail price of the generic capsule.

• Doxepin capsules: Generic doxepin’s price at certain pharmacies is as low as $8.34 with a free GoodRx discount.

• Doxepin oral solution: The price of doxepin oral solution is as low as $30.80 with a free coupon from GoodRx.

• Doxepin cream: GoodRx can help you save over 70% off the average retail price of generic doxepin cream.

• Doxepin tablets: If you have commercial insurance, you may be eligible to pay as little as $25 for brand-name doxepin tablets (Silenor) using a savings card from the manufacturer. And GoodRx can help you save over 60% off the average retail price of the generic version.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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