doxepin
Doxepin (Silenor) is a tricyclic antidepressant that's used to help adults who have insomnia (trouble sleeping) stay asleep. Doxepin (Silenor) is a tablet that you take by mouth 30 minutes before bedtime. As expected, the most common side effects are sleepiness and tiredness, so only take the medication when you're ready to fall asleep for the night. Unlike some other sleep medications, doxepin (Silenor) isn't considered a controlled substance. Doxepin (Silenor) is available as brand-name and generic versions.
What is Doxepin (Silenor)?
What is Doxepin (Silenor) used for?
Insomnia (specifically trouble staying asleep)
How Doxepin (Silenor) works
Doxepin (Silenor) is a tricyclic antidepressant (TCA). It blocks histamine receptors in the brain. This helps you stay asleep during the night and keeps you from waking up too early in the morning.
Drug Facts
Get your GoodRx coupon
What are the side effects of Doxepin (Silenor)?
Common Side Effects
- Sleepiness or tiredness (up to 9%)
Other Side Effects
Serious Side Effects
- Allergic reaction: hives, rashes, swollen face or throat, difficulty breathing
- Worsened depression
- Suicidal thoughts or actions
- Unusual behaviors while not fully awake with no memory of them the next day (e.g., driving, eating, cooking, having sex)
Source: DailyMed
More on Doxepin (Silenor) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Thoughts of suicide or self-harm, worsening mood, or feelings of depression
- Trouble passing urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Change in sex drive or performance
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Tremors
- Weight gain
Pros and cons of Doxepin (Silenor)
Pros
Taken once a day close to bedtime
Few side effects (other than sleepiness)
Non-addictive sleep medication
Cons
Shouldn't take with food (must take at least 3 hours before or after food)
Risk of doing activities while you're not fully awake and not remembering that you did them the next day
Not approved for people younger than 18 years of age
Pharmacist tips for Doxepin (Silenor)
Take doxepin (Silenor) 30 minutes right before you go to bed. Don't take doxepin (Silenor) unless you know you can get a full night's sleep. Otherwise, you might still feel sleepy during the next day.
Avoid taking doxepin (Silenor) within 3 hours of a meal. Food can make the medication take longer to kick in and also raise the risk that you'll still feel sleepy the next day.
Don't mix doxepin (Silenor) with alcohol because it can make you become too sleepy. It can also raise your risk of doing activities, like driving a car, talking on the phone, making food, while you're not fully awake. This can be very dangerous.
Avoid driving or do anything requiring concentration after you take doxepin (Silenor). This medication can make you feel very sleepy and make it harder to think clearly or react quickly.
Speak with your prescriber if you're still having problems sleeping after you've taken doxepin (Silenor) for 7 to 10 days. Your sleep problem might be caused by another medical condition. Your care team can also recommend other options for sleep.
Doxepin (Silenor) is approved for insomnia only. There are other forms of doxepin that are available at higher doses and are specifically for treating depression.
Frequently asked questions about Doxepin (Silenor)
How to save using GoodRx
What are the risks and warnings for Doxepin (Silenor)?
Doxepin (Silenor) 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.
Check for other causes of insomnia
Sometimes, insomnia can be caused by other issues, such as depression, stress, or pain. Talk to your prescriber if you're still having trouble sleeping after you've taken doxepin (Silenor) for more than a week. They can evaluate other reasons why you're not getting good sleep.
Behavior changes
Risk factors: Alcohol | Taking other medications that cause sleepiness | Taking higher-than-recommended dose of doxepin (Silenor)
Some people have had instances where they've done activities while they're not fully awake after they've taken a sleep medication, such as doxepin (Silenor). These activities can include driving, cooking, or having sex. Most people don't remember these events when they're fully awake. This is more likely to happen if you're drinking alcohol or taking other medications that can make you sleepy, such as opioids or other sedatives, with .
Talk to your prescriber right away if you or your loved ones notice this side effect happening to you while you're taking doxepin (Silenor).
Worsened depression and risk for suicidal thoughts and behavior
Risk factors: People under 24 years old
When taken at much higher doses, the active ingredient doxepin works to treat depression. Studies show that people with depression who take antidepressants can have worsening mental health, including a higher risk for self-harm or suicide.
Even though doxepin (Silenor) is taken at lower doses for sleep, the likelihood that it can cause worsening depression or suicidal thoughts can't be ruled out. Talk to your prescriber or a healthcare professional right away if you have symptoms of depression or feelings of self-harm or suicide while you're taking doxepin (Silenor).
Sleepiness and tiredness
Risk factors: Alcohol | Taking opioid medications at the same time | Taking medications that cause sleepiness (e.g., antihistamines, opioids
Doxepin (Silenor) can make you sleepy and tired. Only take doxepin (Silenor) when you're ready to go to bed. Don't do any activities that require you to focus, operate machinery, or drive after you take doxepin (Silenor) to prevent accidental injuries.
Don't mix doxepin (Silenor) with alcohol. And avoid taking doxepin (Silenor) with any other medications that can make you sleepy, such as other sleep medications, opioids, and sedatives. Sleepiness can be more intense and make you have an even harder time thinking clearly and focusing.
Doxepin (Silenor) dosage forms
Typical dosing for Doxepin (Silenor)
Adults: The typical dose is 6 mg by mouth daily 30 minutes before bedtime.
Adults 65 years and older: The recommended starting dose is 3 mg by mouth daily 30 minutes before bedtime.
Your prescriber will adjust the dose depending on your needs. The maximum dose is 6 mg by mouth daily.
More on Doxepin (Silenor) dosage forms
How much does Doxepin (Silenor) cost?
Doxepin (Silenor) contraindications
Currently taking or have taken a monoamine oxidase inhibitor (MAOI) within the last 14 days
Can't urinate (urinary retention)
What are alternatives to Doxepin (Silenor)?
What is the latest news about Doxepin (Silenor)?
Doxepin (Silenor) images
Get savings updates for Doxepin (Silenor)
Receive price alerts, news, and other messages from GoodRx about Doxepin (Silenor) and other healthcare topics and relevant savings offers.By providing your email, you consent to receive marketing communications from GoodRx, which may include content and/or data related to men’s health, women's health, reproductive care, or sexual health. You agree to the GoodRx Terms of Use and acknowledge the Privacy Policy. You can unsubscribe at any time.
References
Best studies we foundNational Institute of Diabetes and Digestive and Kidney Disease. (2019). Definition & facts of urinary retention.
North Star Rx LLC. (2024). Doxepin tablet, film coated [package insert]. DailyMed.
Thakkar M. M. (2011). Histamine in the regulation of wakefulness. Sleep Medicine Reviews.
Compare other Insomnia drugs
Browse medications
View AllResearch prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.