Doxepin (Zonalon) is a prescription cream used to relieve itching in adults with skin conditions like eczema or lichen simplex chronicus, a condition that causes thick, dry, patchy skin from repeated scratching or rubbing. You apply this medication 4 times a day on affected areas for up to 8 days. Common side effects include burning or stinging on the skin. If you apply it to a large area of your body, you might also feel drowsy. doxepin (Zonalon) is available as both a brand-name and generic medication.
Itching in adults with eczema or lichen simplex chronicus
Doxepin (Zonalon) is a tricyclic antidepressant used to treat itchy skin. The exact way it works to relieve itching isn't known, but it's thought to block a chemical in your body called histamine, which normally causes itching. By blocking histamine, doxepin (Zonalon) reduces itching with certain skin conditions.
Source: DailyMed
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 as soon as possible if any of the following side effects occur:
More common
Burning, crawling, or tingling sensation of the skin
swelling at the site of application
Rare
Symptoms of overdose
Abdominal pain and swelling
blurring of vision
convulsions (seizures)
decreased awareness or responsiveness
difficulty in breathing
difficulty in passing urine
dizziness, fainting, or lightheadedness
drowsiness
enlarged pupils
excessive dryness of mouth
extremely high fever or body temperature
extremely low body temperature
fast heartbeat
increased or excessive unconscious or jerking movements
incurable constipation
irregular heartbeat
unconsciousness
vomiting
weak pulse
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
Burning and/or stinging at the site of application
changes in taste
dizziness
drowsiness
dryness and tightness of skin
dryness of mouth and/or lips
emotional changes
headache
thirst
unusual tiredness or weakness
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.
Only for short-term use, up to 8 days
Needs to be applied 4 times a day
Commonly causes drowsiness
Tell your prescriber about all the medications you're taking before starting doxepin (Zonalon). Include prescription medications, over-the-counter (OTC) medications, vitamins, and supplements to make sure they don’t interact.
Wash your hands before and after using doxepin (Zonalon). Keep it away from your eyes to prevent irritation.
Avoid using occlusive bandages (air-tight or water-tight bandages) over the areas where you applied doxepin (Zonalon). Bandaging can cause your body to absorb too much medication, putting you at higher risk of side effects like drowsiness or skin irritation.
Avoid drinking alcohol while taking doxepin (Zonalon). Combining these can cause dizziness, falls, or serious injuries. Wait to drive or do activities that require alertness until you know how this medication affects you.
Doxepin (Zonalon) commonly causes drowsiness. Your risk is higher if you're applying the cream to larger areas of your body (more than 10%). If this happens, speak to your prescriber, they might recommend using it less often or even applying a smaller amount.
If you're still experiencing itchiness after 8 days of using doxepin (Zonalon), let your prescriber know. Using it longer can increase your risk of side effects like allergic reactions or drowsiness.
Doxepin (Zonalon) 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.
Risk factors: Alcohol use | Applying doxepin (Zonalon) to a larger area of the body | Taking other medications that make you sleepy or less alert | Using doxepin (Zonalon) for more than 8 days | Using air- and water-tight bandages on top
Doxepin (Zonalon) can cause drowsiness and weaken your ability to focus, think, and react. If you're an older adult, you might also be at greater risk of falling due to these effects. Using it along with alcohol, antihistamines, or other medications that make you sleepy can make you even more drowsy. Your risk is higher if you apply doxepin (Zonalon) to more than 10% of your body, cover the area with occlusive bandages, or use it longer than 8 days, since your body can absorb too much of the medication. Avoid activities that require focus, like driving or using machinery, until you know how the medication affects you. If you feel very drowsy, let your prescriber know. They might suggest using doxepin (Zonalon) less often, applying less of it, or treating a smaller area of your body. In some cases, you might need to stop using it altogether.
Risk factors: Using doxepin (Zonalon) for more than 8 days
Doxepin (Zonalon) can cause contact sensitization, which is when your body begins to develop an allergic reaction to a substance. Using the cream for more than 8 days raises your risk of this happening. Contact your prescriber if you notice a rash, redness, or swelling where you apply doxepin (Zonalon).
Doxepin (Zonalon) can interact with certain medications, which might raise your risk for side effects. For example, taking cimetidine with doxepin (Zonalon) could cause serious anticholinergic side effects like dry mouth, trouble urinating, and blurred vision. You should also stop taking monoamine oxidase inhibitors (MAOIs) at least 2 weeks before starting doxepin (Zonalon) to reduce your risk of serotonin syndrome. Always tell your prescriber about all medications, including supplements and vitamins, you’re taking.
Apply a thin layer to the affected areas 4 times a day, leaving 3 to 4 hours between each application, for up to 8 days.
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.
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.
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.
Trouble passing urine
Untreated narrow angle glaucoma
Itching in adults with eczema or lichen simplex chronicus
Skin inflammation
Skin rashes
Eczema
Psoriasis
Insect bites
Poison ivy or oak
Skin allergies
Dry scalp
Genital or rectal irritation
Minor burns
Sunburns
Minor cuts
Scrapes
Insect bites
Minor skin irritations
Joint and muscle pain
Hemorrhoids and other irritations in the anal area
Tattoos, piercings, microblading, and other skin procedures
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Amneal Pharmaceuticals NY LLC. (2023). Doxepin Hydrochloride cream [package insert]. DailyMed.
Breneman, D., et al. (1997). Doxepin cream relieves eczema-associated pruritus within 15 minutes and is not accompanied by a risk of rebound upon discontinuation. Journal of Dermatological Treatment.
Charifa, A., et al. (2023). Lichen simplex chronicus. StatPearls.
Drugs and Lactation Database (LactMed®). (2024). Doxepin. National Institute of Child Health and Human Development.
Esser, P. R., et al. (2017). Pathomechanisms of contact sensitization. Current Allergy and Asthma Reports.
Fukasawa, T., et al. (2022). Pharmacotherapy of itch-antihistamines and histamine receptors as G protein-coupled receptors. International Journal of Molecular Sciences.
MedlinePlus. (2017). Histamine: The stuff allergies are made of.
Rheinecker, S. B. (1995). Wound management: The occlusive dressing. Journal of Athletic Training.
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