Doset
Generic Name
Doxepin Hydrochloride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| doset 100 mg capsule | ৳ 4.00 | ৳ 40.00 |
Description
Overview of the medicine
Doset 100 mg Capsule contains Doxepin Hydrochloride, a tricyclic antidepressant used to treat depression, anxiety, and insomnia. It works by affecting certain chemicals in the brain that may be out of balance.
Uses & Indications
Dosage
Adults
Initial: 25-50 mg daily, usually at bedtime. Maintenance: 75-150 mg daily, max 300 mg daily in severe cases. For insomnia: 3-6 mg at bedtime.
Elderly
Lower initial doses (e.g., 10-25 mg daily) and slower titration due to increased sensitivity and potential for adverse effects.
Renal_impairment
Use with caution; dose reduction may be necessary. Monitoring for adverse effects is recommended.
How to Take
Take orally, with or without food. For insomnia, take 30 minutes before bedtime. The daily dose can be given as a single dose at bedtime or in divided doses.
Mechanism of Action
Doxepin works by inhibiting the reuptake of norepinephrine and serotonin in the central nervous system, thereby increasing their concentrations in the synaptic cleft. It also has significant antihistaminic (H1 receptor blockade) and anticholinergic effects.
Pharmacokinetics
Onset
Antidepressant effects may take 2-4 weeks; sedative effects within hours.
Excretion
Mainly excreted in urine as metabolites, with a small amount excreted as unchanged drug.
Half life
Doxepin: 8-24 hours; active metabolite (desmethyldoxepin): 28-51 hours.
Absorption
Well absorbed orally, but undergoes significant first-pass metabolism.
Metabolism
Extensively metabolized in the liver, primarily by N-demethylation to desmethyldoxepin, and by hydroxylation and glucuronide conjugation.
Side Effects
Contraindications
- Known hypersensitivity to doxepin or other tricyclic antidepressants
- Glaucoma (especially narrow-angle glaucoma)
- Urinary retention (especially due to prostatic hypertrophy)
- Concurrent use of MAO inhibitors
Drug Interactions
MAO Inhibitors
Concurrent use can lead to hyperpyretic crises, severe convulsions, and death. A 14-day washout period is required.
Anticholinergic drugs
Increased risk of anticholinergic side effects (e.g., dry mouth, blurred vision).
Adrenergic neuron blocking agents (e.g., guanethidine)
May diminish the antihypertensive effect.
CNS Depressants (alcohol, barbiturates, benzodiazepines)
Potentiation of CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include CNS depression (drowsiness, coma), cardiovascular effects (tachycardia, arrhythmias, hypotension), severe anticholinergic effects. Treatment is supportive, including gastric lavage, activated charcoal, and symptomatic management.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Doxepin is excreted in breast milk; advise against breastfeeding.
Side Effects
Contraindications
- Known hypersensitivity to doxepin or other tricyclic antidepressants
- Glaucoma (especially narrow-angle glaucoma)
- Urinary retention (especially due to prostatic hypertrophy)
- Concurrent use of MAO inhibitors
Drug Interactions
MAO Inhibitors
Concurrent use can lead to hyperpyretic crises, severe convulsions, and death. A 14-day washout period is required.
Anticholinergic drugs
Increased risk of anticholinergic side effects (e.g., dry mouth, blurred vision).
Adrenergic neuron blocking agents (e.g., guanethidine)
May diminish the antihypertensive effect.
CNS Depressants (alcohol, barbiturates, benzodiazepines)
Potentiation of CNS depressant effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include CNS depression (drowsiness, coma), cardiovascular effects (tachycardia, arrhythmias, hypotension), severe anticholinergic effects. Treatment is supportive, including gastric lavage, activated charcoal, and symptomatic management.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies potential risk to the fetus. Doxepin is excreted in breast milk; advise against breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved
Patent Status
Generic available
Clinical Trials
Extensive clinical trials have established the efficacy and safety of doxepin for its approved indications. Ongoing research may explore new uses or formulations.
Lab Monitoring
- Baseline and periodic liver function tests
- ECG monitoring (especially in patients with pre-existing cardiac disease or elderly)
- Blood pressure monitoring
Doctor Notes
- Emphasize the delayed onset of antidepressant effect and the importance of continued therapy.
- Counsel patients on potential anticholinergic side effects and how to manage them.
- Monitor for suicidal ideation, especially at the beginning of treatment or during dose adjustments.
Patient Guidelines
- Do not stop taking this medication abruptly without consulting your doctor.
- Avoid alcohol while on this medication.
- Be aware of drowsiness and avoid driving or operating heavy machinery until you know how it affects you.
- Report any suicidal thoughts or worsening depression immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up.
Driving Precautions
This medication can cause drowsiness, dizziness, and blurred vision. Avoid driving or operating machinery until you know how it affects you and are sure it is safe.
Lifestyle Advice
- Maintain a healthy diet and exercise routine.
- Practice good sleep hygiene (consistent sleep schedule, comfortable sleep environment).
- Engage in stress-reducing activities like meditation or yoga.
- Stay hydrated to manage dry mouth.
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Global Brand Names
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