hyperthyroidism, opne angle glaucoma, seizure d/o, brain tumor, respiratory impairment, hyperthyroidism Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (18-24 yo) Risk of anticholinergic side effects Possibility of tardive dyskinesia & NMS Pregnancy Category: C Lactation: enters breast milk; use with cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Neurotransmitter (esp NE & serotonin) reuptake inhibitor; anticholinergic Pharmacokinetics Half-Life: 8-30 hr Peak Plasma Time: 90 min Bioavailability: Almost complete absorption Metabolites: 8-hydroxyamoxapine Vd: 0.9-1.2 L/kg Protein binding: 90% Excretion: Urine (60%); Feces: (18%) BRAND FORM. UNIT PRICE PILL IMAGE amoxapine oral- 150 mg tabletamoxapine oral- 100 mg tabletamoxapine oral- 50 mg tabletamoxapine oral- 25 mg tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationamoxapine oral AMOXAPINE - ORAL (a-MOX-a-peen) COMMON BRAND NAME(S): Asendin WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed. USES: This medication is used to treat depression. Treating depression can improve your mood and sense of well-being and allow you to enjoy everyday life more.Amoxapine is a tricyclic antidepressant. It works by restoring the balance of natural chemicals (neurotransmitters) in the brain. Because amoxapine has some effects that are similar to those of major tranquilizers, it may work better in patients who have agitation or anxiety along with depression. HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking amoxapine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually 1 to 3 times daily. To lessen side effects, amoxapine may be started at a low dose and slowly increased as your body gets used to it. Follow your doctor's instructions carefully. If you are taking this medication once daily, it is usually taken at bedtime to prevent daytime drowsiness. The dosage is based on your medical condition, age, and response to treatment.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day. This medication does not work right away. It may take up to two weeks before you experience the full benefits.Keep taking this medication even if you feel well. Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.Inform your doctor if your condition does not improve or if it worsens. SIDE EFFECTS: See also the Warning section.Drowsiness, dizziness, difficulty urinating, dry mouth, constipation, headache, weakness, blurred vision, or changes in appetite/weight may occur as your body gets used to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute. If any of these effects last or get worse, notify your doctor or pharmacist promptly.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, mental/mood changes (such as confusion, depression, hallucinations, nervousness, restlessness), numbness/tingling of the hands/feet, ringing in the ears, shakiness (tremors), stomach/abdominal pain, severe vomiting/constipation.Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, slow/fast/irregular heartbeat, pain/redness/swelling of arms/legs, seizures, severe headache, weakness on one side of the body, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), trouble speaking.In rare instances, this medication may increase your level of a certain natural chemical made by the body (prolactin). For females, this increase in prolactin may result in unwanted breast milk, missing/stopped periods, or difficulty becoming pregnant. For males, it may result in decreased sexual ability, inability to produce sperm, or enlarged breasts. If you develop any of these symptoms, tell your doctor right away.This drug may rarely cause a condition known as tardive dyskinesia. In some cases, this condition may be permanent. Tell your doctor right away if you develop any unusual/uncontrolled movements (especially of the face, mouth, tongue, arms or legs).Amoxapine may rarely cause a serious condition called neuroleptic malignant syndrome. Get medical help right away if you develop the following: fever, muscle stiffness, increased sweating, fast/irregular heartbeat, severe confusion.This medication may rarely cause serious blood problems (such as agranulocytosis, thrombocytopenia) or liver problems. Get medical help right away if you notice any of the following very serious side effects: easy bleeding/bruising, signs of infection (such as sore throat that doesn't go away, fever), severe stomach/abdominal pain, dark urine, yellowing of the eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: See also the Warning section.Before taking amoxapine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (such as amitriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (such as agranulocytosis, thrombocytopenia), breathing problems (such as asthma, COPD), personal or family history of glaucoma (angle-closure type), intestinal problems (such as chronic constipation, ileus), heart problems (such as recent heart attack, arrhythmias, coronary artery disease, heart failure), kidney problems, liver problems, other mental/mood conditions (such as bipolar disorder, psychosis), family history of mental/mood conditions (such as bipolar disorder) or suicide, history of neuroleptic malignant syndrome, movement disorders (such as Parkinson's disease, tardive dyskinesia), overactive thyroid (hyperthyroidism), problems urinating (urinary retention, enlarged prostate), seizures, conditions that may increase your risk of seizures (such as electroshock therapy, stroke, alcohol withdrawal).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).To minimize the dizziness and lightheadedness, get up slowly when rising from a seated or lying position.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, confusion, constipation, trouble urinating, and involuntary movements (tardive dyskinesia). Drowsiness, dizziness, and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Infants born to mothers who have taken similar medications during pregnancy may have problems such as very deep sleep, trouble urinating, shaking (tremors), and seizures. Discuss the risks and benefits with your doctor.Since untreated mental/mood problems (such as depression, panic disorders, bipolar disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: anticholinergics (such as atropine, belladonna alkaloids), certain drugs for high blood pressure (such as clonidine, guanethidine), drugs for motion sickness (such as meclizine), psychiatric drugs (such as antipsychotics, antidepressants), thyroid supplements.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This medication may interfere with certain medical/lab tests (such as brain scan for Parkinson's disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Overdose of this medication may be fatal and symptoms include: seizures, delirium, and loss of consciousness . NOTES: Do not share this medication with others.Lab and/or medical tests may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details. MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up. STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications