Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .vortioxetinedoxepin, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.xylometazolinedoxepin, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.yohimbeyohimbe, doxepin. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.yohimbinedoxepin, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.ziprasidonedoxepin and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.Monitor Closely (382)5-HTPdoxepin and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.abirateroneabiraterone increases levels of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.abobotulinumtoxinAabobotulinumtoxinA increases effects of doxepin by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .aclidiniumaclidinium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.acrivastineacrivastine and doxepin both increase sedation. Use Caution/Monitor.albuteroldoxepin increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxepin and albuterol both increase QTc interval. Use Caution/Monitor.alfentanilalfentanil and doxepin both increase sedation. Use Caution/Monitor.alfuzosindoxepin and alfuzosin both increase QTc interval. Use Caution/Monitor.almotriptanalmotriptan and doxepin both increase serotonin levels. Modify Therapy/Monitor Closely.alprazolamalprazolam and doxepin both increase sedation. Use Caution/Monitor.amifampridinedoxepin increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.amiodaroneamiodarone will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.amisulpridedoxepin and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.amitriptylineamitriptyline and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.amitriptyline and doxepin both increase sedation. Use Caution/Monitor.amobarbitalamobarbital and doxepin both increase sedation. Use Caution/Monitor.amoxapineamoxapine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.amoxapine and doxepin both increase sedation. Use Caution/Monitor.anagrelidedoxepin and anagrelide both increase QTc interval. Use Caution/Monitor.anticholinergic/sedative combosanticholinergic/sedative combos and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.apomorphinedoxepin and apomorphine both increase sedation. Use Caution/Monitor.doxepin and apomorphine both increase QTc interval. Use Caution/Monitor.arformoteroldoxepin increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxepin and arformoterol both increase QTc interval. Use Caution/Monitor.aripiprazolearipiprazole and doxepin both increase sedation. Use Caution/Monitor.doxepin and aripiprazole both increase QTc interval. Use Caution/Monitor.armodafinildoxepin increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.asenapineasenapine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.doxepin and asenapine both increase QTc interval. Use Caution/Monitor.asenapine and doxepin both increase sedation. Use Caution/Monitor.asenapine transdermalasenapine transdermal and doxepin both increase QTc interval. Use Caution/Monitor.asenapine transdermal and doxepin both increase sedation. Use Caution/Monitor.atazanaviratazanavir increases levels of doxepin by unspecified interaction mechanism. Use Caution/Monitor.atomoxetinedoxepin and atomoxetine both increase QTc interval. Use Caution/Monitor.atracuriumatracurium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.atropineatropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.atropine IV/IMatropine IV/IM and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.avapritinibavapritinib and doxepin both increase sedation. Use Caution/Monitor.azelastineazelastine and doxepin both increase sedation. Use Caution/Monitor.azithromycindoxepin and azithromycin both increase QTc interval. Use Caution/Monitor.baclofenbaclofen and doxepin both increase sedation. Use Caution/Monitor.bedaquilinedoxepin and bedaquiline both increase QTc interval. Use Caution/Monitor.belladonna alkaloidsbelladonna alkaloids and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opiumbelladonna and opium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.belladonna and opium and doxepin both increase sedation. Use Caution/Monitor.benperidolbenperidol and doxepin both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, doxepin. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.benzphetaminedoxepin increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.benztropinebenztropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.bethanecholbethanechol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.brexpiprazolebrexpiprazole and doxepin both increase sedation. Use Caution/Monitor.brimonidinebrimonidine and doxepin both increase sedation. Use Caution/Monitor.brivaracetambrivaracetam and doxepin both increase sedation. Use Caution/Monitor.brompheniraminebrompheniramine and doxepin both increase sedation. Use Caution/Monitor.buprenorphinebuprenorphine and doxepin both increase sedation. Use Caution/Monitor.buprenorphine buccalbuprenorphine buccal and doxepin both increase sedation. Use Caution/Monitor.buprenorphine subdermal implantdoxepin, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.buprenorphine, long-acting injectiondoxepin, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.bupropionbupropion will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.doxepin increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.butabarbitalbutabarbital and doxepin both increase sedation. Use Caution/Monitor.butalbitalbutalbital and doxepin both increase sedation. Use Caution/Monitor.butorphanolbutorphanol and doxepin both increase sedation. Use Caution/Monitor.caffeinedoxepin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbacholcarbachol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbinoxaminecarbinoxamine and doxepin both increase sedation. Use Caution/Monitor.carisoprodolcarisoprodol and doxepin both increase sedation. Use Caution/Monitor.celecoxibcelecoxib will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cenobamatecenobamate will decrease the level or effect of doxepin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.cenobamate, doxepin. Either increases effects of the other by sedation. Use Caution/Monitor.ceritinibdoxepin and ceritinib both increase QTc interval. Use Caution/Monitor.cevimelinecevimeline increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydratechloral hydrate and doxepin both increase sedation. Use Caution/Monitor.chlordiazepoxidechlordiazepoxide and doxepin both increase sedation. Use Caution/Monitor.chloroquinechloroquine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.chlorpheniraminechlorpheniramine and doxepin both increase sedation. Use Caution/Monitor.chlorpromazinechlorpromazine and doxepin both increase sedation. Use Caution/Monitor.chlorzoxazonechlorzoxazone and doxepin both increase sedation. Use Caution/Monitor.cimetidinecimetidine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cinnarizinecinnarizine and doxepin both increase sedation. Use Caution/Monitor.ciprofloxacindoxepin and ciprofloxacin both increase QTc interval. Use Caution/Monitor.cisatracuriumcisatracurium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.clemastineclemastine and doxepin both increase sedation. Use Caution/Monitor.clobazamclobazam will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly. doxepin, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).clofaziminedoxepin and clofazimine both increase QTc interval. Use Caution/Monitor.clomipramineclomipramine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.clomipramine and doxepin both increase sedation. Use Caution/Monitor.clonazepamclonazepam and doxepin both increase sedation. Use Caution/Monitor.clorazepateclorazepate and doxepin both increase sedation. Use Caution/Monitor.clozapineclozapine and doxepin both increase sedation. Use Caution/Monitor.doxepin and clozapine both increase QTc interval. Use Caution/Monitor.cobicistatcobicistat will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant responsecobicistat will increase the level or effect of doxepin by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat. cocaine topicaldoxepin and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeinecodeine and doxepin both increase sedation. Use Caution/Monitor.crizotinibdoxepin and crizotinib both increase QTc interval. Use Caution/Monitor.cyclizinecyclizine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.cyclizine and doxepin both increase sedation. Use Caution/Monitor.cyclobenzaprinecyclobenzaprine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.cyclobenzaprine and doxepin both increase sedation. Use Caution/Monitor.cyproheptadinecyproheptadine and doxepin both increase sedation. Use Caution/Monitor.dabrafenibdabrafenib will decrease the level or effect of doxepin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dantrolenedantrolene and doxepin both increase sedation. Use Caution/Monitor.daridorexantdoxepin and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. darifenacindarifenacin will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.darifenacin and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.dasatinibdoxepin and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.debrisoquinedoxepin decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.degarelixdegarelix and doxepin both increase QTc interval. Use Caution/Monitor.desfluranedesflurane and doxepin both increase sedation. Use Caution/Monitor.desflurane and doxepin both increase QTc interval. Use Caution/Monitor.desipraminedesipramine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.desipramine and doxepin both increase sedation. Use Caution/Monitor.desvenlafaxinedesvenlafaxine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mgdeutetrabenazinedoxepin and deutetrabenazine both increase sedation. Use Caution/Monitor.deutetrabenazine and doxepin both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).dexchlorpheniraminedexchlorpheniramine and doxepin both increase sedation. Use Caution/Monitor.dexfenfluraminedoxepin increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxepin and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.dexmedetomidinedexmedetomidine and doxepin both increase sedation. Use Caution/Monitor.dexmethylphenidatedoxepin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetaminedoxepin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxepin and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.doxepin increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.dextroamphetamine transdermaldoxepin will increase the level or effect of dextroamphetamine transdermal by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in dextroamphetamine levels in brain; May be potentiate cardiovascular effects. Monitor frequently and adjust or use an alternant based on clinical response.dextromoramidedextromoramide and doxepin both increase sedation. Use Caution/Monitor.diamorphinediamorphine and doxepin both increase sedation. Use Caution/Monitor.diazepamdiazepam and doxepin both increase sedation. Use Caution/Monitor.diazepam intranasaldiazepam intranasal, doxepin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.dichlorphenamidedichlorphenamide and doxepin both decrease serum potassium. Use Caution/Monitor.dicyclominedicyclomine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.diethylpropiondoxepin increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.difelikefalindifelikefalin and doxepin both increase sedation. Use Caution/Monitor.difenoxin hcldifenoxin hcl and doxepin both increase sedation. Use Caution/Monitor.dihydroergotaminedoxepin and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.dihydroergotamine intranasaldoxepin and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.dimenhydrinatedimenhydrinate and doxepin both increase sedation. Use Caution/Monitor.diphenhydraminediphenhydramine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.diphenhydramine and doxepin both increase sedation. Use Caution/Monitor.diphenoxylate hcldiphenoxylate hcl and doxepin both increase sedation. Use Caution/Monitor.dipipanonedipipanone and doxepin both increase sedation. Use Caution/Monitor.dobutaminedoxepin increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dolasetrondoxepin and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.donepezildonepezil increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.donepezil and doxepin both increase QTc interval. Use Caution/Monitor.dopaminedoxepin increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dopexaminedoxepin increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.doxylaminedoxylamine and doxepin both increase sedation. Use Caution/Monitor.droperidoldroperidol and doxepin both increase sedation. Use Caution/Monitor.echothiophate iodideechothiophate iodide increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.efavirenzefavirenz and doxepin both increase QTc interval. Use