Use Caution/Monitor.belladonna and opiumMonitor Closely (2)belladonna and opium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. belladonna and opium and doxepin both increase sedation. Use Caution/Monitor.benperidolMonitor Closely (1)benperidol and doxepin both increase sedation. Use Caution/Monitor.benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/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.Serious - Use Alternative (1)benzhydrocodone/acetaminophen and doxepin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebenzphetamineMonitor Closely (1)doxepin increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, benzphetamine. 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.benztropineMonitor Closely (1)benztropine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.bethanecholMonitor Closely (1)bethanechol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.brexpiprazoleMonitor Closely (1)brexpiprazole and doxepin both increase sedation. Use Caution/Monitor.brimonidineMonitor Closely (1)brimonidine and doxepin both increase sedation. Use Caution/Monitor.Minor (1)doxepin decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.brivaracetamMonitor Closely (1)brivaracetam and doxepin both increase sedation. Use Caution/Monitor.brompheniramineMonitor Closely (1)brompheniramine and doxepin both increase sedation. Use Caution/Monitor.buprenorphineMonitor Closely (1)buprenorphine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)doxepin and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine buccalMonitor Closely (1)buprenorphine buccal and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and doxepin both increase QTc interval. Avoid or Use Alternate Drug.buprenorphine subdermal implantMonitor Closely (1)doxepin, 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.Serious - Use Alternative (2)buprenorphine subdermal implant and doxepin both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine subdermal implant and doxepin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine transdermalSerious - Use Alternative (2)buprenorphine transdermal and doxepin both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine transdermal and doxepin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebuprenorphine, long-acting injectionMonitor Closely (1)doxepin, 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.Serious - Use Alternative (2)buprenorphine, long-acting injection and doxepin both increase QTc interval. Avoid or Use Alternate Drug. buprenorphine, long-acting injection and doxepin both increase sedation. Avoid or Use Alternate Drug. Limit use to patients for whom alternative treatment options are inadequatebupropionMonitor Closely (2)doxepin increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible. bupropion will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.buspironeSerious - Use Alternative (1)doxepin and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.butabarbitalMonitor Closely (1)butabarbital and doxepin both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, doxepin. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.butalbitalMonitor Closely (1)butalbital and doxepin both increase sedation. Use Caution/Monitor.Minor (1)butalbital, doxepin. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.butorphanolMonitor Closely (1)butorphanol and doxepin both increase sedation. Use Caution/Monitor.caffeineMonitor Closely (1)doxepin increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.calcium/magnesium/potassium/sodium oxybatesSerious - Use Alternative (1)doxepin, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.carbacholMonitor Closely (1)carbachol increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.carbamazepineMinor (1)carbamazepine decreases levels of doxepin by increasing metabolism. Minor/Significance Unknown.carbinoxamineMonitor Closely (1)carbinoxamine and doxepin both increase sedation. Use Caution/Monitor.carisoprodolMonitor Closely (1)carisoprodol and doxepin both increase sedation. Use Caution/Monitor.celecoxibMonitor Closely (1)celecoxib will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cenobamateMonitor Closely (2)cenobamate, doxepin. Either increases effects of the other by sedation. Use Caution/Monitor. cenobamate 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.ceritinibMonitor Closely (1)doxepin and ceritinib both increase QTc interval. Use Caution/Monitor.cevimelineMonitor Closely (1)cevimeline increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.chloral hydrateMonitor Closely (1)chloral hydrate and doxepin both increase sedation. Use Caution/Monitor.chlordiazepoxideMonitor Closely (1)chlordiazepoxide and doxepin both increase sedation. Use Caution/Monitor.chloroquineMonitor Closely (1)chloroquine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)doxepin and chloroquine both increase QTc interval. Avoid or Use Alternate Drug.chlorpheniramineMonitor Closely (1)chlorpheniramine and doxepin both increase sedation. Use Caution/Monitor.chlorpromazineMonitor Closely (1)chlorpromazine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and doxepin both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)doxepin, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. doxepin, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.chlorpropamideMinor (1)doxepin increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.chlorzoxazoneMonitor Closely (1)chlorzoxazone and doxepin both increase sedation. Use Caution/Monitor.cimetidineMonitor Closely (1)cimetidine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.cinnarizineMonitor Closely (1)cinnarizine and doxepin both increase sedation. Use Caution/Monitor.ciprofloxacinMonitor Closely (1)doxepin and ciprofloxacin both increase QTc interval. Use Caution/Monitor.cisatracuriumMonitor Closely (1)cisatracurium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.citalopramSerious - Use Alternative (2)citalopram and doxepin both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended. doxepin and citalopram both increase QTc interval. Avoid or Use Alternate Drug.clarithromycinSerious - Use Alternative (1)doxepin and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.clemastineMonitor Closely (1)clemastine and doxepin both increase sedation. Use Caution/Monitor.clobazamMonitor Closely (2)clobazam 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).clofazimineMonitor Closely (1)doxepin and clofazimine both increase QTc interval. Use Caution/Monitor.clomipramineMonitor Closely (2)clomipramine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. clomipramine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and doxepin both increase QTc interval. Avoid or Use Alternate Drug. clomipramine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.clonazepamMonitor Closely (1)clonazepam and doxepin both increase sedation. Use Caution/Monitor.clonidineSerious - Use Alternative (1)doxepin decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.clorazepateMonitor Closely (1)clorazepate and doxepin both increase sedation. Use Caution/Monitor.clozapineMonitor Closely (2)clozapine and doxepin both increase sedation. Use Caution/Monitor. doxepin and clozapine both increase QTc interval. Use Caution/Monitor.cobicistatMonitor Closely (2)cobicistat 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 response cobicistat 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 topicalMonitor Closely (1)doxepin and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.codeineMonitor Closely (1)codeine and doxepin both increase sedation. Use Caution/Monitor.conjugated estrogensMinor (1)conjugated estrogens, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.conjugated estrogens, vaginalMinor (1)conjugated estrogens, vaginal, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.crizotinibMonitor Closely (1)doxepin and crizotinib both increase QTc interval. Use Caution/Monitor.cyclizineMonitor Closely (2)cyclizine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. cyclizine and doxepin both increase sedation. Use Caution/Monitor.cyclobenzaprineMonitor Closely (2)cyclobenzaprine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. cyclobenzaprine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)doxepin and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.cyproheptadineMonitor Closely (1)cyproheptadine and doxepin both increase sedation. Use Caution/Monitor.dabrafenibMonitor Closely (1)dabrafenib will decrease the level or effect of doxepin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.dacomitinibSerious - Use Alternative (1)dacomitinib will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities. dantroleneMonitor Closely (1)dantrolene and doxepin both increase sedation. Use Caution/Monitor.daridorexantMonitor Closely (1)doxepin 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. darifenacinMonitor Closely (2)darifenacin and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. darifenacin will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.dasatinibMonitor Closely (1)doxepin and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.debrisoquineMonitor Closely (1)doxepin decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.degarelixMonitor Closely (1)degarelix and doxepin both increase QTc interval. Use Caution/Monitor.desfluraneMonitor Closely (2)desflurane and doxepin both increase sedation. Use Caution/Monitor. desflurane and doxepin both increase QTc interval. Use Caution/Monitor.Minor (1)desflurane, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.desipramineMonitor Closely (2)desipramine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor. desipramine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and doxepin both increase QTc interval. Avoid or Use Alternate Drug. desipramine and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.desvenlafaxineMonitor Closely (1)desvenlafaxine 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 mgSerious - Use Alternative (1)doxepin and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.deutetrabenazineMonitor Closely (2)doxepin 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).dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine and doxepin both increase sedation. Use Caution/Monitor.dexfenfluramineMonitor Closely (2)doxepin and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. doxepin increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, dexfenfluramine. 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.dexmedetomidineMonitor Closely (1)dexmedetomidine and doxepin both increase sedation. Use Caution/Monitor.dexmethylphenidateMonitor Closely (1)doxepin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, dexmethylphenidate. 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