adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transdermalSerious - Use Alternative (1)fentanyl transdermal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.fentanyl transmucosalSerious - Use Alternative (1)fentanyl transmucosal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.flibanserinMonitor Closely (1)doxylamine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.fluphenazineMonitor Closely (1)doxylamine and fluphenazine both increase sedation. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam and doxylamine both increase sedation. Use Caution/Monitor.gabapentinMonitor Closely (1)gabapentin, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.gabapentin enacarbilMonitor Closely (1)gabapentin enacarbil, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.ganaxoloneMonitor Closely (1)doxylamine and ganaxolone both increase sedation. Use Caution/Monitor.gotu kolaMonitor Closely (1)gotu kola increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.haloperidolMonitor Closely (1)doxylamine and haloperidol both increase sedation. Use Caution/Monitor.hawthornMonitor Closely (1)hawthorn increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.hopsMonitor Closely (1)hops increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.hyaluronidaseMonitor Closely (1)doxylamine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect. .hydrocodoneSerious - Use Alternative (1)hydrocodone, doxylamine. Either increases toxicity 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.hydromorphoneMonitor Closely (1)doxylamine and hydromorphone both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and doxylamine both increase sedation. Use Caution/Monitor.iloperidoneMonitor Closely (1)doxylamine and iloperidone both increase sedation. Use Caution/Monitor.imipramineMonitor Closely (1)doxylamine and imipramine both increase sedation. Use Caution/Monitor.isocarboxazidSerious - Use Alternative (1)isocarboxazid increases effects of doxylamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .kavaMonitor Closely (1)kava increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.ketamineMonitor Closely (1)ketamine and doxylamine both increase sedation. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)doxylamine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lasmiditanMonitor Closely (1)lasmiditan, doxylamine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lemborexantSerious - Use Alternative (1)lemborexant, doxylamine. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.levorphanolMonitor Closely (1)doxylamine and levorphanol both increase sedation. Use Caution/Monitor.lofepramineMonitor Closely (1)doxylamine and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)doxylamine and lofexidine both increase sedation. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam and doxylamine both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam and doxylamine both increase sedation. Use Caution/Monitor.lormetazepamMonitor Closely (1)lormetazepam and doxylamine both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)doxylamine and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)doxylamine and loxapine inhaled both increase sedation. Use Caution/Monitor.lurasidoneMonitor Closely (1)lurasidone, doxylamine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (1)doxylamine and maprotiline both increase sedation. Use Caution/Monitor.marijuanaMonitor Closely (1)doxylamine and marijuana both increase sedation. Use Caution/Monitor.melatoninMonitor Closely (1)doxylamine and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)doxylamine and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)doxylamine and meprobamate both increase sedation. Use Caution/Monitor.metaxaloneMonitor Closely (1)doxylamine and metaxalone both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (1)doxylamine and methadone both increase sedation. Use Caution/Monitor.methocarbamolMonitor Closely (1)doxylamine and methocarbamol both increase sedation. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and doxylamine both increase serotonin levels. Avoid or Use Alternate Drug. If drug combination must be administered, monitor for evidence of serotonergic or opioid-related toxicitiesmethylenedioxymethamphetamineMonitor Closely (1)doxylamine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metoclopramide intranasalSerious - Use Alternative (1)doxylamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.midazolamMonitor Closely (1)midazolam and doxylamine both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.mirtazapineMonitor Closely (1)doxylamine and mirtazapine both increase sedation. Use Caution/Monitor.morphineMonitor Closely (1)doxylamine and morphine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)doxylamine and motherwort both increase sedation. Use Caution/Monitor.moxonidineMonitor Closely (1)doxylamine and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)doxylamine and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)doxylamine and nalbuphine both increase sedation. Use Caution/Monitor.nettleMinor (1)nettle increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.nortriptylineMonitor Closely (1)doxylamine and nortriptyline both increase sedation. Use Caution/Monitor.olanzapineMonitor Closely (1)doxylamine and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (1)oliceridine, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. 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.olopatadine intranasalSerious - Use Alternative (1)doxylamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. opium tinctureMonitor Closely (1)doxylamine and opium tincture both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)doxylamine and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam and doxylamine both increase sedation. Use Caution/Monitor.oxycodoneMonitor Closely (1)doxylamine and oxycodone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)doxylamine and oxymorphone both increase sedation. Use Caution/Monitor.paliperidoneMonitor Closely (1)doxylamine and paliperidone both increase sedation. Use Caution/Monitor.papaveretumMonitor Closely (1)doxylamine and papaveretum both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)doxylamine and papaverine both increase sedation. Use Caution/Monitor.passion flowerMonitor Closely (1)passion flower increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.pentazocineMonitor Closely (1)doxylamine and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and doxylamine both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)doxylamine and perphenazine both increase sedation. Use Caution/Monitor.phenelzineMonitor Closely (1)phenelzine increases effects of doxylamine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .phenobarbitalMonitor Closely (1)phenobarbital and doxylamine both increase sedation. Use Caution/Monitor.phenylephrine POMonitor Closely (1)doxylamine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodineMonitor Closely (1)doxylamine and pholcodine both increase sedation. Use Caution/Monitor.pimozideMonitor Closely (1)doxylamine and pimozide both increase sedation. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primidoneMonitor Closely (1)primidone and doxylamine both increase sedation. Use Caution/Monitor.prochlorperazineMonitor Closely (1)doxylamine and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and doxylamine both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)propofol and doxylamine both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (1)doxylamine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)doxylamine and protriptyline both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam and doxylamine both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (1)doxylamine and quetiapine both increase sedation. Use Caution/Monitor.ramelteonMonitor Closely (1)doxylamine and ramelteon both increase sedation. Use Caution/Monitor.remimazolamMonitor Closely (1)remimazolam, doxylamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.risperidoneMonitor Closely (1)doxylamine and risperidone both increase sedation. Use Caution/Monitor.sageMinor (1)doxylamine and sage both increase sedation. Minor/Significance Unknown.scullcapMonitor Closely (1)doxylamine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and doxylamine both increase sedation. Use Caution/Monitor.selinexorSerious - Use Alternative (1)selinexor, doxylamine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.sevofluraneMonitor Closely (1)sevoflurane and doxylamine both increase sedation. Use Caution/Monitor.shepherd's purseMonitor Closely (1)doxylamine and shepherd's purse both increase sedation. Use Caution/Monitor.Siberian ginsengMinor (1)Siberian ginseng increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.sodium oxybateSerious - Use Alternative (1)doxylamine, sodium oxybate. 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.stiripentolMonitor Closely (1)stiripentol, doxylamine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.sufentanilMonitor Closely (1)doxylamine and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. 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.tapentadolMonitor Closely (1)doxylamine and tapentadol both increase sedation. Use Caution/Monitor.temazepamMonitor Closely (1)temazepam and doxylamine both increase sedation. Use Caution/Monitor.thioridazineMonitor Closely (1)doxylamine and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneMonitor Closely (1)doxylamine and thiothixene both increase sedation. Use Caution/Monitor.topiramateMonitor Closely (1)doxylamine and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)doxylamine and tramadol both increase sedation. Use Caution/Monitor.tranylcypromineSerious - Use Alternative (1)tranylcypromine increases effects of doxylamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .trazodoneMonitor Closely (1)doxylamine and trazodone both increase sedation. Use Caution/Monitor.triazolamMonitor Closely (1)triazolam and doxylamine both increase sedation. Use Caution/Monitor.triclofosMonitor Closely (1)doxylamine and triclofos both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)doxylamine and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)doxylamine and trimipramine both increase sedation. Use Caution/Monitor.triprolidineMonitor Closely (1)triprolidine and doxylamine both increase sedation. Use Caution/Monitor.valerianMonitor Closely (1)valerian increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.Serious - Use Alternative (1)valerian and doxylamine both increase sedation. Avoid or Use Alternate Drug.xylometazolineMonitor Closely (1)doxylamine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideMonitor Closely (1)doxylamine and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)doxylamine and ziprasidone both increase sedation. Use Caution/Monitor.zotepineMonitor Closely (1)doxylamine and zotepine both increase sedation. Use Caution/Monitor. Frequency Not Defined Tachycardia Dysuria Urinary retention Palpitations Constipation Diarrhea Epigastric pain Xerostomia Anorexia Dizziness Drowsiness Blurred vision Vertigo Paradoxical CNS stimulation Disorientation Diplopia Contraindications Hypersensitivity Children <12 years Coadministration with any other product containing doxylamine Cautions May cause CNS depression, which may impair physical and mental activities Not to exceed 2 weeks of use Caution in