With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.phentermineMonitor Closely (1)doxepin increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, phentermine. 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.phenylephrineMonitor Closely (1)doxepin increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, phenylephrine. 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.phenylephrine ophthalmicMonitor Closely (1)doxepin, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.phenylephrine POMonitor Closely (1)doxepin increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Serious - Use Alternative (1)doxepin, phenylephrine PO. 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.pholcodineMonitor Closely (1)doxepin and pholcodine both increase sedation. Use Caution/Monitor.physostigmineMonitor Closely (1)physostigmine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpineMonitor Closely (1)pilocarpine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimavanserinMonitor Closely (1)doxepin and pimavanserin both increase QTc interval. Use Caution/Monitor.pimozideContraindicated (1)doxepin and pimozide both increase QTc interval. Contraindicated.Monitor Closely (1)pimozide and doxepin both increase sedation. Use Caution/Monitor.pioglitazoneMinor (1)doxepin increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.pirbuterolMonitor Closely (1)doxepin increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, pirbuterol. 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.pitolisantSerious - Use Alternative (2)doxepin decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant. doxepin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.pleurisy rootMinor (1)pleurisy root decreases effects of doxepin by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.ponesimodSerious - Use Alternative (1)doxepin and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleMonitor Closely (1)doxepin and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.pralidoximeMonitor Closely (1)pralidoxime and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.pregabalinMonitor Closely (1)pregabalin, doxepin. 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.primaquineSerious - Use Alternative (1)doxepin and primaquine both increase QTc interval. Avoid or Use Alternate Drug.primidoneMonitor Closely (1)primidone and doxepin both increase sedation. Use Caution/Monitor.Minor (1)primidone, 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.procainamideContraindicated (1)doxepin and procainamide both increase QTc interval. Contraindicated.procarbazineContraindicated (1)procarbazine and doxepin both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.prochlorperazineMonitor Closely (2)prochlorperazine and doxepin both increase QTc interval. Use Caution/Monitor. prochlorperazine and doxepin both increase sedation. Use Caution/Monitor.Minor (2)doxepin, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. doxepin, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.progesterone micronizedMinor (1)progesterone micronized, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.promazineSerious - Use Alternative (1)promazine and doxepin both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)doxepin, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. doxepin, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.promethazineMonitor Closely (2)promethazine and doxepin both increase QTc interval. Use Caution/Monitor. promethazine and doxepin both increase sedation. Use Caution/Monitor.Minor (2)doxepin, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects. doxepin, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.propafenoneMonitor Closely (2)propafenone will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. doxepin and propafenone both increase QTc interval. Use Caution/Monitor.propanthelineMonitor Closely (1)propantheline and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.propofolMonitor Closely (1)propofol and doxepin both increase sedation. Use Caution/Monitor.Minor (1)propofol, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.propylhexedrineMonitor Closely (1)doxepin increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, propylhexedrine. 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.protriptylineMonitor Closely (2)doxepin and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor. doxepin and protriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)doxepin and protriptyline both increase QTc interval. Avoid or Use Alternate Drug. doxepin and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.pseudoephedrineSerious - Use Alternative (1)doxepin increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.pyridostigmineMonitor Closely (1)pyridostigmine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam and doxepin both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (2)quetiapine and doxepin both increase sedation. Use Caution/Monitor. doxepin and quetiapine both increase QTc interval. Use Caution/Monitor.quinacrineMinor (1)quinacrine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.quinidineContraindicated (1)quinidine and doxepin both increase QTc interval. Contraindicated.Serious - Use Alternative (1)quinidine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Both agents increase QTc interval.quinineSerious - Use Alternative (1)doxepin and quinine both increase QTc interval. Avoid or Use Alternate Drug.ramelteonMonitor Closely (2)doxepin and ramelteon both increase sedation. Use Caution/Monitor. doxepin will increase the level or effect of ramelteon by unspecified interaction mechanism. Use Caution/Monitor. AUC and Cmax increased by 66% and 69% respectively.ranolazineMonitor Closely (1)doxepin and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)ranolazine will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rapacuroniumMonitor Closely (1)rapacuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.rasagilineSerious - Use Alternative (1)rasagiline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.remifentanilMonitor Closely (1)doxepin, remifentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May also increase risk of serotonin syndrome.remimazolamMonitor Closely (1)remimazolam, doxepin. 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.repaglinideMinor (1)doxepin increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.ribociclibSerious - Use Alternative (2)ribociclib will increase the level or effect of doxepin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. doxepin and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.rifabutinMonitor Closely (1)rifabutin decreases levels of doxepin by increasing metabolism. Use Caution/Monitor.rilpivirineMonitor Closely (1)doxepin and rilpivirine both increase QTc interval. Use Caution/Monitor.risperidoneMonitor Closely (2)doxepin and risperidone both increase QTc interval. Modify Therapy/Monitor Closely. risperidone and doxepin both increase sedation. Use Caution/Monitor.ritonavirMonitor Closely (1)ritonavir will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.rivastigmineMonitor Closely (1)rivastigmine increases and doxepin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.rizatriptanMonitor Closely (1)rizatriptan and doxepin both increase serotonin levels. Modify Therapy/Monitor Closely.rocuroniumMonitor Closely (1)rocuronium and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.rolapitantMonitor Closely (1)rolapitant will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsinMonitor Closely (1)doxepin and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.rosiglitazoneMinor (1)doxepin increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.safinamideContraindicated (1)doxepin, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.sageMinor (1)doxepin and sage both increase sedation. Minor/Significance Unknown.salmeterolMonitor Closely (2)doxepin and salmeterol both increase QTc interval. Use Caution/Monitor. doxepin increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, salmeterol. 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.SAMeMonitor Closely (1)doxepin and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirMonitor Closely (1)doxepin and saquinavir both increase QTc interval. Use Caution/Monitor.saxagliptinMinor (1)doxepin increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.scopolamineMonitor Closely (1)scopolamine and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.scullcapMonitor Closely (1)doxepin and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and doxepin both increase sedation. Use Caution/Monitor.Minor (1)secobarbital, 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.selegilineContraindicated (1)selegiline and doxepin both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicatedselegiline transdermalSerious - Use Alternative (1)selegiline transdermal and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.selinexorSerious - Use Alternative (1)selinexor, doxepin. 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.selpercatinibMonitor Closely (1)doxepin and selpercatinib both increase QTc interval. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidateSerious - Use Alternative (1)doxepin, serdexmethylphenidate/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 of indirect sympathomimetics into the adrenergic neuron.Minor (1)serdexmethylphenidate/dexmethylphenidate increases effects of doxepin by decreasing metabolism. Minor/Significance Unknown.sertralineSerious - Use Alternative (2)sertraline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug. doxepin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)sertraline will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.sevofluraneMonitor Closely (2)doxepin and sevoflurane both increase QTc interval. Use Caution/Monitor. sevoflurane and doxepin both increase sedation. Use Caution/Monitor.Minor (1)sevoflurane, doxepin. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.shepherd's purseMonitor Closely (1)doxepin and shepherd's purse both increase sedation. Use Caution/Monitor.siponimodMonitor Closely (1)doxepin and siponimod both increase QTc interval. Use Caution/Monitor.sitagliptinMinor (1)doxepin increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.sodium oxybateSerious - Use Alternative (1)doxepin, 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.sodium sulfate/?magnesium sulfate/potassium chlorideMonitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases effects of doxepin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycolMonitor Closely (1)doxepin, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.sodium sulfate/potassium sulfate/magnesium sulfateMonitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases effects of doxepin by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.solifenacinMonitor Closely (2)solifenacin and doxepin both