Doxepin Topical (patient information)

# Why this medication is prescribed
Doxepin topical is used to relieve itching of the skin caused by eczema. Doxepin is in a class of medications called topical antipruritics. It may work by blocking histamine, a substance in the body that causes certain symptoms, such as itching.

# How this medication should be used
Doxepin comes as a cream to apply to the skin. It is usually applied four times a day, at least 3 to 4 hours apart, for up to 8 days. Use doxepin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use doxepin topical exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
To use the cream, follow these steps:
- Wash the affected skin with water and a mild soap or soapless cleansing lotion and pat dry with a soft towel.
- Apply a thin layer of cream to the affected skin. Gently and thoroughly massage it into the skin. Be careful not to get the medication in your eyes or mouth. If you do get doxepin in your eyes, wash with plenty of water and call your doctor if your eyes are irritated.
- Do not cover the affected area with any bandages, dressings, or wrappings.
- Wash your hands with soap and water after you finish handling the medication.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# Special precautions
Before using doxepin cream:
- tell your doctor and pharmacist if you are allergic to doxepin (Adapin, Sinequan) or any other medications.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants (mood elevators); antihistamines; carbamazepine (Tegretol); cimetidine (Tagamet); medications for irregular heart beat, including encainide (Enkaid), flecainide (Tambocor), propafenone (Rythmol), and quinidine (Quinaglute, Quinidex); and medications for mental illness and nausea. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past 2 weeks: monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), and tranylcypromine (Parnate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had glaucoma, benign prostatic hypertrophy (enlargement of the prostate), or urinary retention (inability to empty your bladder completely or at all).
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using doxepin, call your doctor. You should not use doxepin if you are breast-feeding.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are using doxepin.
- you should know that doxepin may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If you become very drowsy from doxepin, talk to your doctor.
- remember that alcohol can add to the drowsiness caused by this medication.

# Special dietary instructions
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply extra cream to make up for a missed dose.

# Side effects
Doxepin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- drowsiness
- dry mouth
- dry lips
- thirst
- headache
- extreme tiredness
- dizziness
- mood changes
- taste changes
- burning or stinging at affected area
- worsened itching
- dryness and tightness of skin at affected area
- tingling of the fingers or toes
- swelling of the affected area
Doxepin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- drowsiness
- unconsciousness
- blurred vision
- very dry mouth
- difficulty breathing
- dizziness
- fainting
- seizures
- change in body temperature
- fast or irregular heart beat
- urinary retention
- enlarged pupils (dark part of eye)

# Other information
Keep all appointments with your doctor.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Zonalon
- Prudoxin