Some of the adverse reactions noted below have not been specifically reported with doxepin HCl use. However, due to the close pharmacological similarities among the tricyclics, the reactions should be considered when prescribing doxepin HCl. If they do not subside with continued therapy, or become severe, it may be necessary to reduce the dosage.
Drowsiness is the most commonly noticed side effect.
This tends to disappear as therapy is continued. Other infrequently reported CNS side effects are confusion , disorientation, hallucinations, numbness, paresthesias, ataxia , and extrapyramidal symptoms and seizures. Skin rash , edema , photosensitization, and pruritus have occasionally occurred. Eosinophilia has been reported in a few patients. There have been occasional reports of bone marrow depression manifesting as agranulocytosis , leukopenia , thrombocytopenia , and purpura.