Indications  

Sinequan is a prescribed medication indicated for alleviating symptoms of depression and/or anxiety linked to alcoholism, psychiatric disorders, or bipolar conditions. 

As a tricyclic antidepressant, Sinequan works by modulating the levels of certain neurotransmitters in the brain. This mechanism of action can potentially enhance mood, alleviate anxiety and tension, improve sleep quality, and increase energy levels. 

Uses and Dosage 

Before taking Sinequan and with each prescription refill, carefully review its medication guide and patient information leaflet. Should you have any questions, seek the guidance of your doctor or pharmacist. 

The dosage of Sinequan is determined based on the patient’s medical condition and response to the treatment. 

Typically, this medication is taken one to three times a day as prescribed by the doctor without regard to food intake. For once-a-day regimen, taking it before bedtime is recommended to minimize drowsiness during the day. 

To minimize the chances of experiencing side effects like drowsiness, dry mouth, and dizziness, your doctor may advise you to initiate Sinequan with a small dosage and gradually raise it.  

For optimal results, take this medication exactly as directed around the same times daily. Avoid exceeding the prescribed dosage or frequency of intake, as doing so will not expedite improvement and may elevate the likelihood of adverse effects. 

Keep taking Sinequan even if you are feeling better. Consult with your doctor before discontinuing treatment, as they may recommend a gradual reduction in dosage. 

Side Effects 

Listed below are the potential adverse effects of Sinequan. Inform your physician promptly if any of them persist or deteriorate. 

Common Side Effects 

• Dizziness, drowsiness, fatigue, or weakness 
• Constipation, diarrhea, abdominal pain, upset stomach, vomiting, reduced appetite 
• Dry mouth 
• Altered taste sensation 
• Mouth irritation or sores 
• Weight gain 
• Excessive sweating 
• Flushing 
• Hair loss 
• Headache 

Serious Side Effects 

• Indications of elevated or reduced blood pressure: 
  • Severe headache 
  • Dizziness 
  • Fainting 
  • Vision changes 
• Rapid heart rate 
• Difficulty urinating 
• Heightened nervousness and restlessness 
• Presence of fever, chills, sore throat; unexplained bruising or bleeding; profound fatigue or weakness 
• Jaundice (yellowing of skin or eyes) 
• Tinnitus (ringing in ears) 
• Alteration in sexual interest 
• Breast enlargement 
• Nipple discharge 
• Testicular swelling 

Call your doctor right away and ask for medical help if any of the above-listed serious side effects are experienced. 

Allergic Reactions 

Although rare, a severe allergic reaction to Sinequan may occur. Seek immediate medical attention in case of any signs of an allergic reaction, such as: 

• Rash 
• Hives 
• Itching 
• Redness, swelling, blisters, or peeling skin (with or without fever) 
• Wheezing 
• Chest or throat tightness 
• Trouble breathing, swallowing, or talking 
• Unusual hoarseness 
• Swelling of the mouth, face, lips, tongue, or throat 

Not all side effects of Sinequan are included in this list. Notify your doctor if any unlisted effects occur. 

Cautions 

Before starting treatment with Sinequan, inform your doctor if you have any known allergies, particularly to: 

• Doxepin 
• Other tricyclic antidepressants (e.g., nortriptyline) 
• Other medicines 

Seek further guidance from your pharmacist regarding Sinequan, as it may contain inactive ingredients that may cause allergic reactions or other complications. 

To ensure Sinequan is safe for you, disclose to your physician your medical background, especially if you have a history of: 

• Bleeding disorders 
• Respiratory issues 
• Liver problems 
• Recent heart attack 
• Urinary difficulties (e.g., due to enlarged prostate) 
• Hyperthyroidism 
• Personal or family history of angle-closure glaucoma 
• Personal or family history of mental/mood disorders (e.g., bipolar disorder, psychosis) 
• Family history of suicide 
• Seizures 
• Conditions heightening seizure risk (e.g., brain disease, alcohol/sedative withdrawal) 

Inform your healthcare providers of any current, recently started, or stopped medications, including prescription/nonprescription drugs, vitamins, and herbal supplements, to lower the risk of drug interaction with Sinequan. 

Some of the products that may interact with Sinequan include: 

• Arbutamine 
• Thyroid supplements 
• Central-acting medications for hypertension (e.g., clonidine, guanabenz) 

The combination of Sinequan and MAO inhibitors can lead to a potentially life-threatening drug interaction. Avoid concurrent use of MAO inhibitors listed below during the course of treatment with this medication: 

• Isocarboxazid 
• Linezolid  
• Metaxalone  
• Methylene blue  
• Moclobemide  
• Phenelzine  
• Procarbazine  
• Rasagiline  
• Safinamide  
• Selegiline  
• Tranylcypromine 

Moreover, most MAO inhibitors should not be taken for a period of two weeks before and following the use of Sinequan. Talk to your healthcare provider for guidance on when to initiate or discontinue this medication. 

Certain medications can impact the elimination of Sinequan from the system, consequently influencing its effectiveness. Examples of such drugs include: 

• Cimetidine  
• St. John’s Wort 
• Medications for irregular heart rate (e.g., quinidine propafenone flecainide) 
• Antidepressants (e.g., SSRIs including paroxetine fluoxetine fluvoxamine) 

Ensure to review the labels of all your medications, including allergy and cough-and-cold products, as they might contain decongestants or drowsiness-inducing ingredients. Consult your pharmacist for guidance on the safe usage of such products. 

Inform your healthcare provider or pharmacist if you are using any other products that induce drowsiness, including: 

• Opioid pain or cough medications (e.g., codeine, hydrocodone) 
• Alcohol 
• Marijuana (cannabis) 
• Sleep or anxiety medications (e.g., alprazolam, lorazepam, zolpidem) 
• Muscle relaxants (e.g., carisoprodol, cyclobenzaprine) 
• Antihistamines (e.g., cetirizine, diphenhydramine) 

Avoid driving or using machinery while taking Sinequan until you know its impact on your level of alertness. 

Sinequan can heighten sun sensitivity. Minimize sun exposure, avoid tanning booths and sunlamps, apply sunscreen, and don protective clothing outside. Promptly inform your doctor of any sunburn or skin inflammation. 

Diabetes patients should be aware that Sinequan can impede blood sugar control. Regular monitoring and reporting to the doctor is crucial, as adjustments to medication, exercise, or diet may be necessary. 

Exercise caution when using Sinequan if you have asthma, as there have been instances of worsened asthma symptoms in users. Promptly contact your doctor if your asthma deteriorates while taking this medication. 

Sinequan should only be used during pregnancy if absolutely necessary. Infants born to mothers who took this medication in the final trimester may occasionally experience withdrawal symptoms, including issues with feeding and breathing, seizures, muscle stiffness, or persistent crying. Promptly inform your doctor if you observe any of these signs in your newborn. 

Doxepin is transmitted through breast milk and could adversely impact a nursing infant. Avoid breastfeeding while taking this medication. Before breastfeeding, consult your doctor for guidance.