Indications  

Silenor is a prescribed medication indicated to treat insomnia characterized by sleep maintenance difficulties. 

Silenor falls under the classification of tricyclic antidepressants. Its sleep-enhancing effects are attributed to its ability to block histamine receptors, although its exact mechanism remains unclear. 

Uses and Dosage 

Before taking Silenor and with each prescription refill, carefully review its medication guide and patient information leaflet. Seek your doctor or pharmacist’s guidance if you have any questions. 

The dosage of this medication may differ for each individual, depending on their medical condition, age, and response to the treatment.  

Typically, Silenor is taken once nightly on an empty stomach, 30 minutes before going to bed, as prescribed by the doctor. 

Refrain from taking this medication within three hours of a meal to avoid delayed effects. 

Anticipate significant drowsiness shortly after taking Silenor, which may last for an extended period. Promptly go to bed and allocate 7 to 8 hours for sleep following medication intake. If unable to adhere to this timeframe, refrain from taking this medication. 

For best results, take this medication exactly as directed at a consistent time(s) each day. 

Inform your doctor if your condition persists or deteriorates beyond 7 to 10 days. 

Side Effects 

Listed below are the potential adverse effects of Silenor. Inform your physician immediately if any of them persist or worsen. 

Common Side Effects 

• Drowsiness 
• Fatigue 
• Nausea 
• Cold symptoms: 
  • Nasal congestion 
  • Sneezing 
  • Sore throat 

Serious Side Effects 

• Unusual thoughts or behavior 
• Confusion, hallucinations 
• Depressed mood, self-harm ideation 
• Uncontrolled muscle movements 
• Seizure 
• Feeling light-headed, near-fainting sensation 
• Mouth blisters/ulcers, swollen gums, swallowing issues 
• Eye pain, redness 
• Chest pain 
• Low red blood cells (anemia): 
  • Pale skin 
  • Fatigue 
  • Dizziness 
  • Cold extremities 
• Signs of infection: 
  • Flu-like symptoms 
  • Swelling 
  • Redness 
  • Diarrhea 
  • Skin sores 
  • Breathing difficulties 
  • Painful/burning urination 

Call your doctor immediately if any of the above-listed serious side effects are experienced. 

Instances have been reported where individuals taking this medication have participated in actions while not fully awake and subsequently have no recollection of them. These actions could include walking, driving, or making phone calls. Should any of this occur, promptly contact your doctor. 

Allergic Reactions 

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

• Hives 
• Difficulty breathing 
• Face, lips, tongue, or throat swelling 

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

Cautions 

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

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

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

To ensure Silenor is safe for you, disclose to your physician your medical background, especially if you have a history of urinary retention and personal or familial history of angle-closure glaucoma. 

Many products may interact with Silenor, including cimetidine. To prevent such drug interactions, inform your healthcare providers of any current, recently started, or stopped medications, including prescription/nonprescription drugs, vitamins, and herbal supplements. 

Taking MAO inhibitors with Silenor can lead to a severe (potentially fatal) drug interaction. Refrain from using the MAO inhibitors listed below while undergoing this treatment: 

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

In most cases, MAO inhibitors should be avoided for two weeks prior to and following Silenor’s usage. Seek guidance from your doctor regarding the timing of initiating or discontinuing this medication. 

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

Notify your doctor or pharmacist of any additional products you are currently taking that have sedative effects. These may include: 

• Opioid analgesics 
• Cough suppressants (e.g., codeine, hydrocodone) 
• Alcohol 
• Cannabis (marijuana) 
• Sleep aids or anti-anxiety medications (e.g., alprazolam, lorazepam, zolpidem) 
• Muscle relaxants (e.g., carisoprodol, cyclobenzaprine) 
• Antihistamines (e.g., cetirizine, diphenhydramine) 

Caution should be exercised when taking Silenor as it may cause drowsiness. Avoid driving, operating machinery, or participating in any dangerous activities at night after taking this medication. Furthermore, until the individual is aware of how this medication affects them, driving a car or operating machinery should be avoided the next day. 

Silenor should only be used during pregnancy if absolutely necessary. Consult your doctor to weigh the risks and benefits.  

Infants born to mothers who had taken this medication within the final three months of pregnancy could occasionally display withdrawal symptoms, encompassing challenges in feeding/breathing, seizures, muscular rigidity, or persistent crying. Should any of these symptoms manifest in your newborn, promptly inform your doctor. 

Doxepin can be transferred to breast milk and may cause unfavorable effects in a nursing baby. Breastfeeding while taking this medication is not advisable. Seek advice from your healthcare provider before breastfeeding.