Mental Health
DoxepinDoxepin Hydrochloride
Doxepin is a tricyclic medicine sold in four forms: capsules and an oral concentrate for major depressive disorder in adults, 3 and 6 mg tablets (Silenor) for trouble staying asleep, and a 5 percent cream (Zonalon, Prudoxin) for short-term itching. Every form has generics and the Sinequan brand is discontinued; the antidepressant forms carry a boxed warning about suicidal thoughts in young people, and doxepin is not a controlled substance.
This page is general information about a medication and how cash prices for it are set. It is not medical advice and does not replace the label, your prescriber or your pharmacist. How we handle medical information
Capsules, concentrate, sleep tablets (rated equivalent to Silenor) and cream (rated equivalent to Zonalon) all have generic versions; the Sinequan brand has been discontinued.
About Doxepin
Doxepin is a tricyclic antidepressant first approved in 1969. Capsule and oral concentrate labels revised in 2026 cover major depressive disorder in adults (older Sinequan labeling also listed anxiety): treatment starts at 25 mg three times a day or 75 mg once a day, the usual target is 75 to 150 mg a day, the maximum is 100 mg three times a day, and older adults generally start lower. Silenor tablets treat insomnia marked by trouble staying asleep, at 6 mg a day for adults and a 3 mg start from age 65, never more than 6 mg a day, possibly by blocking histamine H1 receptors. The cream is for moderate itching in adults with atopic dermatitis (eczema) or lichen simplex chronicus, for no more than 8 days.
The capsules and concentrate carry the antidepressant boxed warning: in short-term studies these medicines raised the risk of suicidal thoughts and behavior in children, teenagers and young adults, and these forms are not approved for anyone under 18. Silenor and the cream have no boxed warning, though Silenor’s label warns about worsening depression and suicidal thinking, and the cream is not recommended for children. No form is used with an MAO inhibitor or within two weeks of one, or with urinary retention or glaucoma (untreated narrow-angle glaucoma for Silenor and the cream). The antidepressant forms also carry warnings on serotonin syndrome, angle-closure glaucoma, sedation and driving, mania, seizures and psychosis; sleepiness, dry mouth, dizziness, constipation and fatigue are their most common side effects, and anticholinergic effects such as blurred vision call for a lower dose. Silenor’s label warns about next-day impairment and complex behaviors such as sleep-driving, and the cream commonly causes drowsiness and burning or stinging.
The forms are separate products: the sleep tablets are 3 and 6 mg, below the smallest 10 mg capsule. Enough cream is absorbed through the skin to cause drowsiness, more often when over a tenth of the body surface is treated; it is never covered with a bandage or plastic and is kept away from the eyes. People known to be poor CYP2D6 or CYP2C19 metabolizers may need a lower dose, and Silenor is capped at 3 mg with cimetidine. The antidepressant forms are tapered rather than stopped suddenly, breastfeeding is not recommended during treatment with the capsules, and newborns exposed late in pregnancy are monitored after birth.
Taking Doxepin
- How to take it
- Capsules: once a day or in divided doses, as prescribed. Concentrate: measure the dose with the dropper, mix it with 120 mL (4 ounces) of water, milk, or orange, grapefruit, tomato, prune or pineapple juice, never another liquid, and drink it right away. Silenor tablets: within 30 minutes of bedtime, not within 3 hours of a meal. Cream: a thin film four times a day, at least 3 to 4 hours apart, left uncovered.
- If you miss a dose
- Capsules or concentrate: take it as soon as you remember unless the next dose is almost due; then skip it. Sleep tablets: skip a missed dose, since they are taken only within 30 minutes of bedtime. Cream: apply it when you remember unless the next application is near, and never use extra.
- Storage
- Capsules, concentrate and tablets at room temperature, 68 to 77°F (20 to 25°C), tightly closed and away from light; the cream below 80°F (27°C). Keep every form out of reach of children.
- Interactions to know about
- Never combine it with an MAO inhibitor, including linezolid or intravenous methylene blue. Other antidepressants and serotonergic drugs add to the risk of serotonin syndrome; cimetidine and strong CYP2D6 inhibitors raise doxepin levels, and carbamazepine lowers them. Alcohol, sedating antihistamines and other sedatives add to the drowsiness.
This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.
Why the cash price for Doxepin differs from pharmacy to pharmacy
Doxepin is four products under one name, each quoted on its own, and a pharmacy cannot swap one form for another. The oral concentrate comes in one bottle size that not every pharmacy stocks, so it may have to be ordered in.
Generic 3 and 6 mg tablets from several makers are rated equivalent to Silenor, so a prescription that names Silenor and blocks substitution is priced as a brand. The cream has fewer generic makers and is priced by the tube.
Upload it and licensed pharmacies reply with their own cash price. You pay the pharmacy, not us.
Ways to pay less for Doxepin without insurance
- Ask for a generic, and make sure a prescription for the sleep tablets allows substitution rather than naming Silenor only.
- Ask for a ninety-day supply of capsules or tablets once your dose is settled.
- For the cream, ask whether the pharmacy has a generic and which tube sizes it stocks.
- Compare more than one pharmacy, especially for the oral concentrate.
- Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.
How Script Unlock gets you a cash price for Doxepin
Prices on this site come from pharmacies responding to a real prescription. We do not publish estimated, average or "typical" prices, because none of those would be your price.
- 1You upload your prescription
A photo of your Doxepin prescription is enough. Nothing is sold on the site; you are asking pharmacies to quote.
- 2Licensed pharmacies respond
Pharmacies that Script Unlock has verified see the request and each can reply with its own cash price for your exact drug, strength and quantity.
- 3You choose and pay the pharmacy
You compare the responses, pick a pharmacy, and pay that pharmacy directly when you collect. Script Unlock never takes a patient payment and never sets the price.
Questions to ask your pharmacist about Doxepin
- 1.Which of my medicines, such as cimetidine or sleep aids, interact with doxepin?
- 2.How do I measure and mix my oral concentrate?
- 3.How much of my skin can I treat with the cream, and for how long?
- 4.Will doxepin leave me drowsy the next day?
Where Doxepin fits
Related medications
Sources
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.