Doxepin Hydrochloride, Topical DOKS-e-pin hy-droh-KLOR-ide

What are other names for this medicine?

Type of medicine: antipruritic (anti-itch)

Generic and brand names: doxepin hydrochloride, topical; Prudoxin; Zonalon

What is this medicine used for?

This medicine is a skin cream used to treat itching that occurs with certain kinds of skin disorders.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• glaucoma
• urinary retention (trouble urinating)

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while using this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Apply the cream exactly as directed by your healthcare provider. Apply a thin layer of cream to the affected areas of the skin. Keep the medicine away from your eyes and mouth. Do not apply the cream more often than directed. Using the cream too often or using too much may increase the chances of side effects. Do not use a bandage that seals a wound (such as OpSite) on the areas where you apply the cream, because you may absorb too much of this medicine and increase the chances of side effects.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: confusion, hallucinations, enlarged pupils, restlessness, drowsiness, vomiting, dry mouth, blurred vision, change in body temperature, problems urinating, fast or irregular heartbeat, fainting, seizures, coma.

What should I watch out for?

Contact your healthcare provider if your condition does not improve in 7 days or if it gets worse. Do not use this medicine for more than 8 days or as instructed by your healthcare provider.

This medicine may make you drowsy. Do not drive or operate machinery unless you are fully alert. If this medicine causes severe drowsiness, contact your healthcare provider.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Severe drowsiness or dizziness, fainting, fast or irregular heartbeat, increased irritation of the treated skin, problems urinating, blurred vision, confusion, restlessness.

Other: Headache; drowsiness; tiredness; dizziness; mild stinging or burning of the skin where the cream is applied; itching, dry skin; tingling, scaling, or cracking of skin; dry mouth; dry lips; thirst; taste changes; mood changes.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• alcohol
• antianxiety medicines such as alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• antiarrhythmic medicines such as disopyramide (Norpace), dronedarone (Multaq), flecainide (Tambocor), procainamide, propafenone (Rythmol), and quinidine
• antibiotics such as azithromycin (Zithromax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (Ery-Tabs, E.E.S.), levofloxacin (Levaquin), linezolid (Zyvox), moxifloxacin (Avelox), and telithromycin (Ketek)
• anticholinergic medicines such as amantadine (Symmetrel), benztropine (Cogentin), dicyclomine (Bentyl), propantheline, hyoscyamine (Levsin, Levsinex), and scopolamine (Transderm Scop)
• antidepressants such as amitriptyline, bupropion (Wellbutrin, Zyban), citalopram (Celexa), desipramine (Norpramin), doxepin, duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), imipramine (Tofranil), fluvoxamine (Luvox), nortriptyline (Pamelor), paroxetine (Paxil), sertraline (Zoloft), trazodone, and venlafaxine (Effexor)
• antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antihistamines such as chlorpheniramine (Chlor-Trimeton), loratadine (Claritin), diphenhydramine (Benadryl), and fexofenadine (Allegra)
• anti-HIV medicines such as amprenavir (Lexiva), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• antinausea medicines such as prochlorperazine and promethazine (Phenergan)
• antipsychotic medicines such as chlorpromazine, haloperidol (Haldol), olanzapine (Zyprexa), pimozide, quetiapine (Seroquel), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• antiseizure medicines such as carbamazepine (Tegretol, Carbatrol), phenytoin (Dilantin), and valproic acid (Depakote, Depakene)
• barbiturates such as butabarbital (Butisol) and phenobarbital
• chloroquine (Aralen)
• cimetidine (Tagamet)
• clonidine (Catapres)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• methylene blue
• ranolazine (Ranexa)
• medicine that reduces the chance of blood clots forming such as warfarin (Coumadin)
• muscle relaxants such as baclofen (Lioresal), carisoprodol (Soma), cyclobenzaprine (Flexeril), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• natural remedies such as gotu kola, kava, St. John's wort, and valerian
• pain medicines such as codeine (Tylenol #3), hydromorphone (Dilaudid), morphine (MS Contin), oxycodone (OxyContin), oxycodone/acetaminophen (Percocet, Tylox), pentazocine (Talwin), tapentadol (Nucynta), and tramadol (Ultram)
• sedatives such as eszopiclone (Lunesta), flurazepam, temazepam (Restoril), zaleplon (Sonata), and zolpidem (Ambien)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.