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This safety and warning information is essential for the safe use of Doxepin (Zonalon). Please review these points carefully and discuss any concerns with your healthcare provider.

• Drowsiness: Doxepin (Zonalon) may cause drowsiness, impairing your focus and reaction time. This effect is more pronounced in older adults, increasing the risk of falls. Combining this medication with alcohol, antihistamines, or other sedatives can intensify drowsiness. Be cautious if you apply it to more than 10% of your body, use occlusive bandages, or extend use beyond 8 days, as it may lead to excessive absorption. Avoid tasks requiring concentration, such as driving, until you know how Doxepin (Zonalon) affects you. If you experience severe drowsiness, consult your prescriber. They may adjust your application frequency or dosage, or advise discontinuation. Key risks include alcohol use, applying to large skin areas, concurrent use with other sedatives, and prolonged use with occlusive dressings.

• Allergic Reactions: There is a risk of contact sensitization with Doxepin (Zonalon), particularly if used for over 8 days, leading to allergic reactions. Notify your prescriber if you observe a rash, redness, or swelling at the application site.

• Drug Interactions: Doxepin (Zonalon) may interact with certain drugs, increasing side effects. For instance, concurrent use with cimetidine can cause severe anticholinergic effects like dry mouth, difficulty urinating, and blurred vision. Discontinue monoamine oxidase inhibitors (MAOIs) at least two weeks before starting Doxepin (Zonalon) to avoid serotonin syndrome. Inform your prescriber about all medications, including supplements and vitamins, you are taking.

• Contraindications: Do not use Doxepin (Zonalon) if you have trouble urinating or untreated narrow-angle glaucoma, as it may pose significant health risks. Consult your healthcare provider if these conditions apply to you.

This information aims to ensure your safety while using Doxepin (Zonalon) and should be followed to minimize potential risks.

When using this medication, you may experience some common side effects which are generally mild, such as burning or stinging at the application site, drowsiness, dry mouth, dizziness, blurred vision, and changes in taste. To help manage dizziness and lightheadedness, rise slowly from sitting or lying positions. For dry mouth relief, consider sucking on sugarless hard candy or ice chips, chewing sugarless gum, drinking water, or using a saliva substitute. Most people taking this medication do not experience serious side effects.

However, be vigilant for any serious reactions, including persistent heartburn, mental or mood changes like agitation or depression, trouble urinating, or swelling of the hands or feet. Seek medical attention immediately if you experience very serious side effects such as a fast or irregular heartbeat, vision changes, fainting, or seizures. Although rare, a severe allergic reaction can occur, characterized by rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing—these require urgent medical care.

Other reported side effects include itching, tiredness, worsening eczema, mood changes, a bitter or metallic taste in the mouth, headache, fever, and nausea. If you encounter any side effects not mentioned here, or if any side effect persists or worsens, consult your healthcare provider.

It's important to inform your doctor and pharmacist about all the medications and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products. This is because doxepin can interact with various other drugs, potentially leading to serious or even fatal consequences.

Certain medications for high blood pressure, such as clonidine, guanadrel, and guanethidine, as well as thyroid medications, may interact with doxepin. Additionally, using MAO inhibitors like isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, and tranylcypromine with doxepin can cause dangerous interactions. Avoid taking these MAO inhibitors during treatment with doxepin and typically for two weeks before and after discontinuing doxepin. Consult your doctor for advice on when to start or stop these medications.

Other drugs can influence how doxepin is metabolized in your body. This can alter its effectiveness. Examples include cimetidine, St. John's Wort, drugs for irregular heartbeats like propafenone and flecainide, SSRIs such as paroxetine, fluoxetine, and fluvoxamine, and seizure medications like phenobarbital and phenytoin.

Doxepin, like many other drugs, can affect heart rhythm (QT prolongation). Medications such as amiodarone, dofetilide, halofantrine, pimozide, quinidine, procainamide, sotalol, and certain antibiotics like erythromycin and sparfloxacin are known to have similar effects. Therefore, it is crucial to discuss all current medications with your healthcare provider.

Additionally, doxepin can cause drowsiness. Inform your doctor if you are using other products that have the same effect, such as opioid pain and cough relievers (e.g., codeine, hydrocodone), alcohol, marijuana, sleep or anxiety medications (e.g., alprazolam, lorazepam, zolpidem), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), or antihistamines (e.g., cetirizine, diphenhydramine). Also, check the labels of all your medications for ingredients that may cause drowsiness and consult your pharmacist about their safe usage.