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This document outlines essential safety and warning information regarding the use of doxepin (Silenor). It is crucial to understand these details to ensure safe and effective use of the medication. Please consult your healthcare provider if you have any questions or concerns.

• Potential Causes of Insomnia: If insomnia persists after using doxepin (Silenor) for more than a week, consider discussing other possible causes with your healthcare provider, such as depression, stress, or pain.

• Behavioral Changes: Some individuals may engage in activities while not fully awake after taking doxepin (Silenor), such as driving, cooking, or engaging in sexual activity, often with no memory of the events. The likelihood increases with alcohol consumption or use of other sedatives (e.g., opioids). Avoid combining these substances with doxepin.

• Worsening Depression and Suicidal Risk: At higher doses, doxepin is used for depression treatment and may worsen mental health or increase the risk of self-harm or suicidal thoughts, particularly in individuals under 24 years old.

• Sedation and Drowsiness: Doxepin (Silenor) can cause drowsiness. Only take the medication when ready for bed, and refrain from activities requiring concentration, such as operating machinery or driving, to prevent accidents.

• Contraindications: Doxepin (Silenor) should not be used if you are currently taking or have recently taken a monoamine oxidase inhibitor (MAOI) within 14 days, have narrow-angle glaucoma, or experience urinary retention. Consult your healthcare provider if any of these conditions apply to you.

Please remember that combining doxepin with alcohol, opioids, or other sedative medications can increase the risks of drowsiness and behavioral changes. If an overdose occurs, seek emergency medical attention immediately.

When taking this medication, some individuals may experience mild side effects such as drowsiness, tiredness, or nausea. These are generally not a cause for concern and tend to improve over time. If they persist or become bothersome, it is advisable to consult a healthcare provider. In some cases, users have reported upper respiratory tract infections, which should also be monitored if symptoms persist.

However, there are more serious side effects that, although rare, require immediate medical attention. These include allergic reactions characterized by hives, rashes, swelling of the face or throat, and difficulty breathing. Additionally, some people may experience worsened depression or suicidal thoughts or actions, particularly in those under 25 years of age. It is crucial to be vigilant for any unusual behavior changes, such as increased anxiety, panic attacks, or irritability.

There are reports of individuals engaging in activities like driving, eating, or having sex while not fully awake, with no memory of these actions later. This can be dangerous and should be reported to a healthcare provider immediately. Moreover, very serious side effects like eye pain, vision changes, or severe allergic reactions require urgent medical attention. Always discuss any unusual symptoms or concerns with your healthcare provider to ensure the safe use of this medication.