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This safety information provides key details about potential risks and precautions associated with the use of doxepin (Zonalon). It is important to review this information carefully and discuss any concerns with your healthcare provider.

• Drowsiness: Doxepin (Zonalon) may cause drowsiness, affecting your concentration, thinking, and reaction times. The risk of drowsiness is higher in older adults, who may also be more susceptible to falls. Combining this medication with alcohol, antihistamines, or other drowsiness-inducing substances can increase these effects. Be cautious if applying doxepin (Zonalon) to more than 10% of your body, using occlusive bandages, or using it for more than 8 days, as this can lead to excessive absorption. Avoid tasks that require full attention, such as driving or operating machinery, until you understand how the medication affects you. If significant drowsiness occurs, consult your healthcare provider, who may adjust your usage or suggest discontinuing the medication.

• Allergic Reactions: Prolonged use of doxepin (Zonalon) beyond 8 days can increase the risk of developing an allergic reaction, known as contact sensitization. Symptoms such as rash, redness, or swelling at the application site should be reported to your healthcare provider immediately.

• Drug Interactions: Doxepin (Zonalon) may interact with other medications, potentially increasing the risk of side effects. Notably, combining it with cimetidine can lead to significant anticholinergic effects, such as dry mouth, difficulty urinating, and blurred vision. If you have been using monoamine oxidase inhibitors (MAOIs), discontinue them at least 2 weeks prior to starting doxepin (Zonalon) to minimize the risk of serotonin syndrome. Always inform your healthcare provider about all medications, supplements, and vitamins you are currently taking.

• Contraindications: This medication should not be used if you have certain conditions, as it may pose significant health risks. These include difficulty urinating and untreated narrow-angle glaucoma. If you have these conditions, consult your healthcare provider before using doxepin (Zonalon).

When using this medication, you might experience some common side effects. These include burning or stinging at the application site, drowsiness, dizziness, and dry mouth. Additionally, some individuals may notice a bitter or metallic taste, blurred vision, changes in taste, or mild itching. These effects are generally mild and should not cause alarm. However, if any of these symptoms persist or worsen, it is advisable to consult with your healthcare provider.

There are also other side effects that may occur, such as tiredness, worsening eczema, headache, fever, and nausea. While these are less common, it is important to monitor how you feel and seek medical advice if necessary. Remember to take precautions to reduce dizziness and lightheadedness, such as rising slowly from sitting or lying positions.

Rarely, more serious side effects can occur, which require immediate medical attention. These include persistent heartburn, significant mood changes, trouble urinating, swelling of hands or feet, fast or irregular heartbeat, vision changes, fainting, and seizures. An allergic reaction, though rare, may present as a rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing, and warrants urgent care. Always stay vigilant and communicate any unusual or severe symptoms to your healthcare provider promptly.

To ensure safe use of doxepin, it's important to inform your doctor and pharmacist about all medications and supplements you are taking, including prescription drugs, over-the-counter medications, and herbal products. Doxepin can interact with several other medications, which can impact its effectiveness or increase the risk of side effects.

Avoid combining doxepin with MAO inhibitors like isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, and tranylcypromine, as this could lead to a serious, potentially fatal reaction. It's usually advised to stop MAO inhibitors at least two weeks before starting doxepin and wait two weeks after stopping doxepin before resuming any MAO inhibitors. Always consult your doctor about the timing for starting or stopping these medications.

Doxepin's removal from your body can be affected by other drugs, possibly changing how it works. This includes medications like cimetidine, St. John's Wort, certain heart rhythm drugs (e.g., propafenone, flecainide), SSRIs (e.g., paroxetine, fluoxetine, fluvoxamine), and seizure medications (e.g., phenobarbital, phenytoin).

Certain drugs that prolong the QT interval, such as amiodarone, dofetilide, halofantrine, and some antibiotics like erythromycin, can also affect heart rhythm when taken with doxepin. Inform your healthcare provider about all the medications you are taking to prevent any adverse interactions.

Additionally, be cautious when using products that cause drowsiness, such as opioid pain relievers (e.g., codeine, hydrocodone), alcohol, marijuana, sleep or anxiety medications (e.g., alprazolam, lorazepam), muscle relaxants (e.g., carisoprodol, cyclobenzaprine), and antihistamines (e.g., cetirizine, diphenhydramine). Check medicine labels for ingredients that cause drowsiness and consult your pharmacist for safe use of such products.