Comparative Pharmacology
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus PAMELOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus PAMELOR.
DOXEPIN HYDROCHLORIDE vs PAMELOR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Doxepin is a tricyclic antidepressant (TCA) that inhibits the reuptake of serotonin and norepinephrine, thereby increasing their concentrations in the synaptic cleft. It also exhibits potent histamine H1 receptor antagonism, leading to antihistaminic effects, and has anticholinergic, alpha-adrenergic blocking, and anti-serotonergic properties.
Nortriptyline, the active ingredient, is a tricyclic antidepressant that inhibits the reuptake of norepinephrine and serotonin at the presynaptic neuronal membrane, increasing their availability in the synaptic cleft.
25-150 mg orally at bedtime; initially 25 mg, may increase gradually to 150 mg. For minor depression: 25-50 mg orally at bedtime.
25-150 mg orally per day, typically as a single daily dose at bedtime or in divided doses; start at 25 mg 1-3 times daily and titrate gradually. Maximum 150 mg/day.
None Documented
None Documented
Terminal elimination half-life: 8-24 hours (mean 15 hours). Steady-state achieved in 3-5 days. Active metabolite nordoxepin has half-life of 31-50 hours.
Mean terminal elimination half-life is 18-24 hours (range 13-40 hours) in adults; prolonged in elderly and hepatic impairment (up to 60 hours). Steady-state achieved in 4-5 days.
Primarily renal (50-60% as metabolites, <5% unchanged). Biliary/fecal: approximately 20-30%.
Primarily renal (approximately 70% as metabolites, 40-50% as glucuronide conjugates, 20-30% as free or conjugated nortriptyline; <5% unchanged), with 20-30% biliary/fecal elimination.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant