Comparative Pharmacology
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus SILENOR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DOXEPIN HYDROCHLORIDE versus SILENOR.
DOXEPIN HYDROCHLORIDE vs SILENOR
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.
Selective histamine H1 receptor antagonist; promotes sleep by antagonizing central histaminergic neurotransmission.
25-150 mg orally at bedtime; initially 25 mg, may increase gradually to 150 mg. For minor depression: 25-50 mg orally at bedtime.
6 mg orally once daily at bedtime, not to exceed 6 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.
Terminal elimination half-life is approximately 10 hours (range 8-15 hours) in healthy adults; prolonged in elderly and hepatic impairment.
Primarily renal (50-60% as metabolites, <5% unchanged). Biliary/fecal: approximately 20-30%.
Primarily renal (approximately 60% as unchanged drug and metabolites), with 30% fecal elimination.
Category C
Category C
Tricyclic Antidepressant
Tricyclic Antidepressant