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Silenor Warnings and Precautions
Before taking Silenor, tell your healthcare provider about any medical conditions you have, such as glaucoma, sleep apnea, or any allergies. Also, this medication can cause drug interactions, so it's important that your healthcare provider is aware of all other medicines you are taking (including nonprescription products). Other precautions and warnings with Silenor apply to women who are pregnant or breastfeeding.
You should talk with your healthcare provider prior to taking Silenor® (doxepin tablets) if you have:
- A history of suicide attempts or suicidal thoughts
- Glaucoma
- Bladder problems or difficulty passing urine
- Liver disease, such as liver failure, cirrhosis, or hepatitis
- Sleep apnea
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
- Are pregnant or thinking of becoming pregnant
- Are breastfeeding
- Drink alcohol regularly.
Make sure to tell your healthcare provider about any other medicines you are taking, including prescription and nonprescription medications, vitamins, and herbal supplements.
Some warnings and precautions to be aware of include the following:
- Doxepin (the active ingredient in Silenor) is used as an antidepressant, although at much higher doses than are used in Silenor. Antidepressants may increase the risk of suicidal thoughts or behavior (see Antidepressants and Suicide for more information).
Therefore, if you notice any changes in symptoms or develop new symptoms, talk to your healthcare provider immediately. Some of these symptoms may include:
- Anxiety
- Hostility
- Agitation
- Panic
- Restlessness
- Hallucinations
- Extreme hyperactivity
- Suicidal thoughts or behavior.
- Sometimes, sleeping problems are caused by other medical conditions (not just insomnia). If your insomnia does not improve within 7 to 10 days of starting Silenor, your healthcare provider should make sure there is no other medical condition causing your sleeping problem.
- Be aware that you may get out of bed while not fully awake and do things that you may not remember, such as sleep-walking, sleep-eating, or sleep-driving. If this happens, your healthcare provider will probably recommend that you stop taking Silenor.
- Silenor can cause daytime drowsiness. Use caution when driving, operating heavy machinery, or performing other tasks that require concentration, especially when first starting Silenor or when switching dosages. This is because Silenor may affect a person's mental or physical ability to perform these tasks. Make sure to understand how Silenor affects you before performing any task that requires mental or physical concentration.
- If you have liver disease, you may need a lower Silenor dosage.
- Sleep medications (like Silenor) are generally not recommended for people with sleep apnea. This is especially important for people with severe sleep apnea.
- Silenor can interact with certain medications (see Silenor Drug Interactions).
- Silenor may enhance the effects of alcohol and medicines that affect the brain. This can lead to an increased risk for drowsiness, dizziness, suicidal thoughts, or Silenor overdose symptoms. Make sure to talk with your healthcare provider about drinking alcohol while taking Silenor.
- Silenor is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are currently unknown. Discuss the benefits and risks of using Silenor during pregnancy with your healthcare provider (see Silenor and Pregnancy for more information).
- Silenor passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, make sure to talk with your healthcare provider about what makes the most sense for your particular situation (see Silenor and Breastfeeding).
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD