ドキセピン

使用用途

• Treatment of psychogenic dermatoses
• Excessive grooming
• Treatment of behavior problems (e.g., overgrooming, intercat aggression)
• Treatment of anxiety, pruritus caused feather plucking in psittacines
• Treatment of anxiety, pruritus caused feather plucking in psittacines
• Treatment of psychogenic dermatoses
• Treatment of psychogenic dermatoses
• Antihistaminic effects in treatment of atopy
• Antihistaminic effects in treatment of atopy
• Antihistaminic effects in treatment of atopy
• Antihistaminic effects in treatment of atopy
• Treatment of behavior problems (OCD)

投与方法

考えられる副作用

• Hyperexcitability (paradoxical)
• Gastrointestinal distress
• Lethargy and sedation
• Ventricular arrhythmias (particularly in overdose)
• Anticholinergic effects (dry mouth, urinary retention, constipation)
• Altered blood glucose levels
• Sedation
• Lethargy
• Dry mouth (xerostomia)
• Tachycardia
• Urinary retention
• Constipation

注意事項と禁忌

• Prior sensitivity to doxepin or other tricyclic antidepressants
• Concomitant use with Monoamine Oxidase Inhibitors (MAOIs) such as selegiline or amitraz (within 14 days)
• Urinary retention
• Glaucoma
• Severe cardiac disease
• History of seizures
• Concurrent use with MAOIs
• **Pregnancy & Nursing:** Safety during pregnancy has not been established (FDA Category C). Doxepin and its active metabolite distribute into milk; use with caution in nursing patients as sedation and respiratory depression have been reported in human infants. **Cardiac Effects:** Tricyclics can widen QRS complexes, prolong PR intervals, and invert or flatten T-waves on ECG. Use with caution in patients with pre-existing cardiac disease. **Laboratory Alterations:** May alter (increase or decrease) blood glucose levels.

薬物相互作用

• Anticholinergic Agents: Additive anticholinergic effects; use cautiously.
• Cimetidine: May inhibit tricyclic antidepressant metabolism and increase the risk of toxicity.
• CNS Depressants: Additive CNS depression; use cautiously.
• Meperidine, Pentazocine, Dextromethorphan: Increased risk for serotonin syndrome.
• Monoamine Oxidase Inhibitors (MAOIs, e.g., amitraz, selegiline): Concomitant use (within 14 days) is generally contraindicated due to high risk of serotonin syndrome.
• Quinidine: Increased risk for QTc interval prolongation and tricyclic adverse effects.
• SSRIs (e.g., fluoxetine, paroxetine, sertraline): Increased risk for serotonin syndrome.
• Sympathomimetic Agents: May increase the risk of cardiac effects (arrhythmias, hypertension, hyperpyrexia).
• Monoamine Oxidase Inhibitors (MAOIs): Risk of fatal serotonin syndrome
• Selective Serotonin Reuptake Inhibitors (SSRIs): Increased risk of serotonin syndrome

よくある質問