Sinequan - Comprehensive Usage Guide: instructions, indications, composition, side effects

• Active Ingredient: Doxepin hydrochloride
• Excipients: May include lactose monohydrate, magnesium stearate, colloidal silicon dioxide, and other inactive ingredients depending on the formulation.

• Tablets: Available in various strengths, including 10 mg, 25 mg, 50 mg, 75 mg, and 100 mg tablets.
• Oral Solution: Available as a liquid formulation, typically in a concentration of 10 mg/mL.

Sinequan belongs to the pharmacological group of tricyclic antidepressants (TCAs) (ATC code: N06AA12).

• Pharmacodynamics: Doxepin inhibits the reuptake of serotonin and norepinephrine, leading to increased neurotransmitter levels in the brain. It also antagonizes histamine H1 receptors and alpha-adrenergic receptors, contributing to its sedative and anxiolytic effects.
• Pharmacokinetics: Doxepin is well-absorbed after oral administration, with peak plasma concentrations achieved within 2 to 3 hours. It undergoes hepatic metabolism and has a half-life of approximately 8 to 25 hours.

Sinequan is indicated for the treatment of:

• Major Depressive Disorder (MDD)
• Anxiety Disorders
• Insomnia (off-label use)

Sinequan is contraindicated in individuals with a known allergy or hypersensitivity to doxepin or any other component of the formulation.
It should not be used concomitantly with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to the risk of serotonin syndrome.

Doxepin may interact with other medications, including MAOIs, selective serotonin reuptake inhibitors (SSRIs), anticholinergic drugs, and CNS depressants. Caution is advised when combining Sinequan with other central nervous system depressants or medications that affect hepatic metabolism.

Sinequan tablets should be taken orally once daily, preferably at bedtime, with or without food, as directed by a healthcare provider.
The oral solution should be measured with a calibrated dropper or syringe and administered according to the prescribed dosage.

The initial dosage of Sinequan varies depending on the indication, patient age, and severity of symptoms. Healthcare providers may start with a low dose and titrate gradually to achieve optimal therapeutic effects while minimizing side effects.
Maintenance therapy typically involves long-term treatment with the lowest effective dose.

In cases of Sinequan overdose, supportive measures should be initiated as needed. Symptoms of overdose may include drowsiness, confusion, hallucinations, seizures, and cardiac arrhythmias. Gastric lavage and activated charcoal may be considered to reduce absorption.

Common side effects of Sinequan may include dry mouth, drowsiness, dizziness, constipation, blurred vision, and weight gain. Serious adverse effects such as cardiac conduction abnormalities, orthostatic hypotension, and serotonin syndrome are rare but require immediate medical attention if they occur.

Store Sinequan tablets at room temperature (15-30°C) in a dry place, protected from light and moisture.
Oral solution should be stored according to the manufacturer’s instructions, typically at controlled room temperature.