Drug interactions
Doxepin + Escitalopram
Severity: Moderate
Doxepin and Escitalopram: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs can prolong the QT interval and both raise serotonergic activity, so combined use may increase arrhythmia and serotonin toxicity risk. Escitalopram may also modestly raise tricyclic levels via CYP2D6 inhibition. At low-dose doxepin for insomnia the risk is lower.
What this interaction means in plain words
Doxepin and Escitalopram can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Doxepin belongs to Dermatology; Escitalopram belongs to Central Nervous System.
Why it happens
Additive QTc prolongation and serotonin reuptake inhibition, with weak CYP2D6 inhibition by escitalopram.
What to do
Use the lowest effective doses, obtain an ECG if higher doxepin doses are used or cardiac risk factors exist, and monitor for serotonin toxicity.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Escitalopram?
MediHelp rates the interaction as moderate. Doxepin and Escitalopram can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs can prolong the QT interval and both raise serotonergic activity, so combined use may increase arrhythmia and serotonin toxicity risk. Escitalopram may also modestly raise tricyclic levels via CYP2D6 inhibition. At low-dose doxepin for insomnia the risk is lower.
How serious is the interaction between Doxepin and Escitalopram?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses, obtain an ECG if higher doxepin doses are used or cardiac risk factors exist, and monitor for serotonin toxicity.
What other medicines interact with Escitalopram?
MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.
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