Drug interactions
Doxepin + Paliperidone
Severity: Major
Doxepin and Paliperidone: major interaction.
Last updated Sources: US FDA label
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, so combined use may increase the risk of torsades de pointes, especially with other risk factors. They also add sedative and anticholinergic effects and orthostatic hypotension.
What this interaction means in plain words
Doxepin and Paliperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Doxepin belongs to Dermatology; Paliperidone belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive central nervous system depression and alpha-adrenergic blockade.
What to do
Obtain a baseline ECG and correct potassium and magnesium. Monitor the QTc and sedation, and use the lowest effective doses or choose an alternative if the QTc becomes prolonged.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
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 Paliperidone?
MediHelp rates the interaction as major. Doxepin and Paliperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs can prolong the QT interval, so combined use may increase the risk of torsades de pointes, especially with other risk factors. They also add sedative and anticholinergic effects and orthostatic hypotension.
How serious is the interaction between Doxepin and Paliperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and correct potassium and magnesium. Monitor the QTc and sedation, and use the lowest effective doses or choose an alternative if the QTc becomes prolonged.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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