Drug interactions
Doxepin + Pyridostigmine
Severity: Moderate
Doxepin and Pyridostigmine: 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
Doxepin has antimuscarinic activity that can oppose the effects of pyridostigmine. At low doses used for insomnia the effect is small, but sedation could also worsen weakness in myasthenia.
What this interaction means in plain words
Doxepin and Pyridostigmine 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; Pyridostigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism between a cholinesterase inhibitor and a drug with anticholinergic properties.
What to do
Monitor myasthenia symptoms and use the lowest effective doxepin dose. Consider a less anticholinergic agent if control worsens.
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 Pyridostigmine
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 Pyridostigmine?
MediHelp rates the interaction as moderate. Doxepin and Pyridostigmine 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 has antimuscarinic activity that can oppose the effects of pyridostigmine. At low doses used for insomnia the effect is small, but sedation could also worsen weakness in myasthenia.
How serious is the interaction between Doxepin and Pyridostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor myasthenia symptoms and use the lowest effective doxepin dose. Consider a less anticholinergic agent if control worsens.
What other medicines interact with Pyridostigmine?
MediHelp also lists interactions of Pyridostigmine with, for example, Echothiophate iodide, Huperzine a, Neostigmine. The full list is on the Pyridostigmine page.
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