Drug interactions
Doxepin + Rivastigmine
Severity: Moderate
Doxepin and Rivastigmine: 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 marked anticholinergic activity and can counteract the cognitive benefit of rivastigmine. This is particularly concerning in dementia, where anticholinergic drugs may worsen confusion and memory.
What this interaction means in plain words
Doxepin and Rivastigmine 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; Rivastigmine belongs to Central Nervous System.
Why it happens
Pharmacodynamic antagonism through muscarinic blockade by the tricyclic opposing cholinesterase inhibition.
What to do
Avoid doxepin at antidepressant doses in patients with dementia and consider a less anticholinergic agent. If needed, use the lowest dose and monitor cognition.
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 Rivastigmine
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 Rivastigmine?
MediHelp rates the interaction as moderate. Doxepin and Rivastigmine 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 marked anticholinergic activity and can counteract the cognitive benefit of rivastigmine. This is particularly concerning in dementia, where anticholinergic drugs may worsen confusion and memory.
How serious is the interaction between Doxepin and Rivastigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid doxepin at antidepressant doses in patients with dementia and consider a less anticholinergic agent. If needed, use the lowest dose and monitor cognition.
What other medicines interact with Rivastigmine?
MediHelp also lists interactions of Rivastigmine with, for example, Donepezil, Galantamine, Memantine-donepezil. The full list is on the Rivastigmine page.
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