Generic Name: amoxapine (a MOX a peen)Brand Names: Asendin
Amoxapine is in a group of drugs called tricyclic antidepressants. Amoxapine affects chemicals in the brain that may become unbalanced.
Amoxapine is used to treat symptoms of depression, anxiety, or agitation.
Amoxapine may also be used for purposes other than those listed in this medication guide.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Before taking amoxapine, tell your doctor if you are allergic to any drugs, or if you have:
a history of heart attack, stroke, or seizures;
schizophrenia or other mental illness;
diabetes (amoxapine may raise or lower blood sugar);
problems with urination.
If you have any of these conditions, you may not be able to use amoxapine, or you may need a dosage adjustment or special tests during treatment.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.FDA Pregnancy Category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Amoxapine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine. Do not give this medication to anyone under 18 years old without the advice of a doctor.
Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.It may take up to 3 weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve after 3 weeks of treatment. Store amoxapine at room temperature away from moisture and heat.
See also: Amoxapine dosage in more detail
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
Symptoms of an amoxapine overdose may include uneven heartbeats, increase or decrease in urination, drowsiness, agitation, confusion, hallucinations, seizure (convulsions), or coma.
Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, medicine for seizures, or other antidepressants). They can add to sleepiness caused by amoxapine.
Grapefruit and grapefruit juice may interact with amoxapine. Discuss the use of grapefruit products with your doctor before increasing or decreasing the amount of grapefruit products in your diet.Amoxapine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Amoxapine can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.
Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.Call your doctor at once if you have any of these serious side effects:
fast, pounding, or uneven heart rate;
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
sudden numbness or weakness, especially on one side of the body;
sudden headache, confusion, problems with vision, speech, or balance;
feeling light-headed, fainting;
restless muscle movements in your eyes, tongue, jaw, or neck;
tremors or uncontrollable shaking; or
fever with confusion, muscle stiffness, sweating, and fast or uneven heartbeats.
Less serious side effects may be more likely to occur, such as:
nausea, vomiting, stomach pain, constipation, diarrhea;
dry mouth, unpleasant taste;
increased appetite, weight changes;
weakness, lack of coordination;
numbness or tingly feeling;
feeling dizzy, drowsy, or tired;
blurred vision, headache;
mild skin rash;
breast swelling (in men or women); or
decreased sex drive, impotence, or difficulty having an orgasm.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Depression:
For the relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions:Initial dose: 50 mg 2 or 3 times daily. Depending on tolerance, the dosage may be increased to 100 mg 2 or 3 times daily by the end of the first week. An initial dosage of 300 mg daily may be given, but notable sedation may occur in some patients during the first few days of therapy at this level. Increases above 300 mg daily should be made only if 300 mg daily has been ineffective during a trial period of at least two weeks. When an effective dosage is established, the drug may be given in a single dose (not to exceed 300 mg) at bedtime.Maintenance: 200 to 300 mg daily.Three weeks is an adequate trial period providing the dosage has reached 300 mg daily (or the lower level of tolerance) for at least two weeks. If no response is seen at 300 mg, the dosage may be increased (depending on tolerance) up to 400 mg daily. Hospitalized patients who have been refractory to antidepressant therapy and who have no history of convulsive seizures may have their dosage cautiously raised up to 600 mg daily in divided doses.Amoxapine may be given in a single daily dose up to 300 mg, preferably at bedtime. If the total daily dosage exceeds 300 mg, it should be given in divided doses.
Usual Geriatric Dose for Depression:
For the relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depressions:Initial dose: 25 mg 2 or 3 times daily. If no intolerance is observed, the dosage may be increased by the end of the first week to 50 mg 2 or 3 times daily. Although 100 to 150 mg daily may be adequate for many elderly patients, some may require a higher dosage. Careful increases up to 300 mg daily may be appropriate for such individuals.Once an effective dose has been established, amoxapine may be given as a single bedtime dose, not to exceed 300 mg.
Before taking amoxapine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).
Before taking amoxapine, tell your doctor if you are currently using any of the following drugs:
cimetidine (Tagamet); or
heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).
If you are using any of these drugs, you may not be able to use amoxapine, or you may need dosage adjustments or special tests during treatment.
There are many other medicines that can interact with amoxapine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.