Doxepin for Itching and Hives

Woman with rash on her legs
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Doxepin can help hives and itching, but the medication also has strong side effects and needs to be used cautiously. Doxepin is a tricyclic antidepressant drug that also acts as a powerful antihistamine, making it useful for the treatment of chronic hives and itching. Histamine is produced by your body's mast cells as a first defense against allergens. If you have allergies, your body may produce too much histamine or might create histamine in response to a harmless allergen, like pollen.

Doxepin is able to block H1 and H2, two types of histamine receptors, which makes it particularly effective at treating skin allergies, since both H1 and H2 histamine receptors can be found in the skin.

Oral and Topical Doxepin

Doxepin is available only by prescription, with the dose varying based on the symptoms being treated. For hives and itching, most physicians use lower doses, such as 25 to 50 milligrams before bed. Higher doses of Doxepin are used to treat depression and anxiety, although it is difficult for many people to tolerate high doses of this medication due to its side effects of sedation and drowsiness.

Doxepin can also be used for to relieve symptoms of eczema. If you are prescribed Doxepin for eczema, you will be given a topical cream to use. In most cases, the cream is used four times per day for up to eight days. Side effects of topical Doxepin include drowsiness, dry mouth, dehydration, headache, fatigue, dizziness, mood changes, burning and stinging at the application site, increased itchy, dryness and tightening at the application site, tingling in the fingers and toes, and swelling.

What to Know Before Taking Doxepin

Doxepin carries a black box warning as it may increase the risk of suicide in children and young adults with a history of depression or other mental illness. Doxepin has many drug interactions with other medications, and therefore it is important for any person taking doxepin to inform their doctor or pharmacist about other medications they are taking.

Due to its many side effects, doxepin prescriptions are often started low and increased slowly.

If you take Doxepin and decide to stop, you will need to wean yourself off of the medication in order to avoid withdrawal symptoms such as nausea, vomiting, diarrhea, headache, sleeping problems, dizziness, fatigue, and irritability. Do not stop taking Doxepin abruptly or without consulting your doctor.

While doxepin can be very useful in treating hives and itching, it should be taken with caution and under the careful supervision of a physician.


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U.S. National Library of Medicine: Medline Plus. Doxepin Topical. 2016.