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Does Doxepin Help for Hives and Itching?

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Updated June 22, 2011

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Question: Does Doxepin Help for Hives and Itching?
Answer: Yes, it does -- but it has strong side effects and needs to be used cautiously. Doxepin is a tricyclic antidepressant drug that is also a powerful antihistamine, and so is often used for the treatment of chronic hives and itching. Doxepin is able to block two types of histamine receptors, both H1 and H2, and therefore is particularly effective at treating skin allergies, since both types of histamine receptors can be found in the skin. Doxepin is available only by prescription, and the dose varies based on the symptoms being treated. For hives and itching, most physicians use lower doses, such as 25 to 50 milligrams before bed. Much higher doses are used for the treatment of 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 carries a black box warning given its potential to increase the risk of suicide in children and young adults who have 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. Lastly, the dose of doxepin is often started low and increased slowly, due to its many side effects, and the medication should also not be stopped abruptly. Doxepin requires a weening off of the medication to avoid withdrawal symptoms, including nausea, vomiting, diarrhea, headache, sleeping problems, dizziness, fatigue and irritability.

While doxepin is very useful for the treatment of hives and itching, it should be taken with caution and under the careful supervision of a physician.

Sources:

Fleischer AB. Histamine H1 Antagonists. N Engl J Med. 1994; 331:1019-1020.

DuBuske LM. Clinical Comparison of Histamine H1-Receptor Antagonist Drugs. J Allergy Clin Immunol. 1996;98:S307-18.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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