Monday, July 20, 2009

Sinequan (Doxepin)

Trade names



Antidepressant tricyclic structures derived.


Pharmacological Effects:

* Antidepressive,
* Anxiolytic,
* Sedative,
* Protivoyazvennoe,
* Antiholinergicheskoe,
* Antiserotoninovoe,
* Antihistaminic,
* Spasmolytic,
* Vasorelaxant (moderate peripheral)
* Miorelaksiruyuschee,
* Anticonvulsant.

Distinct antidepressive effect develops after 2-3 weeks of treatment. It stimulates the central nervous system, does not inhibit MAO.

Mechanism of Action

The mechanism of action associated with an effect on adrenergic transmission in the central nervous system, in particular, to reverse the blockade of neuronal noradrenaline capture.


Quickly and completely absorbed in ZHKT, metabolized in the liver, with the participation of cytochrome P450 2D6 to the pharmacologically active dimethyl-Sinequana further glyukuronidiruetsya and ekskretiruetsya with urine, T1 / 2 - 28-52 h; distributed throughout the tissue is found, particularly in the lungs, heart, brain and liver.


Depression and / or anxiety in the neuroses, alcoholism, organic diseases of the CNS, psychosis (including involutional depression and manic-depressive).

In practice obscheterapevticheskoy - duodenal ulcer, dumping syndrome, premenstrual syndrome, chronic pain in cancer patients, itchy skin, chronic idiopathic urticaria.


* Hypersensitivity to Sinequanu,
* Zakrytougolnaya glaucoma,
* AV blockade
* Adenoma of the prostate and the tendency to delay the urine,
* Pregnancy
* Breast-feeding (should abandon breastfeeding)
* Children age (under 12).

Side Effects

Cuhost mouth, nausea, vomiting, anorexia, disturbance of taste sensation, diarrhea, constipation, thrush, delayed urine, jaundice. Reduced body weight, increased sweating, chills, general weakness, feeling tide of blood-to-face.

Dizziness, the noise in the ears, headache, visual impairment, drowsiness, disorientation, hallucinations, paresthesia, ataxia, ekstrapiramidnye violation, convulsions, diskineziya tardive, tremor, arterial hypotension, hypertension, tachycardia.

Allergic reactions - skin rash, itching, photosensitization, angionevrotichesky edema, eosinophilia.

Aggravation of the flow of bronchial asthma.

Rarely - leukopenia, agranulocytosis, thrombocytopenia.

Increase or decrease in libido, swelling of testicles, ginekomastiya (men), an increase in the mammary glands, galaktoreya (women). Hypo-or hyperglycemia, syndrome of inappropriate secretion antidiureticheskogo hormones, alopecia.

Dependence syndrome and the abolition of

With sudden cessation of treatment may cancel the development of the syndrome (nausea, headache, general weakness).


Tsimetidin Sinequana increases the concentration in plasma, and enhances its main side effect. Patients with diabetes with co-application with tolazamidom may develop pronounced hypoglycemia. If you are applying Sinequana with chlorpromazine developed giperpireksiya.

Dosing and Administration in Adults

When moderately expressed, and the degree of depression or anxiety Sinequan initial dose, with ingestion of 75 mg / day. In the future, gradually picked up individually effective dose (usually 75-150 mg / day).

When the degree of depression and / or anxiety Sinequana effective dose can be as high as 300 mg / day. In patients with a minimally effective dose expressed violations - 25-50 mg / day.

Take inside 1-2 times / day (with a single admission in the course of the day dose Sinequana should not exceed 150 mg).

In most of the disorders of sleep daily dose taken at night.

Dosing and Administration in pediatric practice

Suitable for children over 12 years.

Pregnancy and lactation

Pregnancy and lactation are contraindications.


Drowsiness, stupor, hallucinations, visual impairment, the expansion of pupils, dry mouth, nausea, respiratory depression, severe arterial hypotension, coma, convulsions, muscle rigidity, tachycardia, arrhythmias, typical of the tricyclic antidepressant intoxication ECG changes (especially the QRS).


When treating Sinequanom should not engage in activities that require high concentration and rapid psychomotor reactions, increased rate of mental and motor responses.

During the period of treatment is not allowed alcohol, use of MAO inhibitors.