Learning about Amoxapine dosage and directions

Effective Amoxapine dosage can vary from one person to another. It is always better to check with your doctor before you start using Amoxapine. The right dosage can give you maximum benefits whereas overdose can lead to many other complications. Let us learn about the Amoxapine right dosage and directions.

Normal effective dose is

200-300mg on a daily basis

Three weeks is a sufficient period of trial, providing dosage reaches 300 mg daily for minimum 2 weeks. If the desired response is not seen at 300mg, the dosage can be increased, based on patient’s tolerance say up to 400mg daily.

Patients who are hospitalized and are unmanageable to antidepressant therapy and do not have history of convulsive seizures can get increased dosage of up to 600mg in split doses. Amoxapine can be prescribed as a single dose of not more than 300 mg to be taken daily ideally at bedtime.

Starting doses for Adults

Normal starting dose is

50 mg twice or thrice a day

Based on tolerance, dosage can be increased to 100mg – twice or thrice a day till end of the first week. An increased dose above 300mg is given only when the dose of 300mg proves to be ineffective during the test period of minimum two weeks. When effective dose is built, the drug can be given as a single dose of not more than 300mg during bedtime.

Elderly patients

Generally, low dosages are prescribed for elderly patients. Initial Amoxapine dose recommended is

25mg – twice or thrice a day

If no tolerance is noticed, dosage can be increased at the end of first week to 50mg twice or thrice a day. Although 100-150mg daily dosage is sufficient for a lot of elderly patients, some of them may need higher dosage. Cautious increases up to 300mg on a daily basis are suggested in such cases.

When an effective dose is reached, the Amoxapine single dose of not exceeding 300 mg can be given at bedtime.

Maintenance

Suggested maintenance Amoxapine dosage is the lowest possible dose that can maintain remission. If symptoms come back again, dosage needs to be decreased to the earlier dose until the symptoms are controlled.

Amoxapine Over dosage treatment

Amoxapine over dosage treatment should be supportive and symptomatic, with a special medical care to control or prevent seizures. If patient has lost his consciousness, induced emesis accompanied by gastric lavage with necessary precautions to avoid pulmonary aspiration should be achieved faster. During the process of lavage, activated charcoal can be regulated to reduce absorption and repeated supervision can help in eliminating drug from the patient’s body.

A sufficient airway should be built in patients who are in coma and supported ventilation if required. Seizures can respond to usual anticonvulsant   therapy like intravenous phenytoin and diazepam. Convulsions normally appear after 12 hours of drug ingestion.

In case of symptoms of Amoxapine over dose, immediately call medical help so that the patient gets treatment in time. This can help avoid fatal complications.

Is Amoxapine safe for use in pregnant women and nursing mothers?

Many women during their pregnancy experience different types of pain like pelvic pain, knee pain, back pain etc., which is due to the hormonal changes in their body and weight gain during pregnancy. Apart from pain, many women also face depression during their pregnancy or breastfeeding. In both phases of their lives, it becomes difficult to decide which medications they should consider to eradicate pain or manage depression.  During pregnancy or breastfeeding a woman has to always think about her baby before taking any medication as they are not aware about how the medication is going to work for them or their baby.

While pregnancy is believed to be the period of joy, but this is not the case for every woman.  At least one out of 10 pregnant women suffer from depression. Due to the fluctuation in hormones during pregnancy, many women face depression.

Same thing can happen in case of nursing mother who after the birth of their baby find it difficult to manage depression. In such situations both nursing mothers and pregnant woman often opt for a medication like Amoxapine to manage depression.

Amoxapine and Pregnancy

There are still no sufficient studies available that can justify the use of Amoxapine in pregnancy. Amoxapine should be taken during pregnancy only if has high benefits than risk for you and your baby. Speak to your doctor if you want to use Amoxapine. Use Amoxapine only if your doctor recommends you.  If you are already using Amoxapine and get pregnant, let your doctor know that you are pregnant.

Amoxapine and Breastfeeding

Since it is not easy for nursing mothers to manage depression and care for their babies, they always look for a medication that can control their depression levels without knowing how it is going to affect the lactation or baby’s health.

Amoxapine like any other drugs get transferred into breast milk. Since the effect of Amoxapine on infants is still not known, doctors should take extra caution before prescribing Amoxapine to nursing mothers.  There are possibilities of serious effects to the baby, so speak to you paediatrician before using Amoxapine.

Not adequate research is available on use of this medication in nursing women. It is still not clear how much Amoxapine gets transferred into breast milk and if it is harmful for the baby. It is safer to consult your health care provider as each case is different and based on the medical condition, your doctor can decide whether to take Amoxapine during breastfeeding or not.

It also depends on your current health situation as what is the right dose for you and if you can continue with breastfeeding. You wouldn’t want to harm your baby isn’t? So you can also try alternative medications that can manage depression and would not harm your baby. Speak to your doctor to suggest you safe alternative medications so that you can avoid taking Amoxapine during breastfeeding as Amoxapine comes with a lot of side effects too, which can be troublesome for you while you are taking care of your baby.

Desired effects accompany unwanted side effects too- Amoxapine

Like any other antidepressants, Amoxapine too comes with unwanted side effects. If you are using Amoxapine to get needed effects, then do not forget you should also need to check for the possible and unwanted side effects that accompany the desired effects. This article will help you know about common, major, minor, overdose and other side effects related to Amoxapine.

Commonly reported Amoxapine side effects include drowsiness. Other side effects:  blurred vision

Major Side effects that need immediate medical help are

  • nightmares
  • excitement
  • mental or mood changes
  • trouble sleeping
  • unsteady walk
  • nervousness or fear
  • racing,, pounding, irregular, fast pulse or heartbeat
  • restlessness
  • swelling
  • trembling, unsteadiness or problems like muscle coordination or control
  • shakiness in feet, hand arms and legs

Rare

  • bloating
  • stomach or abdominal pain
  • blurred vision
  • discomfort or chest pain
  • bleeding gums
  • tarry, black stools
  • stomach or abdominal pain
  • chills
  • discomfort or chest pain
  • confusion
  • crawling,, itching, burning, tingling or prickling feelings
  • blood in stools or urine
  • constipation
  • convulsions
  • confusion about time, place or identity
  • hoarseness or cough
  • continuing buzzing or ringing or other noise in ears
  • dark urine
  • drooling
  • double vision
  • disturbed concentration
  • breathing problems
  • dribbling
  • extremely high body temperature or fever
  • weak or fast heart beats
  • fever without chills or with chills
  • headache
  • high fever
  • hearing loss
  • increasing sweating
  • welts or hives
  • itching
  • irritability
  • indigestion
  • appetite loss
  • muscle cramps
  • numbness
  • nervousness
  • clammy or pale skin
  • skin redness
  • sweating
  • thirst
  • swollen glands
  • yellow skin or eyes

Overdose symptoms which can be quite severe and need immediate medical attention are

  • drowsiness
  • fatigue
  • increased thirst
  • increased BP
  • complete body jerking
  • weight gain
  • breathing problems
  • swelling of lower legs, face or fingers
  • epileptic seizures which doesn’t stop

Minor Side effects

Some minor side effects do not need medical attention and vanish with time. These side effects disappear as your body gets used to the medication. But if these side effects last for long and become troublesome, speak to your doctor immediately.

More Common

  • dry mouth

Less Common

  • increased flow of milk from breast
  • increased appetite

Rare

  • breast enlargement
  • agitation
  • full feeling
  • decreased in intercourse(sexual)
  • depression
  • excess gas or air in intestines or stomach
  • menstrual changes
  • increased skin sensitivity to sunlight
  • increased sexual ability, drive, desire or performance
  • heartburn
  • thinning of hair or hair loss
  • passing gas
  • nasal stuffiness
  • painful ejaculation
  • stupor
  • severe sunburn
  • seizures
  • fast weight gain
  • discoloration or redness of skin

In case you experience side effects that you think are severe and need medical attention, do not ignore them as need immediate medical treatment.

Amoxapine drug interactions that can lead to complications

Some medicines can interact with Amoxapine. Let your health care provider know if you are using any other medications like

  • Antiarrhythmics
  • fluconazole
  • SSRIs like fluoxetine
  • ketolides or macrolides (e.g., erythromycin)
  • H1 antagonists like  astemizole
  • mibefradil, linezolid
  • MAOIs like phenelzine
  • phenothiazines like thioridazine
  • terbinafine or quinidine
  • carbamazepine
  • fluconazole
  • cimetidine

The above drugs can interact with Amoxapine to result in side effects like low blood pressure, sedation, serious heart problems.

Quinidine

Using this drug with Amoxapine can increase the Amoxapine levels in your body. This leads to increased side effects of Amoxapine like sleeping problems, irritability and tardive dyskinesia (a movement disorder of face and mouth)

Barbiturates (pentobarbital, butalbital, mephobarbital and phenobarbital)

Using these drugs with Amoxapine can increase drowsiness and sedation.

Alcohol

Drinking alcohol with Amoxapine can cause drowsiness and sedation.

Cimetidine

Taking this medication with Amoxapine can increase Amoxapine levels in the body. This can lead to dry mouth and drowsiness.

Antiarrhythmics (flecainide and propafenone)

Using these drugs with Amoxapine can increase Amoxapine levels in the body, which can lead to dry mouth and drowsiness.

Amoxapine and albuterol

Taking Amoxapine and albuterol together can increase cardiovascular problems like irregular heartbeat, chest pain, heart palpitations, increase pulse or heart rates and increased blood pressure.  Speak to your physician before using these drugs together, especially if you have a history of heart disease or blood pressure.  The risk is there even when albuterol or other similar medications are given via oral inhalation that directly goes into the lungs or if the medications are used in high doses. Avoid using the medications in excess or changing the dose frequency. Do not change your dose or frequency without discussing with your health care provider.

Also inform your doctor about any other medication that you are using currently and do not try to stop taking the medication suddenly without consulting your physician.

Amoxapine and Diazepam

Taking diazepam with Amoxapine can increase the risk of some side effects like confusion, drowsiness, dizziness and difficulty in concentrating. In some cases, elderly patients can experience impairment in motor coordination, judgement or thinking.  Avoid the use of alcohol while you are on these medications.  Do not perform activities that need high alertness like driving etc till the time you are not sure how medication works for you. Let your health care provider know if you are using herbs, vitamins or other medications.

Your doctor can help you know about the possible Amoxapine drug interactions so that you can use the drug with caution.

Anticoagulants like warfarin or sympathomimetics like pseudoephedrine, amphetamine, albuterol as side effects and actions can increase due to Amoxapine.

Guanfacine guanethidine and Clonidine

Its effectiveness can be reduced by Amoxapine. Amoxapine when taken with Clonidine can lower the effects of Clonidine resulting in low blood pressure.

The sedative effect of this medication is increased by certain CNS depressants like sedatives, sleeping medications, alcohol or medications used for some mental disorders like schizophrenia. With other anticholinergic medications the anticholinergic effect of Amoxapine gets increased.

Amoxapine – A tricyclic antidepressant used to manage depression

Depression is a serious mood disorder that leads to severe symptoms that need immediate treatment. Amoxapine is an effective tricyclic antidepressant used to manage depression. The generic name is Amoxapine and there are no brands available for this medication.

Some important Information

Avoid using Amoxapine if

  • You are allergic to any specific ingredient present in Amoxapine.
  • You are regaining health after an heart attack
  • You have used linezolid or you were on MAO inhibitor or linezolid in past 14 days.

In above cases discuss with your doctor before using Amoxapine.

There are certain medical conditions that can interact with Amoxapine. Speak to your pharmacist or doctor if you have any of the below listed medical conditions

  • if you are planning to conceive or if you are pregnant or a nursing mother
  • If you are using any non prescription/prescription medication, herbal medicines or dietary supplements.

If you consume alcohol based beverages regularly or have a history of alcohol addiction

  • If you are allergic to the medication, certain foods or other substances
  • If you a history of thyroid problems, heart problems, glaucoma, enlarged prostate, blood problems or urinating problems.
  • If you have a history of suicidal behaviour or thoughts, mental disorders, seizures or bipolar disorders.
  • If you are receiving electroshock therapy or about to undergo any surgery.
  • If you are using medicine that consists of methylene blue.

Use Amoxapine as recommended by your physician. Read the label and follow the dosing instructions carefully. Take Amoxapine orally without or with food.  If stomach upset happens, take it with food to reduce stomach irritation. Do not stop Amoxapine even if you start feeling better. It can take several weeks to get the maximum benefit of Amoxapine.

You can take Amoxapine at bed time to reduce possible side effects.

Amoxapine addiction is reported by a few so avoid taking Amoxapine in high doses. Amoxapine can lead to blurred vision; light headedness, drowsiness and these effects get worse if you use this medicine with alcohol or certain medications. Avoid drinking alcohol if you are taking Amoxapine. Be careful when rising from standing or sitting position to reduce side effects. Some patients often experience uncontrolled muscle movements, which is common in elderly patients.  This problem can last for long if Amoxapine is taken in high doses or for a prolonged period. Speak to your doctor if symptoms persist so that muscle problems can be treated with the help of low doses of Amoxapine. Let your doctor know if you experience muscle problems with legs, tongue, mouth, jaw, face while using Amoxapine.

Avoid becoming overheated in hot weather or while you are engaged in any activity as heart stroke can occur. Some people are also at risk for problems associated with eyes while using Amoxapine. Your doctor can ask you for an eye exam, so discuss with your doctor if you have pain in eye, changes in vision, redness or swelling around your eye.

Knowing about Antidepressants – Amoxapine

Anti depressants often leads to risks like getting suicidal thoughts in young adults, children and teenagers. Apart from this even mental problems like depression etc can also lead on increased suicide risk. You can speak to the doctor to know the advantages of using  Amoxapine.

Amoxapine is used to treat depression and is a tricyclic antidepressant. It helps increasing some chemicals in your brain and elevates mood. You should not use  Amoxapine if one is recovering from problems like heart attack, have allergies to any of the ingredients present in Amoxapine

If you are planning to use Amoxapine, you need to consider if there is any other medical condition that might interact with Amoxapine and also when

  • You are pregnant, nursing mother or planning pregnancy.
  • Have allergies to foods, medicines or any other substances
  • You are using non prescription or non prescription medicine, dietary supplement or herbal preparation.
  • You consume alcohol or have alcohol abuse in the past.
  • You have history of thyroid problems, heart diseases, glaucoma, urinating problems, enlarged prostate or blood problems.
  • You are going through electroshock therapy or any surgery is scheduled
  • You are using medicine that contains methylene blue.

Side Effects- Amoxapine

If you notice any worsening symptoms like change in behavior, trouble sleeping, anxiety, panic attacks, feel impulsive, irritable, hostile, restless, aggressive, depressed, hyperactive or getting thoughts of committing suicide. Also ask for medical help in case of

  • Fever and skin rash
  • Uncontrolled facial muscle movements like tongue movement , frowning, lip smacking, blinking eye
  • Less urination or no urination
  • Fluttering in chest or pounding heartbeats.
  • Chest pain
  • Sudden weakness/ numbness, slurred speech, problems  with balance or vision
  • Severe reaction in nervous system – high fever, stiff muscles, uneven heartbeats, confusion, sweating, tremors.

Common side effects of Amoxapine are

Blurred vision

Constipation

Drowsiness

Dry mouth

Amoxapine interactions

Avoid alcohol consumption with this medicine as it can lead to serious side effects. The medication also disturbs your reactions and thinking. So you need to be alert while driving. If you are taking this medication along with some other drugs that leave you sleepy can cause serious effects. Check with your doctor before you take Amoxapine with narcotic medicine for pain, sleeping pill, muscle relaxer or medication used for seizures, anxiety or depression.

You should tell your doctor if you are using any current medicines including the medicines that you had started or stopped taking like

Other antidepressants for example bupropion

Drugs for heart rhythm like quinidine, profafenone, flecainide

Urinary or bladder medications like fesoterodine, oxybutynin, tolterodine, solifenacin.

Parkinson’s disease medication

Allergy or cold medication like antihistamine

Bronchodilators like umeclidinium, tiotropium, aclidinium

Motion sickness, stomach ulcer, stomach acid etc., medications.

Amoxapine leads to light headedness, dizziness and fainting and these effects worse in hot weather, due to alcohol intake and fever. In order to avoid these effects, stand slowly and sit up slowly, especially during morning hours so that you may not experience the severe side effects.