Comprehensive medication guide to Doxepin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$15 copay for generic capsules on most insurance plans; covered as Tier 1–2 on most formularies. Brand-name Silenor is covered by ~75% of plans at $32.50–$80 copay with possible step therapy or prior authorization requirements.
Estimated Cash Pricing
$13–$27 retail for generic capsules; as low as $7–$10 with GoodRx or SingleCare coupons for a 30-day supply. Brand-name Silenor 6 mg tablets run $96+ without insurance; generic doxepin tablets at the same dose are a fraction of the cost.
Medfinder Findability Score
75/100
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Doxepin is a tricyclic antidepressant (TCA) that has been FDA-approved since 1969. It is one of the few medications with FDA approval for multiple distinct conditions: major depressive disorder (MDD), anxiety disorders, and insomnia characterized by sleep maintenance difficulties. It is also available as a topical cream (Zonalon, Prudoxin) for itchy skin conditions including atopic dermatitis and lichen simplex chronicus.
Oral doxepin is available as generic capsules (10–150 mg) and oral concentrate for depression and anxiety, and as low-dose tablets (3 mg and 6 mg, brand name Silenor) specifically for insomnia. In 2023, doxepin was the 166th most prescribed medication in the United States with over 3 million prescriptions filled.
Doxepin is not a controlled substance, which distinguishes it from many other sleep medications such as benzodiazepines and Z-drugs (zolpidem, eszopiclone). This makes it accessible through telehealth and refillable without special DEA prescribing requirements.
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Doxepin's mechanism of action differs depending on the dose. At antidepressant doses (75–150 mg/day), doxepin primarily inhibits the reuptake of serotonin and norepinephrine in the brain, increasing the availability of these mood-regulating neurotransmitters in the synaptic cleft. It also blocks H1 histamine receptors, alpha-1 adrenergic receptors, and muscarinic acetylcholine receptors — accounting for its sedative and anticholinergic side effects.
At the very low doses used for insomnia (3–6 mg), doxepin acts almost exclusively as an extremely potent H1 histamine receptor antagonist. Histamine is a key wakefulness-promoting neurotransmitter in the brain; blocking it at this precise dose helps patients stay asleep without producing the excessive sedation of higher doses. Doxepin has one of the highest binding affinities for H1 receptors ever measured (Ki ≈ 0.17 nM) — far greater than over-the-counter antihistamines like diphenhydramine (Ki = 16 nM).
Doxepin is metabolized primarily by the liver enzymes CYP2D6 and CYP2C19. Its half-life is 15–24 hours (parent drug), with an active metabolite nordoxepin at 31 hours, supporting once-daily dosing. Patients who are CYP2D6 poor metabolizers may experience higher plasma levels and increased side effects at standard doses.
3 mg — tablet (Silenor)
FDA-approved for insomnia; taken 30 min before bedtime; starting dose for elderly
6 mg — tablet (Silenor)
FDA-approved for insomnia; standard adult dose; maximum daily dose for insomnia
10 mg — capsule
Lowest capsule dose; for depression/anxiety; often used for dose titration
25 mg — capsule
Common starting dose for depression/anxiety
50 mg — capsule
Mid-range dose for depression/anxiety
75 mg — capsule
Typical target dose for depression/anxiety (once daily)
100 mg — capsule
Higher dose for moderate-severe depression
150 mg — capsule
High dose; often used once daily at bedtime for combined antidepressant and sleep effect
10 mg/mL — oral concentrate
Liquid formulation; mix with water, milk, or juice before taking; useful for precise titration
As of 2026, doxepin is not on the FDA's official Drug Shortage Database. Generic doxepin capsules in common strengths (10–50 mg) are widely available at most major pharmacy chains. However, higher-dose capsules (75–150 mg), the oral concentrate solution, and brand-name Silenor tablets may not be stocked at all pharmacies — particularly smaller independent pharmacies.
The original Sinequan brand was discontinued, which removed a secondary supply source for capsule formulations. Supply disruptions in 2022–2023 caused by a major manufacturer's facility shutdown have largely resolved, but the generic market remains concentrated among a small number of manufacturers, leaving some fragility in the supply chain.
If you're having trouble locating doxepin at your regular pharmacy, medfinder can contact pharmacies near you to find which ones can fill your specific prescription, saving you hours of phone calls.
Doxepin is not a controlled substance, so it can be prescribed by any licensed healthcare provider with prescribing authority without DEA schedule restrictions. Providers do not need a special DEA number or waiver to prescribe doxepin.
The following provider types commonly prescribe doxepin:
Because doxepin is not a controlled substance, it can be prescribed and refilled through telehealth platforms without additional DEA prescribing restrictions. Platforms such as Talkiatry, Teladoc, MDLive, and Brightside can evaluate and prescribe doxepin for appropriate patients via video visit.
No. Doxepin is not a controlled substance and has no DEA schedule. Unlike many other sleep medications (benzodiazepines, zolpidem, eszopiclone) which are Schedule IV, or stimulants which are Schedule II, doxepin is not recognized as having a significant potential for abuse, addiction, or dependence.
This means doxepin can be prescribed without DEA prescribing limitations, can be refilled multiple times on a single prescription (depending on state law), and can be prescribed via telehealth without the additional restrictions that apply to controlled substances. Prescribers can write 90-day supplies and phone-in or electronically transmit prescriptions without a hard-copy requirement.
Note: Doxepin does have a physical dependence potential — meaning abrupt discontinuation after long-term use can cause a discontinuation syndrome (nausea, irritability, insomnia, headache). This is not the same as addiction. Patients should always taper their dose under medical supervision when stopping rather than stopping abruptly.
The following side effects are most commonly reported, particularly at antidepressant doses (25–150 mg):
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Amitriptyline (Elavil)
Most similar TCA; also sedating; used for depression, pain, and insomnia; widely available as generic
Trazodone
Commonly used off-label for insomnia; not a controlled substance; less anticholinergic than doxepin
Sertraline (Zoloft)
SSRI; first-line for depression and anxiety; fewer side effects than doxepin; generic very affordable
Suvorexant (Belsomra)
Orexin receptor antagonist for sleep maintenance insomnia; Schedule IV; different mechanism from doxepin
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MAOIs (phenelzine, tranylcypromine, selegiline)
majorContraindicated; 14-day washout required before and after doxepin; risk of fatal serotonin toxicity
SSRIs (fluoxetine, paroxetine, sertraline)
majorSerotonin syndrome risk; fluoxetine and paroxetine also inhibit CYP2D6, raising doxepin levels
Alcohol and CNS depressants
majorAdditive sedation; respiratory depression risk; avoid alcohol entirely while on doxepin
QT-prolonging drugs
majorAdditive QT prolongation risk; includes some antipsychotics, antibiotics (azithromycin), and antifungals
Cimetidine
moderateIncreases doxepin exposure by inhibiting hepatic metabolism
CYP2D6 inhibitors (bupropion)
moderateIncreases doxepin plasma levels; may require dose reduction
St. John's Wort
majorHerbal serotonin booster; risk of serotonin syndrome with doxepin
Doxepin is a versatile, well-established medication with over 55 years of clinical use. Its unique dual personality — acting as an antidepressant at high doses and a precision sleep-maintenance drug at low doses — makes it valuable across a range of conditions. It is generally affordable as a generic and is not a controlled substance, making it accessible and practical for long-term use.
While availability is generally good in 2026, localized stock gaps can occur — particularly for higher-dose strengths and the oral concentrate. Patients who encounter difficulty at their regular pharmacy should check large chain pharmacies or try mail-order for reliable supply.
If you're having trouble finding doxepin at a pharmacy near you, medfinder can locate pharmacies near you that have your medication in stock — saving you the time and frustration of calling around yourself.
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