Comprehensive medication guide to Silenor including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic doxepin on Tier 1–2 of most commercial plans; brand Silenor typically requires prior authorization and may have a $32–$80 copay on plans that cover it.
Estimated Cash Pricing
$500–$650 retail for brand Silenor; as low as $43–$46 for generic doxepin 3 mg or 6 mg tablets with GoodRx or SingleCare coupons for a 30-day supply.
Medfinder Findability Score
72/100
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Silenor is a brand-name prescription sleep medication that contains doxepin at low doses of 3 mg or 6 mg. It is FDA-approved for the treatment of insomnia characterized by difficulties with sleep maintenance — meaning it is specifically designed to help adults who wake up in the middle of the night or too early in the morning and cannot return to sleep.
Originally approved by the FDA in March 2010 and now manufactured by Currax Pharmaceuticals, Silenor represents a novel use of doxepin — a tricyclic antidepressant that has been used since 1969. At the much lower insomnia doses (3–6 mg vs. 75–300 mg for depression), doxepin acts primarily as a selective histamine H1 receptor antagonist rather than an antidepressant.
Generic versions of low-dose doxepin tablets (3 mg and 6 mg) became available in 2020 and are therapeutically equivalent to brand Silenor. They are more widely available at pharmacies and significantly less expensive.
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At the 3–6 mg insomnia doses, Silenor works by blocking histamine H1 receptors in the brain with extremely high affinity (Ki < 1 nM). Histamine is a wake-promoting neurotransmitter whose activity naturally increases during the later part of the night. By blocking these receptors, Silenor reduces the brain's wake-promoting signals, allowing patients to maintain sleep — particularly in the second half of the night.
This mechanism is distinct from benzodiazepines and Z-drugs (which enhance GABA-A receptor activity), from melatonin receptor agonists like ramelteon, and from orexin receptor antagonists like suvorexant (Belsomra). Clinical trials demonstrated that Silenor increases total sleep time by 25–57 minutes versus placebo and reduces nighttime awakenings.
Unlike Z-drugs and benzodiazepines, Silenor does not cause tolerance or physical dependence. Studies of up to 3 months showed no rebound insomnia or withdrawal symptoms when the medication was discontinued — making it suitable for longer-term use than many other sleep aids.
3 mg — tablet
Starting dose for patients 65 and older; may be used in adults who need a lower starting dose
6 mg — tablet
Standard adult dose; take within 30 minutes of bedtime, not within 3 hours of a meal
Silenor is not on the FDA's active drug shortage list as of 2026. However, many patients still struggle to find it at local pharmacies. Brand Silenor is stocked at relatively few retail pharmacy locations due to low prescription volume — in 2023, only about 3,019 thirty-day supplies of brand Silenor were dispensed nationwide. Generic doxepin low-dose tablets are more widely available and stocked at more pharmacies, but still not universal.
Silenor's findability score is 72 out of 100 — indicating it is generally available as a generic, but brand Silenor and low-dose tablets specifically may require extra effort to find. Independent pharmacies and mail-order pharmacies tend to be more reliable sources.
If you're having trouble finding Silenor or generic doxepin at a pharmacy near you, medfinder contacts pharmacies in your area to check which ones have your medication in stock and sends results directly to your phone.
Because Silenor (doxepin) is not a DEA-scheduled controlled substance, any licensed prescriber in all 50 states can prescribe it without special registration, triplicate requirements, or quantity restrictions. This broad prescribing access makes Silenor particularly flexible for patients.
Primary care physicians (family medicine, internal medicine, general practitioners)
Psychiatrists
Sleep medicine specialists
Geriatricians
Neurologists
Nurse practitioners (NPs)
Physician assistants (PAs)
Silenor is also available via telehealth. Because it is not a controlled substance, it can be evaluated and prescribed through telehealth video visits in all 50 states without the prescribing restrictions that apply to Schedule IV sleep medications. Platforms that commonly prescribe insomnia medications include Teladoc, MDLive, Cerebral, Talkiatry, and many primary care telehealth services.
No. Silenor (doxepin) is not a DEA-scheduled controlled substance. This distinguishes it from most other prescription sleep medications, including zolpidem (Ambien), eszopiclone (Lunesta), temazepam, suvorexant (Belsomra), and lemborexant (Dayvigo) — all of which are Schedule IV controlled substances.
Because Silenor is non-controlled, it can be prescribed without special DEA registration requirements, refilled without restriction on quantity or number of refills, prescribed through telehealth platforms in all 50 states, and transferred between pharmacies without the limitations that apply to controlled substances. It also carries no risk of physical dependence or addiction.
Silenor is one of only two FDA-approved insomnia medications that are not DEA-scheduled — the other being ramelteon (Rozerem). This non-controlled status makes Silenor particularly accessible for patients who prefer to avoid controlled substances or who use telehealth for their healthcare needs.
Silenor has one of the most favorable side effect profiles among prescription sleep medications. In clinical trials, approximately 1% of patients withdrew due to side effects — one of the lowest discontinuation rates for any hypnotic. Common side effects include:
Drowsiness or somnolence (most common)
Nausea
Dizziness
Upper respiratory tract infection (at similar rates to placebo in trials)
Complex sleep behaviors (sleep-driving, sleep-eating, sleep-walking) — rare, more likely with alcohol or other CNS depressants
Worsening of depression or suicidal ideation (boxed warning — particularly in patients under 25)
Urinary retention (particularly in older men or patients with prostate issues)
Angle-closure glaucoma attack (contraindicated in untreated narrow-angle glaucoma)
Severe allergic reaction (rash, swelling, difficulty breathing)
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Suvorexant (Belsomra)
Dual orexin receptor antagonist; FDA-approved for sleep onset and maintenance; Schedule IV controlled substance; costs $350–$450/month brand
Lemborexant (Dayvigo)
Dual orexin receptor antagonist; FDA-approved for sleep onset and maintenance; Schedule IV; costs $350–$400/month brand
Daridorexant (Quviviq)
Newest dual orexin receptor antagonist (approved 2022); FDA-approved for sleep onset and maintenance; Schedule IV
Ramelteon (Rozerem)
Melatonin receptor agonist; not a controlled substance; FDA-approved for sleep onset only (not maintenance); generic available ~$15–$50/month
Eszopiclone (Lunesta)
Z-drug GABA-A modulator; FDA-approved for sleep onset and maintenance; Schedule IV; generic available ~$20–$40/month with coupons
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MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline)
majorAbsolute contraindication. Combining doxepin with MAOIs can cause severe, potentially fatal cardiovascular reactions, hyperthermia, and seizures. Do not use within 2 weeks of MAOI therapy.
Cimetidine (Tagamet)
majorSignificantly increases doxepin plasma levels by inhibiting CYP2D6 and CYP2C19 metabolism. May cause excessive sedation. Avoid or reduce doxepin dose if cimetidine is used.
Alcohol and CNS Depressants
majorAdditive sedation; significantly increases risk of complex sleep behaviors (sleep-driving, sleep-eating). Avoid alcohol on nights when taking Silenor.
CYP2D6 inhibitors (fluoxetine, paroxetine, bupropion)
moderateInhibit doxepin metabolism, increasing plasma levels and risk of side effects. Monitor closely; dose adjustment may be needed.
Serotonergic drugs (SSRIs, SNRIs, triptans)
moderateTheoretical serotonin syndrome risk at higher doxepin doses; at 3-6 mg insomnia dose, interaction risk is low but should be disclosed to prescriber.
Opioid pain medications
moderateAdditive CNS depression. Reserve combination for patients with no adequate alternative; limit doses and monitor for respiratory depression.
Silenor (doxepin) occupies a unique position among sleep medications: it is FDA-approved specifically for sleep maintenance insomnia, is not a controlled substance, carries no dependence or addiction risk, and has a remarkably clean side effect profile at its therapeutic doses. These features make it a particularly appealing option for patients who want an effective sleep aid without the complications of Schedule IV drugs.
The main practical challenges with Silenor in 2026 are cost and availability. Brand Silenor is expensive ($500–$650/month retail) and not stocked at many pharmacies. Generic doxepin low-dose tablets are the solution to both issues — same medication, more accessible, and far less expensive at $43–$46/month with GoodRx coupons. Most patients and providers should default to generic doxepin unless there is a specific reason to use the brand.
If you've been prescribed Silenor and can't find it at your pharmacy, medfinder can help. Enter your medication, dosage, and location, and medfinder contacts nearby pharmacies to find which ones have it in stock — then sends you the results by text.
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