Doxepin (DEPTRAN 50 doxepin 50mg (as hydrochloride) tablet blister pack)
What to know about Doxepin — also sold as DEPTRAN 50 doxepin 50mg (as hydrochloride) tablet blister pack, DEPTRAN 75 doxepin 75mg (as hydrochloride) tablet blister pack, DEPTRAN 25 doxepin 25mg (as hydrochloride) capsule blister pack: uses, side effects, interactions, and safety considerations for people taking it or caring for someone who is.
Doxepin (brand names: DEPTRAN 50 doxepin 50mg (as hydrochloride) tablet blister pack, DEPTRAN 75 doxepin 75mg (as hydrochloride) tablet blister pack, DEPTRAN 25 doxepin 25mg (as hydrochloride) capsule blister pack) is classified as Moderate risk (3 risk points) by AllMeds. It is a S4 medication under the TGA in Australia. FDA approved in the United States. Tricyclic antidepressant with strong sedating effects and anticholinergic properties impacting work safety.
Key Takeaways
- TGA Schedule: S4 in Australia
- Risk level: Moderate (3 points)
- CNS depressant: May cause sedation, impair driving, and affect work capacity
- Serotonergic: Risk of serotonin syndrome when combined with other serotonergic drugs
- Recommended maximum duration: 90 days
Scheduling and Classification
| Jurisdiction | Classification | Status |
|---|---|---|
| Australia (TGA) | S4 | Not PBS listed |
| United States (FDA) | Rx only | FDA approved |
Risk Profile
Tricyclic antidepressant with strong sedating effects and anticholinergic properties impacting work safety.
How Doxepin is regulated
Doxepin is overseen by medicines regulators in each country. The rules below explain how it's scheduled, what oversight applies, and what to discuss with your doctor or pharmacist before starting, changing, or stopping this medication.
Work capacity impact: As a CNS depressant, Doxepin may impair driving, operating machinery, and cognitive function. Work capacity certificates should reflect any medication-related restrictions.
Australia TGA / PBS / State Schemes
Classified as S4 under the Therapeutic Goods Administration (TGA).
SIRA best practice guidelines recommend a maximum opioid duration of 90 days for acute pain. Prescribing beyond this requires documented clinical justification and may trigger a Reasonable and Necessary determination.
WorkSafe Victoria Drugs of Dependence Guidelines require monitoring for all S8 opioids. WorkCover QLD Pain Intervention Guidelines recommend multimodal pain management with opioids as a last resort.
United Kingdom NICE / MHRA / FPM
NICE NG193 (Chronic Pain) recommends against initiating opioids for chronic primary pain. The Faculty of Pain Medicine (FPM) Opioids Aware resource recommends structured opioid prescribing with regular review, dose limits, and documented tapering plans.
For personal injury claims in the UK, opioid prescribing duration and dose should be reviewed against NICE and FPM guidelines. Costs may be recoverable as a disbursement in high-value PI claims.
NICE guidelines recommend certain antidepressants (amitriptyline, duloxetine) for chronic pain management. For personal injury claims, antidepressant prescribing should be assessed for injury relatedness.
UK drug driving laws (Section 5A Road Traffic Act 2006) set specific limits for prescription drugs that cause impairment. Employers and occupational health advisors should assess fitness to work.
United States FDA / CDC / State WC
FDA approved for use in the United States.
The CDC Clinical Practice Guideline for Prescribing Opioids (2022) recommends non-opioid therapies as first-line treatment for pain. When opioids are prescribed, the lowest effective dose should be used for the shortest duration needed.
For workers compensation claims, many states require prior authorization for opioids beyond initial acute prescribing. State drug formularies (e.g. California MTUS, Texas, New York) may restrict or require step therapy before opioid approval.
New Zealand ACC / BPAC NZ / Medsafe
BPAC NZ recommends reassessing opioid therapy at regular intervals and limiting duration. The NZ Opioid Prescribing B-QuiCK Guide provides structured prescribing and tapering protocols.
ACC (Accident Compensation Corporation) covers treatment-related medications for accepted claims. Opioid prescribing beyond guidelines may require ACC clinical review and approval.
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Important: This page is general health information, not personal medical advice. If you have questions about your medication — including starting it, stopping it, changing the dose, or combining it with something else — speak with your doctor or pharmacist. For an emergency or suspected overdose, call your local emergency number or poison information service immediately. Information is drawn from regulator and clinical guideline sources (TGA, FDA, MHRA, NICE, PBS, CDC); see our methodology for details.