Drug Index


Mechanism :

Dothiepin hydrochloride is an antidepressant of the tricyclic family. The clinical effect is due to potentiation of adrenergic synapses by blocking uptake of norepinephrine at nerve endings. Also blocks uptake of serotonin.

Indication :

  • Depression
  • Bruxism

Contraindications :

Dothiepin is contraindicated in patients who have shown prior hypersensitivity to it and in acute porphyria, hepatic impairment and cardiovascular disease.

Dosing :

12-18 years:
50-75 mg at bedtime or in divided doses orally. Max dose: 150 mg/day.

Adverse Effect :

Mainly anticholinergic effects, sedation, postural hypotension, tremor, sweating, arrhythmia, increased appetite and weight gain, sexual dysfunction and lowered seizure threshold.

Interaction :

MAOIs: Hyperpyretic crises, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressant and monoamine oxidase inhibiting drugs simultaneously.
OCPs, Calcium Channel Blockers, Cimetidine, Phenothiazines, SSRIs: Plasma concentration of imipramine increased.
Rifampicin, Anti-Coagulants: Decreased plasma concentration of Imipramine.
Sedatives, Hypotensives, Drugs that Prolong QT Interval: Increased effects of these drugs.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Start with small dose, and titrate according to response
<10Start with small dose, and titrate according to response

Dose in Patients undergoing Renal Replacement Therapies
CAPDNot dialysed. Dose as in GFR<10 mL/min
HDNot dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnknown dialysability. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Use is not recommended in hepatic impairment. There is increased risk of toxicity due to impaired metabolism.
01/19/2024 00:17:55 Dothiepin
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