You should not take Aponal if you have glaucoma or problems with urination.
Aponal is safe for elderly people, but there may be an increased risk of confusion or drowsiness. Dosing may also differ due to decreased kidney function or heart problems.
Aponal is not approved for use in children under age 12.
Do not use if you are allergic to Aponal or to similar medications such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).
Do not use Aponal if you have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days. A dangerous drug interaction could occur.
- Furazolidone (Furoxone)
- Isocarboxazid (Marplan)
- Linezolid (Zyvox)
- Phenelzine (Nardil)
- Rasagiline (Azilect)
- Selegiline (Emsam)
- Tranylcypromine (Parnate)
Report any new or worsening symptoms to your doctor, including:
- Behavior or mood changes, such as feeling impulsive, irritable, agitated, hostile, aggressive, or restless
- Panic attacks
- Trouble sleeping
- Increased depression
- Suicidal thoughts or thoughts of harming yourself
- Hyperactivity (mental or physical)
To make sure Aponal is safe for you, tell your doctor if you have:
- Sleep apnea (breathing stops during sleep)
- Diabetes (Aponal may raise or lower blood sugar)
- Bipolar disorder (manic-depression)
Some children, teenagers, and young adults have thoughts of suicide when first taking an antidepressant.
Your doctor will need to check your progress at regular visits while you are using Aponal.
Your family or other caregivers should also be alert to changes in your mood or symptoms.
Aponal overdose occurs when someone takes more than the normal or recommended amount of this medicine, either by accident or on purpose. Toxic level of a tricyclic antidepressant can build up in the body if the tricyclic antidepressant and other medicines interact. This interaction can affect how well the body can break down the tricyclic antidepressant.
Symptoms of Aponal overdose may include:
- irregular heart beat
- feeling agitated, confused, or drowsy
- trouble concentrating
- muscle stiffness
- increase in pupil size
- hallucination (seeing things or hearing voices that do not exist)
- cold body temperature
- coma (loss of consciousness for a period of time).
Get medical help right away. DO NOT make the person throw up unless poison control or a health care provider tells you to.
Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
AIRWAYS AND LUNGS
- Slow breathing
- Difficulty breathing
BLADDER AND KIDNEYS
- Hard to start urinating
- Hard to empty bladder
EYES, EARS, NOSE, AND THROAT
- Blurred vision
- Ringing in the ears
HEART AND BLOOD
- Irregular heartbeat (may be fatal)
- Low blood pressure
MOUTH, STOMACH, AND INTESTINAL TRACT
- Dry mouth
- Nausea and vomiting
- Unpleasant taste in mouth
- Agitation, confusion
- Drowsiness, decreased alertness, coma
- Muscle rigidity, lack of coordination
- Very sensitive to sunlight
Rated Aponal (Silenor) for Insomnia Report
Started taking 25mgs at night, worked for a month then I was up most of the night, so the doctor up the dose to 75mgs like the first dose worked for a month, I would sleep for 3hrs a night and be up the rest of the night I would be up for the whole day, so doctor up dose to 100mg where I been on it for over a year, this is what upsets me I had weight lost surgery do to health issues, I have lost a lot of weight, I felt good and so proud, after this is when I was put on this so called Med. I have gain 50lbs from taking this med, I have now anger issues, my doctor told me this is a side effect and should get better, why would they put someone that had weight loss surgery on this med. Knowing it causes weight gain, and anger issues, I fought so hard to before and after weight loss surgery, I'm very upset over this, it makes it seem that weight loss surgery was for nothing, my boyfriend doesn't understand why I'm so angry now he does, I would tell people to stay away from this drug it is bad, talking with doctor this month and telling them I'm not going to take this medicine anymore there is meds that have no weight gain, all I want to do is get some sleep and not gain weight
Why it’s used
Aponal oral capsule is used to treat mood disorders, such as depression and anxiety.
Dosage for anxiety
Adult dosage (ages 18 to 64 years)
- Typical starting dosage: 75 mg per day. Your doctor may tell you to take the entire dose at once, or divide it into smaller doses throughout the day.
- Dosage adjustments: Your doctor will adjust your dosage depending on how your body responds to the drug. The usual dosage range is 75 to 150 mg per day. For severe anxiety, your doctor may increase your dosage to 300 mg per day. For very mild anxiety, dosage as low as 25 to 50 mg per day may be used.
- Maximum dosage: 300 mg per day. If given once daily, the maximum dosage is 150 mg per day, which may be given at bedtime.
Child dosage (ages 0 to 17 years)
It isn’t known if Aponal is safe and effective for children younger than 18 years.
FDA warning: Suic >
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- This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
- Antidepressant drugs, such as Aponal, may cause you to have suicidal thoughts or behaviors. This risk may be especially high during the first few months of treatment or when changing doses. Children, teenagers, and young adults have an increased risk. You and your family members, caregivers, and doctor should pay attention to changes in your mood, behaviors, thoughts, or feelings while you take this drug.
Q: I take Aponal daily to help me sleep and help pain due to fibromyalgia. I know from taking it previously for depression that it makes me crave sweets and have a huge appetite. I found out I had diabetes last year. I am wondering if the Aponal is making my weight fluctuate? I have lost 50 lbs, but have not been able to lose any more.
A: Aponal is in a drug class called tricyclic antidepressants. Aponal is used to treat depression and anxiety, which may be associated with a variety of conditions. Aponal works by increasing certain natural brain substances, which are needed for mental health. According to Aponalâ€™s prescribing information, weight gain has been occasionally observed as a side effect of Aponal. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. There are many causes of weight fluctuations. Derek Dore, PharmD
SINEQUAN is available as capsules containing Aponal HCl equivalent to:
10 mg – 100's (NDC 0049-5340-66) 25 mg – 100's (NDC 0049-5350-66) 50 mg – 100's (NDC 0049-5360-66) 75 mg – 100's (NDC 0049-5390-66) 100 mg – 100's (NDC 0049-5380-66) 150 mg – 50's (NDC 0049-5370-50)
SINEQUAN Oral Concentrate is available in 120 mL bottles (NDC 0049-5100-47) with an accompanying dropper calibrated at 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg. Each mL contains Aponal HCl equivalent to 10 mg Aponal. Just prior to administration, SINEQUAN Oral Concentrate should be diluted with approximately 120 mL of water, whole or skimmed milk, or orange, grapefruit, tomato, prune or pineapple juice. SINEQUAN Oral Concentrate is not physically compatible with a number of carbonated beverages. For those patients requiring antidepressant therapy who are on methadone maintenance, SINEQUAN Oral Concentrate and methadone syrup can be mixed together with Gatorade®, lemonade, orange juice, sugar water, Tang®, or water; but not with grape juice. Preparation and storage of bulk dilutions is not recommended.
Distributed by: Roerig, Division of Pfizer Inc, NY, NY 10017. June 2014
Before taking Aponal,
- tell your doctor and pharmacist if you are allergic to Aponal, amoxapine, loxapine, any other medications, or any of the ingredients in doxapine capsules, or concentrate.
- tell your doctor if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or if you have stopped taking an MAO inhibitor within the past 14 days. Also tell your doctor if you are taking or receiving methylene blue (Provayblue) or linezolid (Zyvox). Your doctor will probably tell you not to take Aponal. If you stop taking Aponal, you should wait at least 14 days before you start to take an MAO inhibitor.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antipsychotics such as chlorpromazine, fluphenazine, perphenazine, prochlorperazine (Compro, Procomp), thioridazine, trifluoperazine ; bupropion (Wellbutrin, Zyban, others,in Contrave); cimetidine (Tagamet); duloxetine (Cymbalta); flecainide (Tambocor); propafenone (Rythmol); quinidine (in Nuedexta); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); and tolazamide (Tolinase). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Your doctor may tell you not to take Aponal if you have taken fluoxetine in the past 5 weeks.
- tell your doctor if you have glaucoma or difficulty urinating. Your doctor will probably tell you not to take Aponal.
- tell your doctor if you have or have ever drunk large amounts of alcohol, , or have or have ever had asthma, or liver or kidneydisease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking this medication, call your doctor.
- talk to your doctor about the risks and benefits of taking Aponal if you are 65 years of age or older. Older adults should not usually take Aponal because it is not as safe or effective as other medications that can be used to treat the same condition.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- ask your doctor about the safe use of alcoholic beverages while you are taking Aponal. Alcohol can make the side effects from Aponal worse.
- you should know that Aponal may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.