Sinquan - Clinical Pharmacology
The mechanism of action of Sinquan hydrochloride is not definitely known. It is not a central nervous system stimulant nor a monoamine oxidase inhibitor. The current hypothesis is that the clinical effects are due, at least in part, to influences on the adrenergic activity at the synapses so that deactivation of norepinephrine by reuptake into the nerve terminals is prevented. Animal studies suggest that Sinquan hydrochloride does not appreciably antagonize the antihypertensive action of guanethidine. In animal studies anticholinergic, antiserotonin and antihistamine effects on smooth muscle have been demonstrated. At higher than usual clinical doses, norepinephrine response was potentiated in animals. This effect was not demonstrated in humans.
At clinical dosages up to 150 mg per day, Sinquan can be given to man concomitantly with guanethidine and related compounds without blocking the antihypertensive effect. At dosages above 150 mg per day blocking of the antihypertensive effect of these compounds has been reported.
Sinquan is virtually devoid of euphoria as a side effect. Characteristic of this type of compound, Sinquan has not been demonstrated to produce the physical tolerance or psychological dependence associated with addictive compounds.
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 Sinquan is safe and effective for children younger than 18 years.
Is Sinquan safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of Sinquan use in pregnant women.
It is not known if Sinquan is secreted in breast milk. There is one report of apnea (cessation of breathing) and drowsiness occurring in a nursing infant whose mother was taking Sinquan.
- Store Sinquan at room temperature between 68°F and 77°F (20°C and 25°C).
- Protect this drug from light.
- Keep this drug in the container it came in, with the lid tightly closed.
- Don’t store this medication in moist or damp areas, such as bathrooms.
Sinquan may cause side effects. Call your doctor if any of these symptoms are severe or do not go away:
- weakness or tiredness
- increase in pupil size
- dry mouth
- mouth sores
- skin more sensitive to sunlight than usual
- changes in appetite or weight
- changes in the way things taste
- difficulty urinating
- excessive thirst and urination
- ringing in your ears
- changes in sex drive
- swollen testicles
- increased breast size
- milky discharge from nipples in females
- excessive sweating
- hair loss
Rated Sinquan (Silenor) for Anxiety Report
Doesn't do anything for me. Still up 3-4 times a night.
Sinquan Sinquan (Sinequan and Adapin are discontinued brands in the US; Silenor) is an antidepressant that belongs to the drug class called tricyclic antidepressants. Sinquan is prescribed for depression, anxiety, bipolar disorder, or depression due to alcoholism or brain damage. Side effects and drug interactions should be reviewed prior to taking this medication.
See also Warning section.
Before taking Sinquan, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (such as nortriptyline); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: bleeding problems, breathing problems, liver problems, recent heart attack, problems urinating (such as due to enlarged prostate), overactive thyroid (hyperthyroidism), personal or family history of glaucoma (angle-closure type), personal or family history of mental/mood conditions (such as bipolar disorder, psychosis), family history of suicide, seizures, conditions that may increase your risk of seizures (such as other brain disease, alcohol/sedative withdrawal).
Sinquan may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using Sinquan, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using Sinquan safely.
This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
If you have diabetes, this drug may make it harder to control your blood sugar levels. Monitor your blood sugar levels regularly and tell your doctor of the results. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
Older adults may be more sensitive to the side effects of this drug, especially dry mouth, dizziness, drowsiness, confusion, difficulty urinating, and QT prolongation (see above).
During pregnancy, this medication should be used only when clearly needed. Since untreated mental/mood problems (such as depression, anxiety) can be a serious condition, do not stop using this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.
This medication passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.
The biochemical activity of the drug metabolizing isozyme cytochrome P450 2D6 (debrisoquin hydroxylase) is reduced in a subset of the Caucasian population (about 7–10% of Caucasians are so-called “poor metabolizers”); reliable estimates of the prevalence of reduced P450 2D6 isozyme activity among Asian, African and other populations are not yet available. Poor metabolizers have higher than expected plasma concentrations of tricyclic antidepressants (TCAs) when given usual doses. Depending on the fraction of drug metabolized by P450 2D6, the increase in plasma concentration may be small, or quite large (8-fold increase in plasma AUC of the TCA).
In addition, certain drugs inhibit the activity of this isozyme and make normal metabolizers resemble poor metabolizers. An individual who is stable on a given dose of TCA may become abruptly toxic when given one of these inhibiting drugs as concomitant therapy. The drugs that inhibit cytochrome P450 2D6 include some that are not metabolized by the enzyme (quinidine; cimetidine) and many that are substrates for P450 2D6 (many other antidepressants, phenothiazines, and the Type 1C antiarrhythmics propafenone and flecainide). While all the selective serotonin reuptake inhibitors (SSRIs), e.g., citalopram, escitalopram, fluoxetine, sertraline, and paroxetine, inhibit P450 2D6, they may vary in the extent of inhibition. The extent to which SSRI-TCA interactions may pose clinical problems will depend on the degree of inhibition and the pharmacokinetics of the SSRI involved. Nevertheless, caution is indicated in the co-administration of TCAs with any of the SSRIs and also in switching from one class to the other. Of particular importance, sufficient time must elapse before initiating TCA treatment in a patient being withdrawn from fluoxetine, given the long half-life of the parent and active metabolite (at least 5 weeks may be necessary).
Concomitant use of tricyclic antidepressants with drugs that can inhibit cytochrome P450 2D6 may require lower doses than usually prescribed for either the tricyclic antidepressant or the other drug. Furthermore, whenever one of these other drugs is withdrawn from co-therapy, an increased dose of tricyclic antidepressant may be required. It is desirable to monitor TCA plasma levels whenever a TCA is going to be co-administered with another drug known to be an inhibitor of P450 2D6.
Sinquan is primarily metabolized by CYP2D6 (with CYP1A2 & CYP3A4 as minor pathways). Inhibitors or substrates of CYP2D6 (i.e., quinidine, selective serotonin reuptake inhibitors ) may increase the plasma concentration of Sinquan when administered concomitantly. The extent of interaction depends on the variability of effect on CYP2D6. The clinical significance of this interaction with Sinquan has not been systematically evaluated.
Rated Sinquan (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
COMMON BRAND(S): Sinequan
GENERIC NAME(S): Sinquan
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. Therefore, it is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition. Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
This medication is used to treat mental/mood problems such as depression and anxiety. It may help improve mood and feelings of well-being, relieve anxiety and tension, help you sleep better, and increase your energy level. This medication belongs to a class of medications called tricyclic antidepressants. It works by affecting the balance of certain natural chemicals (neurotransmitters) in the brain.
Which drugs or supplements interact with Sinquan?
Tricyclic antidepressants , including Sinquan, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants (for example, isocarboxazid , phenelzine , tranylcypromine , selegiline , and procarbazine ) or other drugs that inhibit monoamine oxidase such as linezolid and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. Sinquan should not be administered for at least 14 days after stopping.
Drug that affect heart rhythm such as amiodarone (Cordarone), bepridil (Vascor), and disopyramide (Norpace) should not be combined with Sinquan since it also affects heart rhythm.
Cimetidine (Tagamet) increases the breakdown of Sinquan by the liver and can increase Sinquan blood levels, possibly causing side effects from Sinquan.
Q: What is Sinquan 25 mg used for?
A: Sinquan is in a group of drugs called tricyclic antidepressants. Sinquan affects chemicals in the brain that may become unbalanced. Sinquan is used to treat symptoms of depression and/or anxiety associated with alcoholism, psychiatric conditions, or manic-depressive conditions. Sinquan may also be used for other purposes. Kristen Dore, PharmD
Why it’s used
Sinquan oral capsule is used to treat mood disorders, such as depression and anxiety.
Before taking Sinquan,
- tell your doctor and pharmacist if you are allergic to Sinquan, 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 Sinquan. If you stop taking Sinquan, 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 Sinquan 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 Sinquan.
- 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 Sinquan if you are 65 years of age or older. Older adults should not usually take Sinquan 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 Sinquan. Alcohol can make the side effects from Sinquan worse.
- you should know that Sinquan 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.
How should this medicine be used?
Sinquan comes as a capsule, or concentrate (liquid) to take by mouth. It is usually taken one to three times a day and may be taken with or without food. Try to take Sinquan at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Sinquan exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Sinquan concentrate (oral liquid) comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the concentrate in 4 ounces (120 mL) of water; whole or skim milk; or orange, grapefruit, tomato, prune, or pineapple juice just before taking it. Do not mix it with carbonated beverages (soft drinks).
It may take several weeks or longer for you to feel the full effect of Sinquan. Continue to take Sinquan even if you feel well. Do not stop taking Sinquan without talking to your doctor. Your doctor will probably want to decrease your dose gradually.