Drug General Information (ID: DDISYOM34Z)
Drug Name			Ethanol		Drug Info		Doxepin (topical)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Antidepressants
Structure

Mechanism of Ethanol-Doxepin (topical) Interaction (Severity Level: Moderate)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Ethanol				Doxepin (topical)
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Ethanol and Doxepin (topical)

Recommended Action
Management		Patients should be advised to avoid alcohol during TCA therapy. Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy. Dosage adjustments may be required.

References
1	Ciraulo DA, Alderson LM, Chapron DJ, Jaffe JH, Subbarao B, Kramer PA "Imipramine disposition in alcoholics." J Clin Psychopharmacol 2 (1982): 2-7. [PMID: 7068940]
2	Seppala T, Linnoila M, Elonen E, Mattila MJ, Makl M "Effect of tricyclic antidepressants and alcohol on psychomotor skills related to driving." Clin Pharmacol Ther 17 (1975): 515-22. [PMID: 1092511]
3	Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7. [PMID: 3725002]