Home Drug Guide Doxylamine Succinate

Drug Guide

Generic Name

Doxylamine Succinate

Brand Names Decapryn, Unisom, Doxy-sleep-aid

Classification

Therapeutic: Antihistamine, Sedative

Pharmacological: First-generation H1 antihistamine

FDA Approved Indications

  • Short-term management of sleep disturbances (insomnia)

Mechanism of Action

Doxylamine succinate blocks central and peripheral H1 histamine receptors, leading to sedation and decreased wakefulness, which promotes sleep.

Dosage and Administration

Adult: 25 mg at bedtime as needed for sleep.

Pediatric: Typically not recommended for children under 12 without physician advice.

Geriatric: Lower doses may be considered due to increased sensitivity to sedatives.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution as metabolism may be impaired; consider dose reduction.

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Distribution: Wide distribution including crossing the blood-brain barrier.

Metabolism: Metabolized in the liver via the cytochrome P450 system.

Excretion: Excreted mainly in urine.

Half Life: Approximately 10 hours in healthy adults.

Contraindications

  • Hypersensitivity to doxylamine or other antihistamines.
  • Use in newborns or premature infants.

Precautions

  • Use with caution in elderly, patients with glaucoma, urinary retention, prostate hypertrophy, asthma, or hypertension.

Adverse Reactions - Common

  • Drowsiness, dry mouth, dizziness, constipation (Common)

Adverse Reactions - Serious

  • Hepatotoxicity, hypersensitivity reactions, urinary retention, severe allergic reactions (Rare)

Drug-Drug Interactions

  • CNS depressants (additive sedative effect)
  • Anticholinergic drugs (potentiation of anticholinergic effects)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess sleep patterns, medication history, and potential for adverse reactions.

Diagnoses:

  • Risk for injury related to sedation and dizziness.
  • Impaired sleep pattern.

Implementation: Administer at bedtime; avoid activities requiring alertness after dosing.

Evaluation: Monitor sleep quality and adverse effects.

Patient/Family Teaching

  • Avoid alcohol and other CNS depressants while taking doxylamine.
  • Do not operate machinery or drive until response is known.
  • Use for short-term management of sleep disturbances.
  • Report any signs of allergic reactions or severe side effects.

Special Considerations

Black Box Warnings:

  • Use with caution in older adults due to increased risk of confusion, falls, and paradoxical excitation.
  • Potential for dependence with long-term use.

Genetic Factors: Genetic variations in CYP2D6 may affect metabolism.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Severe sedation, hallucinations, seizures, hyperthermia, tachycardia.

Treatment: Supportive care, activated charcoal if ingestion was recent, maintain airway, cardiovascular support, and symptomatic treatment.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.