and formulary information changes. informational and educational purposes only. 3-6 mg PO within 30 minutes before bedtime; not to exceed 6 mg/day. These events can occur in hypnotic-naive as well as in hypnotic-experienced persons. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. If dose exceeds 150 mg/day, divide q12hr. Controlled studies in pregnant women show no evidence of fetal risk.Exact mechanism for doxepin's sleep maintenance effect is unknown; however, doxepin's action is believed to result from antagonism of the histamine H1 receptorMechanism of action for depression is unknown; may increase CNS synaptic concentrations of serotonin and norepinephrine by inhibiting reuptakeAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans.

Maximum Dose. This website also contains material copyrighted by 3rd parties. Dr. Joel Gallant answered. "Pantoprazole - maximum dose?"

Increase in increments of 25 mg-50 mg divided two or three times on Days 2 and 3 to range of 300-400 mg by Day 4. Top answers from doctors based on your search: Disclaimer. 2010 Experts And Viewpoints May give qHS to decrease daytime sedation ; Insomnia (Silenor) Sleep maintenance. Dosing considerations. Initiate at low dose (25 mg/day); gradually titrate upward every 5-7 daysDosage range: 25-300 mg/day PO, up to 150 mg/day as single dose3-6 mg PO within 30 minutes before bedtime; not to exceed 6 mg/dayHepatic impairment/debilitated patients: 3 mg PO within 30 minutes before bedtimeHepatic impairment: Use lower dose and adjust gradually for depression; initiate Silenor at 3 mg daily for insomniaStarting dose: 3 mg PO within 30 minutes before bedtimeLower initial dose (ie, 10 mg/day) and adjust gradually; 10-25 mg PO qHSMay increase by 10-25 mg increments q3Day for inpatients and weekly for outpatients if toleratedAvoid; strong anticholinergic and sedative effects; may cause orthostatic hypotension (Beers criteria)Consider alternatives; if must use, initiate with lower initial doseConfusion, extrapyramidal symptoms (EPS), dizziness, paresthesiaIn short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 years) taking antidepressants for major depressive disorders and other psychiatric illnessesThis increase was not seen in patients >24 years; a slight decrease in suicidal thinking was seen in adults >65 yearsIn children and young adults, risks must be weighed against the benefits of taking antidepressantsPatients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustmentsThe patient’s family should communicate any abrupt changes in behavior to the healthcare providerWorsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapyThis drug is not approved for use in pediatric patientsUse caution in BPH, urinary retention, decreased GI motility, hyperthyroidism, brain tumor, diabetes, hepatic impairment, cardiovascular disease, mania/hypomania, respiratory disease, and seizure disordersClinical worsening and suicidal ideation may occur despite medication in adolescents and young adults (aged 18-24 years)Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomyCNS depressant; can impair alertness and motor coordination; avoid use with other CNS depressants (eg, alcohol)Overdose may cause EKG QRS widening and risk of dysrhythmiasProtect capsules and oral concentrate from direct sunlightPrescriptions should be written for smallest quantity consistent with good patient care; patient's family or caregiver should alert healthcare professional about emergence of suicidality and related behaviors including agitation, panic attacks, irritability, impulsivity, mania, and insomnia or if worsening depression or psychosis occursAnticholinergic effects including blurred vision, urinary retention, xerostomia, and constipation may occurNeuropsychiatric symptoms may occur unpredictably including anxiety and psychosisBone fracture reported with use of antidepressant therapy; consider possibility of fracture if patient presents with unexplained bone pain, joint tenderness, bruising or swellingMay cause orthostatic hypotension; use caution in patients at risk of this effect or that may not tolerate hypotensive episodes (eg, hypovolemia, cardiovascular or cerebrovascular disease and others)Sleep related activities including sleep driving, eating food, cooking, making phone calls reported; discontinue therapy if patient reports sleep-related episodesPossibility of EPS and neuroleptic malignant syndrome (NMS)May cause confusion in the elderly; avoid doses >6 mg/dayLactation: Enters breast milk; not recommended (AAP states "may be of concern")A: Generally acceptable.