What is Asendin (amoxapine)?
Amoxapine is a tricyclic antidepressant. Amoxapine affects chemicals in the brain that may be unbalanced in people with certain conditions.
Amoxapine is used to treat symptoms of depression, anxiety, or agitation.
Amoxapine may also be used for purposes not listed in this medication guide.
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What is the most important information I should know about Asendin (amoxapine)?
You should not use amoxapine if you have recently had a heart attack.
Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
What should I discuss with my healthcare provider before taking Asendin (amoxapine)?
You should not use amoxapine if you are allergic to it, or if you have recently had a heart attack.
Do not use amoxapine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
To make sure amoxapine is safe for you, tell your doctor if you have:
a history of heart attack, stroke, or seizures;
schizophrenia or other mental illness;
diabetes (amoxapine may raise or lower blood sugar);
bipolar disorder (manic depression);
problems with urination.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while taking amoxapine.
Amoxapine can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Amoxapine is not approved for use by anyone younger than 18 years old.
How should I take Asendin (amoxapine)?
Never take amoxapine in larger amounts, or for longer than recommended by your doctor. High doses or long-term use of amoxapine can cause a serious movement disorder that may not be reversible. Symptoms of this disorder include tremors or other uncontrollable muscle movements.
Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
If you take this medicine once daily, take your dose at bedtime.
It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amoxapine can be fatal.
Overdose symptoms may include seizure (convulsions) or coma.
What should I avoid while taking Asendin (amoxapine)?
Drinking alcohol with this medicine can cause side effects.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Asendin (amoxapine) side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
skin rash with fever;
uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);
pounding heartbeats or fluttering in your chest;
little or no urination;
chest pain or pressure, pain spreading to your jaw or shoulder;
sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance; or
severe nervous system reaction–very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.
Side effects may be more likely in older adults.
Common side effects may include:
dry mouth; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
What other drugs will affect Asendin (amoxapine)?
Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking amoxapine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Before taking amoxapine, tell your doctor if you have used an “SSRI” antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.
Tell your doctor about all your current medicines and any you start or stop using, especially:
other antidepressants such as bupropion;
heart rhythm medications such as flecainide, propafenone, or quinidine;
bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;
bronchodilators such as aclidinium, ipratropium, tiotropium, or umeclidinium;
cold or allergy medicine that contains an antihistamine;
medication for Parkinson’s disease; or
medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome.
This list is not complete. Other drugs may interact with amoxapine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Asendin Side Effects
For the Consumer
Applies to amoxapine: oral tablet
Along with its needed effects, amoxapine (the active ingredient contained in Asendin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking amoxapine:
fast, irregular, pounding, or racing heartbeat or pulse
fear or nervousness
mood or mental changes
shakiness and unsteady walk
shakiness in legs, arms, hands, or feet
unable to sleep
unsteadiness, trembling, or other problems with muscle control or coordination
Abdominal or stomach pain
actions that are out of control
black, tarry stools
blood in urine or stools
burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
chest pain or discomfort
confusion about identity, place, and time
continuing ringing or buzzing or other unexplained noise in ears
cough or hoarseness
decrease in frequency of urination
decrease in urine volume
difficulty in breathing
difficulty in passing urine (dribbling)
difficulty in speaking
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
extremely high fever or body temperature
false beliefs that cannot be changed by facts
fast, weak heartbeat
fever with or without chills
general feeling of tiredness or weakness
high or low blood pressure
hives or welts
inability to move arms, legs, or facial muscles
inability to speak
increased need to urinate
lack of coordination
lip smacking or puckering
loss of appetite
loss of bladder control
lower back or side pain
muscle spasm or jerking of all extremities
muscle trembling, jerking, or stiffness
nausea and vomiting
pain or discomfort in arms, jaw, back, or neck
painful or difficult urination
pains in stomach, side, or abdomen, possibly radiating to the back
pale, clammy skin
passing urine more often
pinpoint red spots on skin
pounding in the ears
puffing of cheeks
rapid or worm-like movements of tongue
redness of skin
seeing, hearing, or feeling things that are not there
severe muscle stiffness
shortness of breath
sores, ulcers, or white spots on lips or in mouth
stiffness of limbs
sudden loss of consciousness
talking, feeling, and acting with excitement
trouble in holding or releasing urine
twisting movements of body
uncontrolled chewing movements
uncontrolled movements, especially of face, neck, and back
unpleasant breath odor
unusual bleeding or bruising
unusually pale skin
upper right abdominal pain
vomiting of blood
yellow eyes and skin
Get emergency help immediately if any of the following symptoms of overdose occur while taking amoxapine:
Symptoms of overdose
Change in consciousness
epileptic seizure that will not stop
increased blood pressure
loss of consciousness
swelling of face, fingers, or lower legs
total body jerking
Some side effects of amoxapine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
increased flow of breast milk
change in taste bad unusual or unpleasant (after)taste
decreased interest in sexual intercourse
excess air or gas in stomach or intestines
hair loss, thinning of hair
inability to have or keep an erection
increased in sexual ability, desire, drive, or performance
increased interest in sexual intercourse
increased sensitivity of skin to sunlight
loss in sexual ability, desire, drive, or performance
rapid weight gain
redness or other discoloration of skin
swollen, painful, or tender lymph glands on side of face or neck
tearing of the eyes
unexpected or excess milk flow from breasts
For Healthcare Professionals
Applies to amoxapine: oral tablet
The most commonly reported side effects were drowsiness, dry mouth, constipation, and blurred vision.[Ref]
Very common (10% or more): Drowsiness (up to 14%)
Common (1% to 10%): Alterations in EEG patterns, ataxia, dizziness, headache, tremors
Frequency not reported: Disturbed concentration, extrapyramidal symptoms, incoordination, mydriasis, neuroleptic malignant syndrome, numbness, paresthesia of the extremities, peculiar taste, seizures, stroke, syncope, tardive dyskinesia, tingling[Ref]
Very common (10% or more): Dry mouth (up to 14%), constipation (up to 12%)
Common (1% to 10%): Nausea
Frequency not reported: Abdominal pain, black tongue, diarrhea, epigastric distress, flatulence, pancreatitis, paralytic ileus, parotid swelling, stomatitis, sublingual adenitis, vomiting[Ref]
Common (1% to 10%): Anxiety, confusion, excitement, insomnia, nervousness, nightmares, restlessness
Frequency not reported: Delusions, disorientation, hallucinations, hypomania, increased or decreased libido, suicidality[Ref]
Common (1% to 10%): Edema, palpitations
Frequency not reported: Atrial arrhythmias, atrial fibrillations, heart block, hypertension, hypotension, myocardial infarction, tachycardia, vasculitis[Ref]
Common (1% to 10%): Increased perspiration, skin rash
Frequency not reported: Alopecia, petechia, photosensitization, pruritus, urticaria[Ref]
Common (1% to 10%): Fatigue, weakness
Frequency not reported: Drug fever, hyperthermia, tinnitus[Ref]
Common (1% to 10%): Excessive appetite
Frequency not reported: Anorexia, change in blood glucose levels, weight gain or loss[Ref]
Common (1% to 10%): Increased prolactin levels
Frequency not reported: Gynecomastia, syndrome of inappropriate antidiuretic hormone secretion[Ref]
Common (1% to 10%): Blurred vision
Frequency not reported: Disturbances of accommodation, lacrimation[Ref]
Frequency not reported: Breast enlargement, delayed micturition, dilation of the urinary tract, galactorrhea, impotence, menstrual irregularity, painful ejaculation, testicular swelling, urinary frequency, urinary retention[Ref]
Frequency not reported: Agranulocytosis, eosinophilia, leukopenia, purpura, thrombocytopenia[Ref]
Frequency not reported: Altered liver function, hepatitis, jaundice[Ref]
Frequency not reported: Nasal stuffiness[Ref]
- “Product Information. Asendin (amoxapine)” Lederle Laboratories, Wayne, NJ.
Some side effects of Asendin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.