Dosulepin Viatris (formerly Dosulepin Mylan)

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia.

Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.

1. Why am I using DOSULEPIN VIATRIS?

DOSULEPIN VIATRIS contains the active ingredient dosulepin. DOSULEPIN VIATRIS is used to treat depression. For more information, see Section 1. Why am I using DOSULEPIN VIATRIS? in the full CMI.

2. What should I know before I use DOSULEPIN VIATRIS?

Do not use if you have ever had an allergic reaction to DOSULEPIN VIATRIS or any of the ingredients listed at the end of the CMI.
Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding. For more information, see Section 2. What should I know before I use DOSULEPIN VIATRIS? in the full CMI.

3. What if I am taking other medicines?

Some medicines may interfere with DOSULEPIN VIATRIS and affect how it works. A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

4. How do I use DOSULEPIN VIATRIS?

Your doctor will tell you how much DOSULEPIN VIATRIS you need to take each day and when to take it.
This depends how well you respond to DOSULEPIN VIATRIS and whether or not you are taking any other medicines.
More instructions can be found in Section 4. How do I use DOSULEPIN VIATRIS? in the full CMI.

5. What should I know while using DOSULEPIN VIATRIS?

Things you should do
Remind any doctor, dentist or pharmacist you visit that you are using DOSULEPIN VIATRIS.
Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes.
Tell your doctor immediately if you become pregnant while taking DOSULEPIN VIATRIS.
Things you should not do
Do not stop using this medicine suddenly or lower the dose, without checking with your doctor.
Do not use DOSULEPIN VIATRIS to treat any other conditions unless your doctor tells you to.
Do not give DOSULEPIN VIATRIS to anyone else, even if they have the same condition as you.
Driving or using machines
Do not drive or operate machinery until you know how DOSULEPIN VIATRIS affects you.
Drinking alcohol
Be careful when drinking alcohol while taking DOSULEPIN VIATRIS. Combining DOSULEPIN VIATRIS and alcohol can make you more drowsy, dizzy or lightheaded.
Looking after your medicine
Keep the pack in a cool, dry place below 25°C for capsules and below 30°C for tablets in its original packaging.
Do not store DOSULEPIN VIATRIS in the bathroom, near a sink or leave it in the car on hot days.
Keep your tablets where young children cannot reach it.
For more information, see Section 5. What should I know while using DOSULEPIN VIATRIS? in the full CMI.

6. Are there any side effects?

Tell your doctor if you notice any of the following and they worry you: dry mouth, increased sweating, feeling sick (nausea), vomiting, constipation, blurred vision, drowsiness, dizziness, light-headedness, tremor, increased or decreased sex drive. Tell your doctor as soon as possible if you notice any of the following: fast or irregular heart beat, ongoing difficulty with passing urine, signs of frequent infections such as fever, chills, sore throat or mouth ulcers, unusual bruising or bleeding, tingling or numbness of the hands or feet, uncontrollable movements. Tell your doctor immediately or go to Accident and Emergency at the nearest hospital if you notice any of the following: chest pain, fainting or collapse, allergic symptoms such as skin blisters, rash, itching or hives; swelling of the face, mouth, lips, throat or neck; difficulty swallowing or breathing; seizures or fits.
For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.
Active ingredient(s): dosulepin (dothiepin) hydrochloride

Full Consumer Medicine Information (CMI)

This leaflet provides important information about using DOSULEPIN VIATRIS. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using DOSULEPIN VIATRIS.
Where to find information in this leaflet:

1. Why am I using DOSULEPIN VIATRIS?

DOSULEPIN VIATRIS contains the active ingredient dosulepin hydrochloride.
DOSULEPIN VIATRIS belongs to a group of medicines called tricyclic antidepressants (TCAs). TCA medicines work by correcting the imbalance of certain chemicals in the brain. These chemicals, called amines, are involved in controlling mood. By correcting this imbalance, TCAs can help relieve the symptoms of depression.
DOSULEPIN VIATRIS is used to treat depression.
DOSULEPIN VIATRIS 25 mg capsules can be used at any stage in the treatment of depression. However, the higher strength DOSULEPIN VIATRIS 75 mg tablets are approved only for the maintenance treatment of depression (after your symptoms have improved).
Ask your doctor if you have any questions about why DOSULEPIN VIATRIS has been prescribed for you.
Your doctor may have prescribed DOSULEPIN VIATRIS for another reason.
DOSULEPIN VIATRIS is not approved for use in children and adolescents below 18 years of age for the treatment of depression.
The safe use and effectiveness of DOSULEPIN VIATRIS in treating depression, for this age group, has not been established.
DOSULEPIN VIATRIS is available only with a doctor's prescription.

2. What should I know before I use DOSULEPIN VIATRIS?

Warnings

Do not use DOSULEPIN VIATRIS if:

you are allergic to medicines containing dosulepin (e.g. Prothiaden), or any of the ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include:
shortness of breath
wheezing or difficulty breathing
swelling of the face, lips, tongue or other parts of the body
rash, itching or hives on the skin
discolouration of the skin upon exposure to sunlight
Always check the ingredients to make sure you can use this medicine.
you have epilepsy.
DOSULEPIN VIATRIS may increase the chance of fitting or having convulsions.
you recently had a heart attack, for example within the past two months.
DOSULEPIN VIATRIS may cause irregular and/or rapid heartbeat.
you have liver failure.
Your body may not be able to remove DOSULEPIN VIATRIS from your body.
you are taking a medicine called a monoamine oxidase inhibitor (MAOI), or have taken a MAOI within the last 14 days.
Stop taking MAOIs at least 14 days before starting DOSULEPIN VIATRIS.
Taking DOSULEPIN VIATRIS with a MAOI may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and severe convulsions.
Ask your doctor or pharmacist if you are not sure if you have been taking a MAOI medicine.
MAOIs are medicines used to treat depression and symptoms of Parkinson's disease, such as phenelzine (Nardil), tranylcypromine (Parnate), moclobemide (eg. Aurorix Arima) and selegiline (Eldepryl, Selgene).
the expiry date (EXP) printed on the pack has passed
If you take this medicine after the expiry date has passed, it may not work as well.
the packaging shows signs of tampering or the tablets or capsules do not look quite right.
If you are not sure whether you should start taking this medicine, talk to your doctor.

Check with your doctor if you:

are allergic to any other medicines, foods, dyes or preservatives.
have, or have had, any medical conditions, especially the following:
heart or blood vessel problems
liver problems or hepatitis
kidney problems or difficulty passing urine (water)
glaucoma, a condition characterised by an increased pressure in the eye
prostate problems
difficulty in passing urine
thyroid problems
any other mental illness, such as schizophrenia or manic depression (alternating periods of elation/overactivity and depressed mood)
family history of suicide or manic depression.
plan to have surgery or if you are undergoing electroshock therapy.
take any medicines for any other condition
If you have not told your doctor about any of the above, tell them before you start taking DOSULEPIN VIATRIS.
During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant.
There have been reports of some babies experiencing complications immediately after delivery. Your doctor will discuss the possible risks and benefits of taking DOSULEPIN VIATRIS during pregnancy.
Withdrawal symptoms such as difficulty sleeping, irritability and excessive sweating in newborn infants have been reported in mothers who have taken this medicine during the third trimester.
Tell your doctor if you are breastfeeding or wish to breastfeed.
Like many other medicines, DOSULEPIN VIATRIS passes into breast milk.
Your doctor will discuss the risks and benefits of taking DOSULEPIN VIATRIS when breastfeeding.

3. What if I am taking other medicines?

Do not take DOSULEPIN VIATRIS if you are taking a monoamine oxidase inhibitor (MAOI) such as:
phenelzine (Nardil) and tranylcypromine (Parnate), moclobemide (eg. Aurorix, Arima), used to treat depression
selegiline (Eldepryl, Selgene), used to treat symptoms of Parkinson's disease.
Wait at least 14 days after stopping your MAOI before starting DOSULEPIN VIATRIS.
Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
Medicines that may be affected by DOSULEPIN VIATRIS or may affect how well it works include:
sleeping tablets/sedatives, anti-anxiety medicines
medicines used to treat epilepsy
some medicines used to treat high blood pressure or other heart conditions
some medicines used to relieve stomach cramps
medicines used to treat Parkinson's disease
medicines for travel sickness
some cough and cold preparations
some medicines for hayfever and allergies
certain medicines for weight loss
thyroid hormone medicines.
Your doctor can tell you what to do if you are taking any of these medicines.
Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking DOSULEPIN VIATRIS.
Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect DOSULEPIN VIATRIS.

4. How do I use DOSULEPIN VIATRIS?

Follow all directions given to you by your doctor and pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the pack, ask your doctor or pharmacist.

How much to take

The dose varies from person to person.
Your doctor will tell you how much DOSULEPIN VIATRIS you need to take each day and when to take it. This depends how well you respond to DOSULEPIN VIATRIS and whether or not you are taking any other medicines.
The usual starting dose is 25 mg three times daily for one to two weeks. Your doctor may then increase your dose, up to a maximum of 200 mg per day.
Once your symptoms improve, your doctor will then slowly reduce your dose to the lowest effective dose which maintains relief of symptoms.
Elderly people over 65 years of age and those with liver or kidney problems may need smaller doses.

How to take it

Swallow the tablets or capsules with a glass of water.
The DOSULEPIN VIATRIS 75 mg tablets can be divided in half along the breakline if advised by your doctor or pharmacist.

When to take DOSULEPIN VIATRIS

DOSULEPIN VIATRIS can be taken as a single dose (e.g. at bedtime) or as divided doses (e.g. three times a day). Your doctor will advise you.
Take your medicine at about the same time each day.
Taking it at the same time each day will have the best effect. It will also help you remember when to take it.

How long to take it for

Keep taking DOSULEPIN VIATRIS for as long as your doctor recommends.
The length of treatment will depend on how quickly your symptoms improve.
Most medicines for depression take time to work, so do not be discouraged if you do not feel better right away. Some of your symptoms may improve in 1 or 2 weeks but it can take up to 4 or 6 weeks to feel the full benefit of DOSULEPIN VIATRIS.
Even when you feel well, you will usually have to take DOSULEPIN VIATRIS for several months or longer, to make sure that the benefits last.

If you forget to use DOSULEPIN VIATRIS

IF YOU TAKE ONE DOSE A DAY (AT BEDTIME)
If you forget to take DOSULEPIN VIATRIS before you go to bed and wake up late in the night or early in the morning, do not take the missed dose until you have checked with your doctor.
You may have difficulty waking up, or experience drowsiness in the morning and during the day.
IF YOU TAKE MORE THAN ONE DOSE A DAY
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Otherwise, take the missed dose as soon as you remember, and then go back to taking DOSULEPIN VIATRIS as you would normally.
Do not take a double dose to make up for the dose you missed.
If you are not sure what to do, ask your doctor or pharmacist.
If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you use too much DOSULEPIN VIATRIS

If you think that you have used too much DOSULEPIN VIATRIS, you may need urgent medical attention.
You should immediately:
phone the Poisons Information Centre
(Australia telephone 13 11 26) for advice, or
contact your doctor, or
go to the Emergency Department at your nearest hospital.
You should do this even if there are no signs of discomfort or poisoning.
Taking too much DOSULEPIN VIATRIS at once can be dangerous. The onset of toxicity develops rapidly within 4-6 hours. Too much DOSULEPIN VIATRIS may make you tremble, agitated and/or have difficulty walking. Other signs include dry mouth, blurred vision, dilated pupils, constipation, difficulty passing urine, fitting or convulsions, unusual muscle movements, difficulty breathing, a very high temperature, irregular heartbeat, shock and/or cardiac arrest as well as other serious heart problems which can be life-threatening or fatal.
Keep DOSULEPIN VIATRIS out of the reach of children.
Children are much more sensitive than adults to medicines such as DOSULEPIN VIATRIS. An accidental overdose is especially dangerous in children.

5. What should I know while using DOSULEPIN VIATRIS?

Things you should do

Tell your doctor immediately if you have any suicidal thoughts or other mental/mood changes.
Occasionally, the symptoms of depression or other psychiatric conditions may include thoughts of harming yourself or committing suicide.
These symptoms may continue or get worse during the first one to two months of treatment until the full antidepressant effect of the medicine becomes apparent. This is more likely to occur in young adults under 25 years of age.
Contact your doctor or a mental health professional right away or go to the nearest hospital for treatment if you or someone you know is showing any of the following warning signs of suicide:
worsening of your depression
thoughts or talk of death or suicide
thoughts or talk of self-harm or harm to others
any recent attempts of self-harm
increase in aggressive behaviour, irritability or any other unusual changes in behaviour or mood.
All mentions of suicide or violence must be taken seriously.
Families and caregivers of children and adolescents being treated with DOSULEPIN VIATRIS need to monitor these patients for the emergence of:
anxiety
agitation
panic attacks
insomnia
irritability
aggressiveness
impulsivity
restlessness or difficulty sitting still
hypomania
mania
unusual changes in behaviour
This will help your doctor determine the best way to control these feelings.
Tell your doctor if you feel DOSULEPIN VIATRIS is not helping your condition.
Keep all of your appointments with your doctor so that your progress can be checked.
If you are taking DOSULEPIN VIATRIS for a long time, your doctor may ask you to have your eyes tested regularly.
Tell your doctor immediately if you become pregnant while taking DOSULEPIN VIATRIS. Do not stop taking your tablets or capsules until you have spoken to your doctor.
Before starting any new medicine, tell your doctor or pharmacist that you are taking DOSULEPIN VIATRIS.
Tell all the doctors, dentists and pharmacists who are treating you that you are taking DOSULEPIN VIATRIS.
If you plan to have surgery, including dental surgery, tell your doctor that you are taking DOSULEPIN VIATRIS.
Your doctor may ask you to temporarily stop taking DOSULEPIN VIATRIS a few days before elective surgery.
Tell your doctor if, for any reason, you have not taken your medicine exactly as prescribed.
Otherwise, your doctor may think that it was not effective and change your treatment unnecessarily.

Things you should not do

Do not stop taking DOSULEPIN VIATRIS, or lower the dose, without checking with your doctor.
If you stop taking DOSULEPIN VIATRIS suddenly you may feel sick (nausea), irritable, have a headache, difficulty sleeping or excessive sweating. Other more serious complications such as fits (convulsions) or blood clots may occur.
Your doctor will tell you how to gradually reduce the amount of DOSULEPIN VIATRIS you are taking before stopping completely.
Do not use DOSULEPIN VIATRIS to treat any other conditions unless your doctor tells you to.
Do not give DOSULEPIN VIATRIS to anyone else, even if they have the same condition as you.

Things to be careful of

Be careful getting up from a sitting or lying position.
Dizziness, light-headedness or fainting may occur, especially when you get up quickly. Getting up slowly may help.
Be careful if you are older than 65 years of age.
Elderly people may become confused when taking DOSULEPIN VIATRIS. Families and carers should be aware of this. Special care may be needed.
Tell your doctor or dentist if your mouth continues to feel dry for more than 2 weeks.
DOSULEPIN VIATRIS may cause dry mouth. This can be relieved by frequent sips of water, sucking sugarless lollies or chewing sugarless gum. However, continuing dryness of the mouth may increase the chance of dental disease, including tooth decay and gum disease.

Driving or using machines

Do not drive or operate machinery until you know how DOSULEPIN VIATRIS affects you.
DOSULEPIN VIATRIS may cause drowsiness, dizziness or light-headedness in some people. If any of these occur, do not drive, operate machinery or do anything else that could be dangerous.

Drinking alcohol

Be careful when drinking alcohol while taking DOSULEPIN VIATRIS. Combining DOSULEPIN VIATRIS and alcoholic drinks may affect you much more than usual and can make you more drowsy, dizzy or lightheaded.
Taking DOSULEPIN VIATRIS and alcohol can be dangerous and may cause death.
Your doctor may suggest you avoid alcohol while being treated for depression.

Looking after your medicine

Follow the instructions in the carton on how to take care of your medicine properly.
Keep DOSULEPIN VIATRIS in a cool, dry place where the temperature stays below 30°C for tablets and below 25°C for capsules.
Store away from moisture, heat or sunlight; for example, do not store it:
in the bathroom or near a sink, or
in the car or on window sills.
Heat and dampness can destroy some medicines.
Keep it where young children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

When to discard your medicine

If your doctor tells you to stop taking DOSULEPIN VIATRIS, or your medicine has passed its expiry date, ask your pharmacist what to do with any that is left over.

Getting rid of any unwanted medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Do not use this medicine after the expiry date.

6. Are there any side effects?

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking DOSULEPIN VIATRIS.
DOSULEPIN VIATRIS helps most people with depression, but it may have unwanted side effects in some people.
All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.
Ask your doctor or pharmacist to answer any questions you may have.
See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.
Do not be alarmed by this list of possible side effects.
You may not experience any of them.

Less serious side effects

Less serious side effects
What to do
dry mouth
increased sweating
feeling sick (nausea), vomiting
constipation
blurred vision
drowsiness, dizziness, light-headedness
tremor
increased or decreased sex drive
The above list includes the common and mild side effects of DOSULEPIN VIATRIS.
Speak to your doctor if you have any of these less serious side effects and they worry you.

Serious side effects

Serious side effects
What to do
fast or irregular heart beat
ongoing difficulty with passing urine
signs of frequent infections such as fever, chills, sore throat or mouth ulcers
unusual bruising or bleeding
tingling or numbness of the hands or feet
severe pain in the stomach with bloating, gut cramps and vomiting
symptoms of liver disease such as yellowing of the eyes or skin (jaundice) and passing dark coloured urine
feeling anxious, restless, or confused
abnormal ideas, hallucinations
sudden mood swings alternating from one of excitement, overactivity and uninhibited behaviour to a depressed mood
uncontrollable movements, including trembling and shaking of the hands and fingers, twisting movements of the body, shuffling walk or stiffness of the arms and legs
Disorganised speech or behaviour
Difficulty with concentration and memory
The above side effects are serious and may require medical attention.
Tell your doctor as soon as possible if you notice any of the following.

More serious side effects

More serious side effects
What to do
chest pain
fainting or collapse
allergic symptoms such as skin blisters, rash, itching or hives; swelling of the face, mouth, lips, throat or neck; difficulty swallowing or breathing
seizures or fits
The above side effects are not common but very serious. You may require urgent medical attention or even hospitalisation if they occur.
Tell your doctor immediately or go to Accident and Emergency at the nearest hospital if you notice any of the following.
Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.
Other side effects not listed here may occur in some patients.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of this medicine.
Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

7. Product details

This medicine is only available with a doctor's prescription.

What DOSULEPIN VIATRIS 25 capsules contains

Active ingredient
(main ingredient)
dosulepin (dothiepin) hydrochloride 25 mg
Other ingredients
(inactive ingredients)
Lactose
Lactose monohydrate
povidone
sodium starch glycollate
purified talc
magnesium stearate
sodium lauryl sulfate
colloidal anhydrous silica
gelatin
erythrosine CI 45430 (127)
iron oxide red CI 77491 (172)
titanium dioxide (171)
brilliant blue FCF CI 42090 (133)
quinoline yellow CI 47005 (104)
Potential allergens
DOSULEPIN VIATRIS contains sulfites and sugars as lactose.

What DOSULEPIN VIATRIS 75 tablets contains

Active ingredient
(main ingredient)
dosulepin (dothiepin) hydrochloride 75 mg
Other ingredients
(inactive ingredients)
lactose monohydrate
maize starch
povidone
sodium starch glycollate
purified talc
magnesium stearate
Opadry Red OY-B-25005 (includes colours brilliant scarlet 4R CI 16255 [124], titanium dioxide [171])
Potential allergens
DOSULEPIN VIATRIS contains sulfites, soya bean products and sugars as lactose.
Do not take this medicine if you are allergic to any of these ingredients.

What DOSULEPIN VIATRIS looks like

DOSULEPIN VIATRIS 25 is a hard capsule with green and red cap in PVC/PVdC/aluminium blister packs. Each pack contains 50 capsules. (AUST R 289783).
DOSULEPIN VIATRIS 75 is a round, red, scored film-coated tablet marked "DT" over a breakline over "75" on one side and a Greek alpha symbol on the other. Each pack contains 30 tablets. (AUST R 289784).

Who distributes DOSULEPIN VIATRIS

Alphapharm Pty Ltd trading as Viatris
Level 1, 30 The Bond
30-34 Hickson Road
Millers Point NSW 2000
www.viatris.com.au
Phone: 1800 274 276
This leaflet was prepared in August 2022.
DOSULEPIN VIATRIS_cmi\Aug22/00

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