Sleep Disorders Treatment What Is Doxylamine? An Antihistamine Commonly Used in Sleeping Pills By Brandon Peters, MD Brandon Peters, MD Facebook Twitter Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial process Updated on September 15, 2022 Medically reviewed by Daniel Combs, MD Medically reviewed by Daniel Combs, MD Daniel Combs, MD, is board-certified in sleep medicine and pediatrics. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Uses Before You Take Dosage Contraindications Side Effects Frequently Asked Questions Doxylamine is a sleep aid in products like Unisom and Nyquil that you can buy over the counter. It's also an antihistamine that's used to treat nasal congestion. Some people take doxylamine to treat insomnia. Insomnia is a sleep disorder where you have trouble falling asleep or staying asleep. You don't need a prescription for doxylamine as it is widely available over-the-counter (OTC). But that doesn't mean the medicine doesn't come with potential side effects. Before taking doxylamine, learn the possible risks. This article goes over how doxylamine works, its uses, and what problems it can cause. Verywell / Jessica Olah Doxylamine Uses Doxylamine is an antihistamine, a type of medication used to treat allergies. It can also reduce nighttime cold symptoms. One of its side effects is drowsiness. Because of this effect, doxylamine is often used in over-the-counter sleep aids for those who have trouble getting to sleep or staying asleep. But note that it shouldn't be used for more than two weeks to treat insomnia. Like many sleeping pills, doxylamine affects neurotransmitters. These are chemical messengers that send signals between brain and nerve cells (neurons). Doxylamine blocks receptors that let the chemical histamine stimulate neurons. This causes you to get sleepy. Doxylamine works centrally (within the central nervous system) and elsewhere in the body to sedate you. Before You Take Doxylamine Since doxylamine is an OTC medication, risks might be slightly lower than with prescription medications that need careful monitoring. No routine tests are recommended with its use. Ultimately, doxylamine is not the best option if you are considering taking sleeping pills. There are other choices that are better for aiding sleep. Doxylamine doesn't promote sleep in the same way as prescription sleep medications, such as benzodiazepine and non-benzodiazepine medications. To take a medication for its side effect—in this case, sleepiness—is not recommended. Doxylamine is a non-habit forming medication. However, you can develop a tolerance to it, which means you'll have to take more of it over time to get the same effect. This can lead to an increased risk of other side effects. Doxylamine Dosage As is the case with any medication, it's important to only use the recommended dosage for doxylamine. Doxylamine pills can typically be found in strengths of 12.5 and 25 milligrams (mg). When used as a sleep aid, the recommended dosage for doxylamine is 25 mg, once daily, taken orally (by mouth) up to 30 minutes before bedtime. But if taking 25 mg of doxylamine makes you feel excessively drowsy the next day, you may want to reduce your dosage to 12.5 mg. How Long Does Doxylamine Take to Work? Most people begin to feel drowsy within 30 minutes of taking a 25 mg formulation of doxylamine. The sedative effects of doxylamine typically last up to six hours. Precautions and Contraindications Certain groups of people shouldn't take doxylamine. Age Restrictions Children under 12 years of age shouldn't use doxylamine 25 milligrams (mg). Children under 6 and elderly people shouldn't use it without a healthcare provider's advice. Breastfeeding According to the National Institutes of Health, taking small, occasional doses while nursing shouldn't cause problems for the baby. However, larger doses or long-term use may cause drowsiness, irritability, and colicky symptoms in breastfed babies. It may also lower your milk supply. Medical Conditions People with many conditions should be cautious about doxylamine as it may cause problems or drug interactions. These conditions include: Glaucoma Hyperthyroidism Heart disease High blood pressure (hypertension) Asthma Chronic obstructive pulmonary disease (COPD) Pneumonia Peptic ulcer disease Prostate enlargement Liver disease Bowel or bladder obstruction If you're concerned about whether you may have problems using doxylamine, you should first consult with your healthcare provider. Negative drug interactions are also a risk, especially with other medications that affect the brain, so be sure to review your medications with your healthcare provider or pharmacist before starting to use doxylamine. Side Effects The list of potential side effects for any drug can be quite long, and doxylamine is no exception. Although you likely wouldn't experience most side effects, and may not have any at all, some that occur commonly with doxylamine include: DizzinessLoss of coordinationHeadacheStomach painDry mouth or noseConstipationDifficulty urinatingBlurred or double vision Potential Serious Reactions While they're rare, serious side effects can result from the use of doxylamine, including: Severe allergic reaction (anaphylaxis), including difficulty breathing Low blood cell counts (agranulocytosis, anemia, thrombocytopenia, and leukopenia) Abnormal heart rhythms or altered heart rate Seizures Toxic psychosis Inner ear problems (acute labyrinthitis) Hallucinations Confusion or delirium Low blood pressure Insomnia Healthcare Provider Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. Summary Doxylamine is an antihistamine drug that is often used in over-the-counter medications to promote sleep. Side effects can range from dizziness and headaches to confusion and serious allergic reactions. People with certain medical conditions like glaucoma and heart disease should not take doxylamine. If you want to try it to help with insomnia, talk to your healthcare provider first. A Word From Verywell If you experience any difficulties when taking doxylamine, you should be in close contact with your primary healthcare provider. If you wish to pursue other preferred treatments for insomnia, you should likewise make an appointment and discuss the better prescription options that are available. Effective treatment may include medications, learning better sleep habits, or cognitive behavioral therapy for insomnia (CBTI). Frequently Asked Questions Can I take Unisom every night? No. Unisom is intended as a temporary sleep aid and should not be taken for more than two weeks. If you need ongoing help falling asleep, speak to your healthcare provider. Learn More: What Causes Insomnia? Does Unisom help with morning sickness? Yes. The doxylamine succinate in Unisom taken with vitamin B6 can treat morning sickness during pregnancy. Talk to your healthcare provider before taking the combination to be sure it’s right for you. Learn More: Using Doxylamine Safely in Pregnancy Why is doxylamine not recommended for older adults? Doxylamine may increase the risk for dementia. This is due to its anticholinergic properties, which means it blocks neurotransmitters that transmit messages along the nervous system. According to researchers, anticholinergic medications are associated with cognitive decline. Does doxylamine help with anxiety? Doxylamine promotes relaxation to ease you into sleep, but it should not be used as a regular anxiety medication. If you are experiencing anxiety, your healthcare provider can recommend an anxiety medication that is more suitable for you. 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Krystal AD, Richelson E, Roth T. Review of the histamine system and the clinical effects of Hi antagonists: basis for a noew model for understanding the effects of insomnia medications. Sleep Med Rev. 2013;17(4):263-272. doi:10.1016/j.smrv.2012.08.001 Videla S, Cebrecos J, Lahjou M. Pharmacokinetic dose proportionality between two strengths (12.5 mg and 25 mg) of doxylamine hydrogen succinate film-coated tablets in fasting state: A singe-dose, randomized, two-period crossover study in healthy volunteers. Drugs R D. 2013 Jun;13(2):129-135. doi:10.1007/s40268-013-0015-7 Unisom. Frequently Asked Questions. National Library of Medicine (US). Drugs and Lactation Database. Doxylamine. MedlinePlus. Doxylamine. Koren G, Clark S, Hankins GDV, et al. Maternal safety of the delayed-release doxylamine and pyridoxine combination for nausea and vomiting of pregnancy; a randomized placebo controlled trial. BMC Pregnancy and Childbirth. 2015;15(1):59. Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic drug exposure and the risk of dementia: a nested case-control study. JAMA Intern Med. 2019;179(8):1084. doi:10.1001/jamainternmed.2019.0677 By Brandon Peters, MD Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit