Is it safe to combine Doxepin with Asentra?

Sertraline, the active substance in Asentra, is an inhibitor of the CYP2D6 isoenzyme (which inhibits this isoenzyme) in the liver, through which Doxepin is metabolised. It is therefore recommended to exercise caution when administering sertraline in combination with medicines that are metabolized mainly with this enzyme (e.g. Doxepin), as their concentration in the blood may increase and side effects may increase. If necessary, your doctor may reduce the dose of doxepine. Concomitant treatment with serotonin reuptake inhibitors, to which Asentra with doxepine belongs, can lead to the effect of these drugs on the serotonergic system - the level of serotonin (a neurotransmitter in the brain) increases sharply, leading to the onset of serotonin syndrome. Some of its symptoms are: fever, sweating, increased heart rate, diarrhea, (uncontrollable) muscle spasms, chills, increased reflexes, anxiety, mood changes, loss of consciousness. Several case reports have been published confirming the possibility of serotonin syndrome in people treated with serotonin uptake inhibitors and tricyclic antidepressants (doxepine). It is usually safe to use Asentra in small doses together with Doxepin at appropriately adjusted doses, but you should monitor your body and consult your doctor if you get any alarming symptoms: https://www.gdziepolek.pl/artykuly/czy-przyjmowanie-kilku-lekow-jednoczesnie-jest-bezpieczne If medicines have been prescribed by different doctors, it is necessary to consult them to determine whether these medicines can be used at the same time. If so, your doctor may make other recommendations on how to use them. In the event that the drugs have been prescribed by one doctor, please follow the dosage regimen. I am attaching a study that may be helpful: https://www.gdziepolek.pl/app/artykuly/czy-przyjmowanie-kilku-lekow-jednoczesnie-jest-bezpieczne