doxepin + hydrocortisone

Doxepin + hydrocortisone is a topical combination therapy used primarily for the management of moderate-to-severe pruritus (itching) associated with conditions such as atopic dermatitis and eczema. Doxepin is a tricyclic antidepressant with potent histamine H1 receptor antagonist activity, providing antipruritic effects when applied topically. Hydrocortisone is a corticosteroid that reduces inflammation and suppresses immune responses in the skin. Clinical studies have shown that combining topical doxepin with hydrocortisone results in a statistically significant reduction in pruritus severity compared to hydrocortisone alone, and also improves eczema disease severity[1][2]. The combination acts rapidly, often within 12–24 hours, and adverse effects are generally mild to moderate[1]. Doxepin’s mechanism involves blocking histamine H1 receptors locally in the skin, while hydrocortisone exerts anti-inflammatory effects by modulating gene expression related to inflammatory mediators.