Doxepin-induced acute glossitis.

A case of doxepin-induced acute glossitis is reported. Painful, tender, papular lesions on the tongue were observed in a 48-year-old woman seven days after initiation of doxepin and ampicillin therapy. Doxepin daily dosage (administered in four divided doses) subsequently was reduced from 175 to 150 to 125 mg, then both drugs were discontinued. The glossitis, treated with viscous lidocaine, resolved over a three-week period. Four weeks after doxepin therapy was firt initiated, the drug was reinstituted; glossitis recurred eight days later. After discontinuation of doxepin, the glossitis slowly regressed. Drug-induced glossitis, its mechanism of action, and treatment are reviewed. When unexpected oral inflammation and pain occur, the potential for drug-induced oral lesions should be considered. Treatment is primarily empirical, with unresponsive cases being candidates for therapy of corticosteroids applied topically to the oral lesions.