trimipramine

Generic Name: trimipramine (trye MI pra meen)
Brand Name: Surmontil

What is trimipramine?

Trimipramine is a tricyclic antidepressant. Trimipramine affects chemicals in the brain that may become unbalanced.

Trimipramine is used to treat symptoms of depression.

Trimipramine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about trimipramine?

You should not take trimipramine if you have recently had a heart attack.

Do not use trimipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Slideshow: Depression, the Risk of Suicide, and Treatment Options

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trimipramine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give this medicine to anyone under 18 years old without medical advice. Trimipramine is not approved for use in children.

What should I discuss with my healthcare provider before taking trimipramine?

You should not use trimipramine if you are allergic to it, or if you have:

  • if you have recently had a heart attack; or

  • if you are allergic to antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, or protriptyline.

Do not use trimipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure trimipramine is safe for you, tell your doctor if you have:

  • heart disease, or a history of heart attack;

  • bipolar disorder (manic-depression), schizophrenia or other mental illness;

  • liver disease;

  • history of seizures;

  • narrow-angle glaucoma;

  • a thyroid disorder; or

  • problems with urination.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trimipramine. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. It is not known whether trimipramine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether trimipramine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 18 years old without medical advice. Trimipramine is not approved for use in children.

How should I take trimipramine?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you need surgery, tell the surgeon ahead of time that you are using trimipramine. You may need to stop using the medicine for a short time.

Do not stop using trimipramine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using trimipramine.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve during treatment.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of trimipramine can be fatal.

What should I avoid while taking trimipramine?

Do not drink alcohol. Trimipramine can increase the effects of alcohol, which could be dangerous.

Grapefruit and grapefruit juice may interact with trimipramine and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. Trimipramine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Trimipramine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

  • a light-headed feeling, like you might pass out;

  • new or worsening chest pain, pounding heartbeats or fluttering in your chest;

  • confusion, hallucinations, unusual thoughts or behavior;

  • seizure (convulsions);

  • painful or difficult urination; or

  • restless muscle movements in your eyes, tongue, jaw, or neck.

Older adults may be more likely to have side effects from this medicine.

Common side effects may include:

  • headache, vision changes;

  • sleep problems (insomnia);

  • drowsiness, dizziness;

  • numbness or tingly feeling;

  • upset stomach;

  • breast swelling (in men or women); or

  • decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Trimipramine dosing information

Usual Adult Dose for Depression:

Outpatients:
Initial: 75 mg per day orally in divided doses.
Titration: May increase up to 150 mg per day. Usual range: 50 to 150 mg per day. The entire dose may be given at bedtime to improve patient compliance.
Maximum Dose: 200 mg per day.

Hospitalized patients: 100 mg per day orally in divided doses.
Titration: May increase gradually over a few days to 200 mg per day. If there is no improvement after 2 to 3 weeks, the dose may be increased to 250 to 300 mg per day.
Maximum Dose: 300 mg per day.

Usual Geriatric Dose for Depression:

Initial: 50 mg per day orally.
Titration: May increase in gradual increments up to 100 mg per day depending on patient response and tolerance.

Usual Pediatric Dose for Depression:

>12 years:
Initial: 50 mg per day orally.
Titration: May increase in gradual increments up to 100 mg per day depending on patient response and tolerance.

What other drugs will affect trimipramine?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking trimipramine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking trimipramine, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline.

You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can take trimipramine.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with trimipramine, especially:

  • any other antidepressant;

  • cimetidine (Tagamet);

  • cold medicine that contains a decongestant (such as phenylephrine or pseudoephedrine); or

  • heart rhythm medicine.

This list is not complete. Other drugs may interact with trimipramine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about trimipramine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 9.02. Revision Date: 2014-08-26, 11:40:21 AM.

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