Trimipramine

Generic name: trimipramine [ trye-MI-pra-meen ]
Brand name: Surmontil
Dosage form: oral capsule (100 mg; 25 mg; 50 mg)
Drug class: Tricyclic antidepressants

Medically reviewed by Drugs.com on Jun 8, 2023. Written by Cerner Multum.

What is trimipramine?

Trimipramine is a tricyclic antidepressant that is used to treat symptoms of depression.

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

Trimipramine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty 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.

Trimipramine may cause serious side effects. Call your doctor at once if you have:

• 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, unusual thoughts or behavior;

• a seizure (convulsions);

• painful or difficult urination;

• easy bruising, unusual bleeding;

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

• fever, chills, sore throat, mouth sores, feeling light-headed.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of trimipramine may include:

• increased blood pressure;

• numbness or tingling in your hands or feet;

• dry mouth, nausea, vomiting;

• rash, itching;

• breast swelling (in men or women); or

• abnormal liver function tests.

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.

Warnings

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

Do not use trimipramine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

Before taking this medicine

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

• you recently had a heart attack; or

• 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.

Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone.

Tell your doctor if you have ever had:

• bipolar disorder (manic-depression) or schizophrenia;

• mental illness or psychosis;

• liver disease;

• heart disease;

• a heart attack or stroke;

• a seizure;

• overactive thyroid;

• diabetes (trimipramine may raise or lower blood sugar);

• narrow-angle glaucoma; or

• problems with urination.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with trimipramine and cause a serious condition called serotonin syndrome.

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

Tell your doctor if you are pregnant or breastfeeding.

Trimipramine is not approved for use by anyone younger than 18 years old.

How should I take trimipramine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

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.

If you need surgery, tell your surgeon you currently use this medicine. You may need to stop 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.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Trimipramine dosing information

Usual Adult Dose for Depression:

Outpatients/Office Patients:
-Initial dose: 75 mg orally per day in divided doses
-Maintenance dose: 50 to 150 mg orally per day
-Maximum dose: 200 mg/day

Hospitalized patients:
-Initial dose: 100 mg orally per day in divided doses
-Maintenance dose: 200 mg orally per day
-Maximum dose: 300 mg/day

Comments:
-The entire dose may be given at bedtime to improve patient compliance.
-The maintenance dose should be the lowest dose that will maintain remission.
-To minimize relapse, maintenance therapy should be continued for at least 3 months.

Use: Relief of symptoms of depression

Usual Geriatric Dose for Depression:

Initial: 50 mg orally per day
Maintenance dose: 100 mg orally per day

Comments:
-Maintenance therapy is preferably administered as a single dose at bedtime.
-The maintenance dose should be the lowest dose that will maintain remission.
-To minimize relapse, maintenance therapy should be continued for at least 3 months.

Use: Relief of symptoms of depression

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

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.

Overdose symptoms may include irregular heartbeats, severe drowsiness, confusion, hallucinations, agitation, stiff muscles, overactive reflexes, vomiting, feeling hot or cold, vision problems, feeling like you might pass out, seizures, or coma.

What should I avoid while taking trimipramine?

Drinking alcohol with trimipramine can cause side effects.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

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

What other drugs will affect trimipramine?

Using trimipramine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• medicine to treat depression, anxiety, mood disorders, or mental illness;

• cold or allergy medicine (Benadryl and others);

• medicine to treat Parkinson's disease;

• medicine to treat stomach problems, motion sickness, or irritable bowel syndrome;

• medicine to treat overactive bladder; or

• bronchodilator asthma medication.

This list is not complete. Other drugs may affect trimipramine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Further information

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.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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