Trimipramine

Trimipramine is a prescription medication used to treat symptoms of depression.

• Trimipramine is available under the following different brand names: Surmontil, Trimip, Tripramine

Common side effects of Trimipramine include:

• dizziness
• drowsiness
• difficulty urinating
• headache
• weakness
• changes in appetite or weight
• dry mouth
• blurred vision
• ringing in your ears
• constipation
• diarrhea
• tingly feeling
• lack of coordination
• breast swelling (in men or women)
• decreased sex drive
• impotence
• difficulty having an orgasm

Serious side effects of Trimipramine include:

• jaw, neck, and back muscle spasms
• slow or difficult speech
• shuffling walk
• uncontrollable shaking of a part of the body
• fever and sore throat
• difficulty breathing or swallowing
• rash
• yellowing of the skin or eyes
• seizures
• seeing things or hearing voices that do not exist (hallucinating)
• chest pain
• pounding or irregular heartbeat

Rare side effects of Trimipramine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Capsule

• 25 mg
• 50 mg
• 100 mg

Depression

Adult dosage

• Outpatient
  • Initial: 50 to 75 mg orally once a day in divided doses; gradually titrate upward every 2 to 3 weeks
  • Maintenance: 50 to 150 mg orally once a day; may increase up to 200 mg/day if needed
  • Adolescents: Not to exceed 100 mg/day
• Inpatient
  • 100 mg orally once a day; initially, may increase over a few days up to 200 mg/day
  • May increase up to 250 to 300 mg/day if no improvement in 2 to 3 weeks

Pediatric dosage

• Children aged younger than 12 years: Safety and efficacy not established
• Children aged 12 years and older: 50 mg/day initially; titrate to 100 mg/day
• Administer the lowest effective dose for maintenance

Dosage Considerations – Should be Given as Follows:

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, healthcare provider, or pharmacist first.

• Trimipramine has severe interactions with the following drugs:
  • disopyramide
  • ibutilide
  • indapamide
  • iobenguane I 123
  • isocarboxazid
  • pentamidine
  • phenelzine
  • pimozide
  • procainamide
  • procarbazine
  • quinidine
  • safinamide
  • selegiline
  • sotalol
  • tranylcypromine
• Trimipramine has serious interactions with at least 148 other drugs
• Trimipramine has moderate interactions with at least 374 other drugs
• Trimipramine has minor interactions with at least 75 other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Hypersensitivity
• Severe cardiovascular disorder
• Narrow-angle glaucoma
• Any drugs or conditions that prolong QT interval
• Acute recovery post-MI
• Coadministration with serotonergic drugs
• Do not use monoamine oxidase inhibitors (MAOIs) concomitantly or within 14 days before initiating Trimipramine or within 14 days after discontinuing trimipramine
• Symptoms include tremors, myoclonus, diaphoresis, nausea, vomiting, flushing, dizziness, hyperthermia with features resembling neuroleptic malignant syndrome, seizures, rigidity, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma
• Starting trimipramine in a patient who is being treated with linezolid or IV methylene blue is contraindicated because of an increased risk of serotonin syndrome
• If linezolid or IV methylene blue must be administered, discontinue Trimipramine immediately and monitor for CNS toxicity; may resume imipramine 24 hours after the last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Trimipramine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Trimipramine?”

Cautions

• Benign prostatic hypertrophy (BPH), urinary/GI retention, increases intraocular pressure (IOP), hyperthyroidism, open-angle glaucoma, seizure disorder, brain tumor, respiratory impairment
• Clinical worsening and suicide ideation may occur despite medication
• Risk of anticholinergic side effects
• Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy
• Lactation
  • Avoid