Trimipramine

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

Trimipramine may also be used for reasons not mentioned in this medication guide.

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.

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

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

Some young people may have thoughts about suicide when they first start taking an antidepressant. Be aware of any changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

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 taken an MAO inhibitor in the last 14 days. A dangerous drug interaction could happen. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Tell your doctor if you have taken 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.

Make 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 they first start taking an antidepressant. Your doctor should monitor your progress during regular visits. Your family or other caregivers should also be aware of 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.

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.

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

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

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.

Drinking alcohol with trimipramine can cause side effects.

Avoid driving or doing dangerous activities 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.

Using trimipramine with other medications that cause drowsiness can make you feel even more tired. Talk to your doctor before taking opioid painkillers, sleeping pills, muscle relaxants, or medications for anxiety or seizures.

Inform your doctor about all the other medicines you are taking, especially:

• medicines for depression, anxiety, mood disorders, or mental illness;
• cold or allergy medicines (like Benadryl and others);
• medicines for Parkinson's disease;
• medicines for stomach issues, motion sickness, or irritable bowel syndrome;
• medicines for overactive bladder; or
• bronchodilator asthma medicines.

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