Trimipramine drug interactions that can lead to severe side effects

Drug interactions can completely change how your medicine works, so make sure you check with your doctor about possible drug interactions before taking any antidepressant. Also let your doctor know about other medicines that you are using. Your doctor can guide you on which medications can interact with Trimipramine and result in severe side effects


It has been proved that cimetidine hinders the elimination of antidepressants that belong to tricyclic group. In case cimetidine therapy is started, Trimipramine dosage should be reduced and should be increased when cimetidine therapy is stopped.


According to the studies Trimipramine can increase the power of catecholamines. Therefore extra caution should be taken while using Trimipramine with local decongestants, sympathomimetic amines, local anesthetics which contain atropine, epinephrine or medications with anticholinergic effects.

MAOIs and Trimipramine

Before starting with Trimipramine maleate capsules therapy, MAOI should be stopped at least 14 days before Trimipramine therapy is given. Similarly MAOIs should be allowed to use again after 14 days of halting Trimipramine maleate capsules.

Trimipramine with Methylene blue or Linezolid

Do not use the combination of Linezolid/methylene blue(intravenous) as it can result in a serious medical condition known as serotonin syndrome. In case a patient needs urgent treatment for a psychiatric condition, one can try other interventions along with hospitalization.

In some cases patient need treatment of  Methylene blue or Linezolid with Trimipramine therapy and since there are no alternative available for Methylene blue or Linezolid, the doctors are advised to judge the risks of serotonin syndrome in a particular patient and Trimipramine maleate capsules should be halted promptly and only Methylene blue or Linezolid can be continued.

Do not drink alcohol while you are on Trimipramine as it can be dangerous. Grapefruit juice or grapefruit can also interact with Trimipramine resulting in serious side effects. Speak to your doctor about grapefruit products.

There are many other drugs that can interact with Trimipramine and effect heart rhythm like dronedarone, disopyramide etc., so if you are using these medications, let your doctor know about it.

Also tell your doctor if you are taking certain drugs that lead to drowsiness like some anthistamines, medicine for anxiety, sleep, anti-seizure drugs, muscle relaxer, psychiatric medicines, pain relievers(narcotic) etc.,

Also discuss with your doctor if you are using other drugs that can interact with Trimipramine and increase the risk of seizures like INH, theophylline, phenothiazines, tramadol and tricyclic antidepressants.

The effects of drug interactions can range from mild to severe, but you need to make sure that the medicines you are using currently apart from Trimipramine are safe as they can interact with the medication to yield harmful effects. Let your doctor check the ingredients present in other medications and possibilities of various drug interactions. You can consult your doctor to know which medications can interact with Trimipramine so that your doctor can check the medications you can take along with Trimipramine and use Trimipramine safely. Drug interactions can be quite severe and if the side effects if left untreated can lead to serious problems.

Trimipramine dosage information to get maximum benefits

Trimipramine should be taken as directed by your doctor. Do not change your Trimipramine dose on your own. Do not discontinue the medicine without your doctor’s consent. To get maximum benefits, it is necessary to take the recommended dosage. This article will help you learn about the right Trimipramine dosage information. Consult your health care provider for the right dosage as each case is different and depending upon your medical condition, the doctor can prescribe you the right dose.

Dosage should be started at low doses, which can be increased slowly as required, depending on the patient’s tolerance to the medicine and clinical response. Lower dosages are prescribed for adolescents and elderly patients. Lower dosages are also given to patients who are not being hospitalized as compared to the doses given to a patient who is hospitalized. It is not possible to prescribe a general single dose of Trimipramine maleate(capsules) that can act as an effective treatment method in all patients. Therefore the right dosage depends on various factors like patient’s age, severity and chronicity of the disease, level of psychotherapeutic support and medical condition of a particular patient.

Most antidepressants take a period of minimum 10days to 4 weeks to show positive results. Dosage increment can cut down this period, but would result in adverse reactions too.

Normal Adult Dose

Office patients/Outpatients

Initial Dose: 75mg/day in split doses, which can be increased to 150mg/day.

Dosages should not exceed 200mg/day

Maintenance therapy: 50-150mg/day

Hospitalized patients

Initial dose: 100mg/day in split doses. This can increase to 200/mg/day slowly in a couple of days, depending upon individual’s tolerance and response to the medication

If there is no improvement seen in patient in 2-3 weeks, the dose can be increased to maximum dose of 250-300mg/day

Geriatric and Adolescents patients

Initial Dose: 50mg/day is ideal, which can be increased gradually to 100mg/day depending upon individual’s tolerance and response to the medication

Trimipramine over dosage and treatment

Over dosages of this class of medications can even lead to death. Multiple drug ingestion is very common with antidepressant overdose. The overdose management is changing every day and is quite challenging. Keeping this factor in mind, one should call medical help or poison control centre immediately in case of Trimipramine over dose. Symptoms and signs of toxicity accelerate after overdose of Trimipramine and thus hospitalization is must for a patient.

Signs of Trimipramine overdose include:

  • vomiting
  • drowsiness
  • stupor
  • agitation
  • hypothermia
  • hyperactive reflexes
  • hyperpyrexia
  • dilated pupils
  • disturbed concentration
  • muscle rigidity
  • hallucinations


To treat Trimipramine overdose, an ECG is obtained immediately followed by cardiac monitoring. Patient’s airway is secured, gastric decontamination is started and an intravenous line is established. The patient is kept under medical observation for at least 6 hours wherein cardiac monitoring is conducted to check for signs of hypotension, respiratory or CNS depression, seizures and cardiac dysrhythmias. If the toxicity signs continue during this period, the monitoring is extended for some more time.

Trimipramine can treat depression safely

Trimipramine is used to treat depression and some other health ailments as suggested by the doctor. It is a tricyclic antidepressant, which increases the action of chemicals present in the brain that helps boost your mood. The generic name is Trimipramine and brand name is Surmontil.

Avoid using Trimipramine if

  • You are allergic to the ingredients present in Trimipramine or to some similar drugs.
  • you have used linezolid, furazolidone or MAOI in past 14 days
  • you are regaining health after a heart attack

Contact your health care provider if any of the above conditions are applicable to you.

Some medical conditions can interact with Trimipramine. Tell your health care provider if you are suffering from any health ailments especially

  1. If you are planning to conceive, if you are pregnant or a nursing mother.
  2. if you are allergic to certain substances food or medicines
  3. If you consume alcohol based beverages daily or have a history of alcohol addiction.
  4. If your thyroid gland is overactive, you have glaucoma, irregular heartbeat, liver or kidney problems, heart problems, diabetes, enlarged prostate, porphyria or difficulty in urinating.
  5. if you are using any prescription/non prescription medications, dietary supplement or herbal preparation
  6. If you have a history of suicidal behaviour/ thoughts, seizures, mental disorder or bipolar disorder.
  7. If any surgery is scheduled or undergoing electroshock therapy.
  8. If you are using any medicine that consists of methylene blue.

Important Information

You can take Trimipramine at bedtime as it helps reducing the side effects like drowsiness that occurs during daytime. You can discuss about this possibility with your doctor.

Take Trimipramine orally with/without food. Read the instructions given on the label carefully. To get the effect of the medication, it will take nearly 1-3 weeks, so continue taking Trimipramine even if you think you are feeling well. Try not to miss any doses.

If you miss a Trimipramine dose, take it as soon as you recollect and if it’s almost the time for your next dose then skip the missed dose. Do not take extra dose to make up the missed dose and get back to your normal dosing schedule.

Do not consume alcohol with Trimipramine as it can increase drowsiness. Speak to your doctor about which other medications can lead to drowsiness. In diabetes patients, Trimipramine can change their blood sugar levels, so check your blood sugar levels regularly. Also discuss with your doctor before changing the dose of your diabetes medication.

Teenagers, children and young adults who use Trimipramine are at higher risk of suicidal actions or thoughts. Monitor patients who use Trimipramine closely. Get in touch with your doctor if worsened, sudden or new symptoms like restlessness, panic attacks, irritable behaviour, and unusual change in mood/behaviour occur. Contact your doctor immediately if you notice any signs of suicidal actions or thoughts.

Some people who use Trimipramine also develop eye problems. Your doctor can suggest you an eye exam if you face eye problems. Inform your doctor if you experience vision changes, eye pain, redness or swelling around eyes or in eyes.


Taking Trimipramine during pregnancy or breastfeeding…Is it safe?

Taking any antidepressants during pregnancy or breastfeeding is certainly going to result in some adverse effects on your baby’s health. Doctors do not recommend antidepressants during pregnancy or breastfeeding until and unless the patient needs it badly.

Sometimes women often face serious problems when it comes to depression and to fight depression they need antidepressant like Trimipramine to get desired effects. In such cases doctors determine the benefits and risks of using Trimipramine during pregnancy or breastfeeding

Trimipramine and pregnancy

Animal studies report high risk of embrotoxicity or increased risks of major abnormalities. Still there is no sufficient data available in case of humans. Animal studies report harmful effects on foetus. Trimipramine should be used in pregnancy only if your doctor believes that the benefits are higher than the risks. Withdrawal symptoms, agitation and respiratory depression have been seen in neonates whose mothers had used this medication during the last three months of the pregnancy.

According to the studies and opinions that come from different doctors, use of antidepressant in pregnancy is not safe and can lead to congenital malformations in babies. Though the safety of Trimipramine has still not been generated, but the medication is not recommended in pregnant woman especially in first and third trimester of their pregnancy. Make sure you inform your doctor if you are pregnant or planning to conceive while you are on Trimipramine.

Trimipramine and breastfeeding

There is no data available which supports whether Trimipramine is safe or not during breastfeeding. If you are using this drug during breastfeeding, talk to your doctor to know the possible risks and benefits to your child. The manufacturers of Trimipramine do not make any recommendation regarding Trimipramine use during breastfeeding.

There no evidences available that speak about whether the drug is secreted in breast milk or not. Looking at the possible side effects of Trimipramine, it is better to avoid using Trimipramine during breastfeeding as you are not aware of how it is going to affect your baby’s health. If you feel you need Trimipramine to fight depression, talk to your doctor as he might suggest you low doses of Trimipramine so that you can use the drug safely.

Many woman using Trimipramine often choose to discontinue Trimipramine during breastfeeding while many others discontinue breastfeeding while using Trimipramine. You care for your baby and do not want to harm your baby isn’t? You can also check with your doctor for alternative medicines that can help you treat depression effectively without using narcotic drugs. You can also switch to yoga, meditation and other exercise that can treat depression naturally.

Using any antidepressant can have its adverse effects so try going natural and opting for natural medicines or options for treating depression. They do work and you can also continue nursing your baby without worrying about the side effects of Trimipramine. Since there is no evidence available that describes use of Trimipramine in case of breastfeeding or pregnancy, try if you can avoid using the medicine for a period of time you are nursing your baby.

Long term and short term side effects of Trimipramine

While you are using Trimipramine, you can experience both long term and short term side effects. Short term side effects last for a short period of time and disappear as you get used to the medicine. Long term side effects continue to persist for a prolonged period and keep bothering you. These side effects need immediate medical help. Let us have a look at both types of side effects

Major side effects of Trimipramine

  • agitation
  • tarry, black stools
  • blurred vision
  • chest discomfort or pain
  • cold sweats
  • convulsions
  • pale, cool skin
  • hoarseness or cough
  • confusion about time, identity or place
  • bruising or bleeding
  • dark urine
  • depression
  • decreased urine volume
  • decreased urination frequency
  • speech problems
  • dry mouth
  • double vision
  • false beliefs
  • dry or flushed skin
  • hostility
  • hearing loss
  • headache
  • hyperventilation
  • increased thirst
  • increased urination
  • irritability
  • lethargy
  • rash or itching
  • appetite loss
  • side or lower back pain
  • mental or mood changes
  • nightmares
  • nausea
  • painful/difficult urination
  • passing urine more frequently
  • fast weight gain
  • slow speech
  • restlessness
  • sore throat
  • shuffling walk
  • unsteady walk or shakiness
  • sweating
  • trouble sleeping
  • unusual behaviour
  • trembling, unsteadiness, awkwardness with muscle coordination or muscle control
  • sleeping problems
  • feeling, acting or talking with excitement
  • sudden unconsciousness
  • unusual weakness or tiredness
  • weigh loss or weight gain
  • yellow skin or eyes
  • uncontrolled movements of back, neck and face
  • trouble in holding or releasing urine
  • swollen glands

Minor side effects

Some minor or short term side effects of Trimipramine do not need medical attention. These side effects disappear once your body gets used to the medication. Your doctor can advice you on how to prevent or reduce these side effects. In case these side effects last for longer period or become troublesome, contact your health care provider immediately.

Occurrence not known

  • stomach or abdominal cramps
  • bloating
  • black tongue
  • enlarged or dilated pupils
  • diarrhoea
  • heartburn
  • welts or hives
  • hair thinning or hair loss
  • enlargement of breasts
  • inability to keep or have erection
  • peculiar taste
  • loss in sexual performance, drive or desire
  • increased skin sensitivity to sunlight
  • severe sunburn
  • unexpected flow of milk from breasts
  • swollen testicles
  • breast soreness or swollen breasts in both men and women
  • increased eye sensitivity to light
  • difficulty in bowel movement
  • decreased in intercourse(sexual)
  • discomfort or pain in throat, chest or upper stomach
  • discoloration or redness of skin
  • small purple or red spots on the skin
  • inflammation or swelling of mouth

In case you notice any of the side effects mentioned above, contact your doctor immediately as these side effects can be severe too. Proper medical treatment can help you reduce these side effects.

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