Trimipramine | Side Effects, Dosage, Uses & More
Advertisement

Generic Name:

trimipramine, Oral capsule

All Brands

  • Surmontil
SECTION 1 of 4

Highlights for trimipramine

Oral capsule
1

Trimipramine is used to treat depression.

2

This drug comes in the form of a capsule you take by mouth.

3

Trimipramine is available as a brand-name drug called Surmontil. It’s also available as a generic drug.

4

The more common side effects of this drug include drowsiness, dizziness, dry mouth, blurry vision, problems urinating, or constipation. They also include sexual problems, such as decreased desire (libido) or erectile dysfunction (impotence).

5

Trimipramine may increase thoughts of harming yourself. This is most common within the first few months of treatment or when your dose changes. This risk is higher in children, teenagers, and young adults.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.

Suicide risk warning. Antidepressant medications may increase thoughts and behaviors of harming yourself. This is most common within the first few months of treatment or with changes in dosage. This risk is higher in children, teenagers, and young adults. While taking this drug, pay close attention to any unusual changes in your mood, behaviors, thoughts, or feelings. If you notice these changes, call your doctor right away.

Worsening depression

This drug may make your depression worse. Call your doctor if you have any unusual changes in behavior, especially during the first few months of treatment or when your dose changes. Changes in behavior can include thoughts or attempts to commit suicide, panic attacks, trouble sleeping, or feeling anxious, agitated, or restless. They can also include feeling irritable, hostile, or aggressive, acting on dangerous impulses, or having extreme mood swings.

Drowsiness and dizziness

This drug may cause drowsiness and dizziness. Don’t drive, use heavy machinery, or do any tasks that might be dangerous until you know how this drug affects you.

Drug features

This drug is a prescription drug. It comes in the form of a capsule you take by mouth.

Surmontil is a brand name for the drug trimipramine. It’s also available as a generic drug. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. 

This drug may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

This drug is used to treat depression.

How it works

This drug belongs to a class of drugs called tricyclic antidepressants.

More Details

How it works

This drug belongs to a class of drugs called tricyclic antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

It’s not known exactly how this drug works to help treat depression. It’s believed that tricyclic antidepressants block the reuptake of certain chemicals in your brain. These chemicals are called norepinephrine and serotonin, and they improve your mood. Blocking the reuptake raises the levels of these chemicals in your body, which helps improve your mood.

Advertisement
SECTION 2 of 4

trimipramine Side Effects

Oral capsule

More Common Side Effects

The more common side effects of this drug include:

  • drowsiness

  • dizziness

  • dry mouth

  • blurry vision

  • problems urinating

  • constipation

  • nausea

  • vomiting

  • loss of appetite

  • sexual problems, such as reduced sexual desire (libido) or erectile dysfunction (impotence)

  • fast heart rate

  • high blood pressure or low blood pressure (which occurs when standing after sitting or lying down)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Suicide risk and worsening depression. Symptoms can include:

    • thoughts about suicide or dying
    • attempts to commit suicide
    • new or worse depression
    • new or worse anxiety
    • feeling very agitated or restless
    • panic attacks
    • trouble sleeping
    • new or worse irritability
    • acting aggressive, angry, or violent
    • acting on dangerous impulses
    • mania (an extreme increase in activity and talking)
    • other unusual changes in behavior or mood
  • Eye problems. Symptoms can include:

    • eye pain
    • blurry vision
    • swelling or redness in or around your eyes
  • Heart problems. Symptoms can include:

    • pounding heartbeat
    • irregular heart rhythm
    • heart attack, with symptoms such as chest pain, shortness of breath, or discomfort in your upper body
    • stroke, with symptoms such as weakness in one part or side of your body, or slurred speech
  • Seizures

  • Serotonin syndrome. Symptoms can include:

    • changes in mental status such as agitation, hallucinations (seeing or hearing things that aren’t real), or coma
    • overactive reflexes, with symptoms such as coordination problems or muscle twitching
    • tremors
    • racing heartbeat
    • high or low blood pressure
    • sweating or fever
    • nausea, vomiting, or diarrhea
    • rigid (tense) muscles
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug may cause drowsiness and dizziness. Don’t drive, use heavy machinery, or do any tasks that might be dangerous until you know how this drug affects you.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

trimipramine May Interact with Other Medications

Oral capsule

Trimipramine can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Alcohol interaction

Trimipramine can cause drowsiness. The use of drinks that contain alcohol can increase your risk of drowsiness. If you drink alcohol, talk to your doctor about whether this drug is safe for you.

Medications that might interact with this drug

Drugs you should not use with trimipramine

Do not take these drugs with trimipramine. Doing so can cause dangerous effects in your body. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs) such as isocarboxazid, phenelzine, or tranylcypromine.
    • Taking these drugs with trimipramine raises your risk of a serious condition called serotonin syndrome. Symptoms include sweating, fever, tremors, hallucinations (seeing or hearing things that aren’t real), or even coma. You must wait 14 days between taking trimipramine and taking an MAOI.
  • Linezolid or intravenous methylene blue.
    • Taking these drugs with trimipramine raises your risk of a serious condition called serotonin syndrome. Symptoms include sweating, fever, tremors, hallucinations (seeing or hearing things that aren’t real), or even coma.

Interactions that increase your risk of side effects

Increased side effects from trimipramine: Taking trimipramine with certain medications raises your risk of side effects from trimipramine. This is because the amount of trimipramine in your body may be increased. Examples of these drugs include:

  • Cimetidine.
    • Increased side effects of trimipramine can include dizziness, constipation, high blood pressure, or serotonin syndrome. Your doctor may lower your dosage of trimipramine.
  • Other antidepressants such as citalopram, duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline.
    • Increased side effects can include a serious condition called serotonin syndrome. Symptoms include sweating, fever, tremors, hallucinations (seeing or hearing things that aren’t real), or even coma.
  • Anti-arrhythmic drugs such as flecainide, propafenone, or quinidine.
    • Increased side effects of trimipramine can include an increased risk of QT interval prolongation. This can be a sign of heart rhythm problems. Symptoms can include an irregular heartbeat, fainting, or seizures.
  • Antipsychotics such as chlorpromazine, fluphenazine, or thioridazine.
    • Increased side effects of trimipramine can include drowsiness or irregular heartbeat.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with a history of mania or bipolar disorder

Taking this drug alone may trigger a mixed or manic episode. Talk with your doctor about whether this drug is safe for you.

People with seizures

This drug can cause seizures. If you have a seizure disorder such as epilepsy, talk with your doctor about whether this drug is safe for you.

People with heart problems

Before starting this drug, be sure your doctor knows about any heart problems you have. These can include high blood pressure, heart failure, or a history of heart attack. Taking this drug raises your risk of problems such as a dangerously fast heart rate, heart attack, or stroke. Do not take this drug if you’ve had a recent heart attack. Your doctor will decide if you should start taking this drug again.

People with hyperthyroidism (high thyroid levels)

This drug raises your risk of arrhythmias (irregular heart rhythms). Talk with your doctor about whether this drug is safe for you.

People with closed-angle glaucoma

If your condition isn’t treated, this drug can make it worse. Talk with your doctor about whether this drug is safe for you.

People with problems urinating

This drug can make your condition worse. Talk with your doctor about whether this drug is safe for you.

People with kidney problems

If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects. Talk with your doctor about whether this drug is safe for you.

People with liver problems

If you have liver problems or a history of liver disease, you may not be able to process this drug as well. This may increase the levels of this drug in your body and cause more side effects. Talk with your doctor about whether this drug is safe for you.

Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

It’s not known if this drug can pass into breast milk and cause side effects in a child who is breastfed.

Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects, such as confusion or drowsiness.

For children

  • It has not been confirmed that this drug is safe and effective for use in children younger than 12 years of age.
  • This drug may cause suicidal thoughts and behaviors in children, adolescents, and young adults. This is most common during the first few months of use.

When to call the doctor

Call your doctor if you become pregnant while taking this drug.

Allergies

This drug can cause a severe allergic reaction. Symptoms can include:

  • rash
  • itching
  • trouble breathing
  • swelling of your face, throat, or tongue

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

SECTION 4 of 4

How to Take trimipramine (Dosage)

Oral capsule

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Depression

Generic: trimipramine

Form: Oral capsule
Strengths: 25 mg, 50 mg, 100 mg

Brand: Surmontil

Form: Oral capsule
Strengths: 25 mg, 50 mg, 100 mg
Adult dosage (ages 18–64 years)
  • Typical starting dosage: 75 mg per day, taken in divided doses. Your doctor may suggest that you take 25 mg three times per day, or 25 mg in the morning and 50 mg at bedtime.
    • Dosage increases:
      • Your doctor may slowly increase your dosage to 200 mg per day.
      • During this time, your doctor will monitor you for side effects. They’ll also check how well the medication works for you.
    • Maximum dosage: 200 mg per day.
Adolescent dosage (ages 12–17 years)
  • Typical starting dosage: 50 mg per day.
  • Dosage increases:
    • Your doctor may slowly increase your dosage to 100 mg per day. 
    • During this time, your doctor will monitor you for side effects. They’ll also check how well the medication works for you.
  • Maximum dosage: 100 mg per day.
Child dosage (ages 0–11 years)
  • It has not been confirmed that trimipramine is safe and effective for use in children younger than 12 years.
Senior dosage (ages 65 years and older)
  • Typical starting dosage: 50 mg per day.
  • Dosage increases:
    • Your doctor may slowly increase your dosage to 100 mg per day.
    • During this time, your doctor will monitor you for side effects. They’ll also check how well the medication works for you.
  • Maximum dosage: 100 mg per day.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug comes with risks if you don’t take it as prescribed.   

If you stop taking the drug or don’t take it at all

Your depression may not improve and may even get worse. Do not stop taking this drug suddenly. Stopping this drug suddenly can cause withdrawal symptoms. These symptoms can include nausea, headache, or malaise (feeling uncomfortable or uneasy).

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

You could have dangerous levels of the drug in your body. Taking too much of this drug can even lead to death. Symptoms of an overdose can also include:

  • abnormal or irregular heart rhythms
  • dangerously low blood pressure, with symptoms such as extreme lightheadedness or dizziness
  • seizures
  • coma 

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away. 

What to do if you miss a dose

Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

Your symptoms of depression should decrease. You should feel in a better mood. It may take up to 4 weeks for this drug to start easing your symptoms.

This drug is used for long-term treatment.

Store this drug carefully

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C).
  • Don’t store this medication in moist or damp areas, such as bathrooms.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:

  • Mental health and behavioral problems. Pay close attention to sudden changes in your mood, behaviors, thoughts, or feelings. If you notice any unusual changes, call your doctor right away.
  • Eye exam. This drug may cause problems such as blurred vision or eye pain. If you develop these problems or have a history of vision problems, tell your doctor. They will examine your eyes from time to time while you take this drug.
  • Kidney function. Your doctor will do blood tests to check how well your kidneys are working. This can help make sure this drug is safe for you to take.
  • Liver function. Your doctor will do blood tests to check how well your liver is working. This can help make sure this drug is safe for you to take.

Sun sensitivity

This drug can make your skin more sensitive to the sun. This increases your risk of sunburn. Avoid the sun if you can. If you can’t, be sure to wear protective clothing and apply sunscreen.

Not every pharmacy stocks the brand-name drug Surmontil

When filling your prescription, be sure to call ahead.

Hidden costs

You may need to have blood tests and eye exams during your treatment with this drug. The cost of these tests and exams will depend on your insurance coverage.

Insurance

Many insurance companies require a prior authorization for the brand-name version of this drug. This means your doctor may need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

What does the pill look like?

Showing - out of 14

Show Sources

  • Trimipramine maleate- trimipramine maleate capsule. (2015, May). Retrieved from   http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3e1e4157-bc15-4e2a-bb2a-ff41b2a8f905
  • Surmontil- trimipramine maleate capsule. (2015, February). Retrieved from   http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0177d783-773c-41bf-9db9-eb7e5c64474a

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on December 16, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Advertisement
Advertisement
Advertisement