What is this medication?
Antidepressant, Tricyclic (Tertiary Amine)
“Alert: Black Box Warning
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children, adolescents, and young adults with major depressive disorder (MDD) and other psychiatric disorders in short-term studies. Anyone considering the use of trimipramine or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults older than 24 years; there was a reduction in risk with antidepressants compared with placebo in adults 65 years and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Closely observe patients of all ages who are started on therapy for clinical worsening, suicidality, or unusual changes in behavior. Advise families and caregivers of the need for close observation and communication with the prescriber. Trimipramine is not approved for use in pediatric patients.”
How does this medication work?
Trimipramine, Surmontil effects are proposed to result from postsynaptic sensitization to serotonin.
How should I take this medication?
Oral: Initial: 25 to 300 mg/day at bedtime or in divided doses based on response and tolerability.
How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day without regard to food unless otherwise directed, store at room temperature. Administer initial doses in divided doses to minimize side effects while body gets used to medication; administer maintenance doses as a single dose at bedtime to minimize daytime grogginess.
You Need to Avoid: Do not stop this medication without tapering dose down over time to prevent withdrawal symptoms (nausea, diarrhea, sweating, headaches, agitation, insomnia, anxiety, tremor, vertigo, dizziness, tingling in extremities). Tolerance to sedation may develop however caution operating heavy machinery or driving if feeling impaired. May increase the central nervous system depressant effects of alcohol so caution if alcohol is to be consumed.
What should I watch for while using this medication?
Before starting Trimipramine, Surmontil make sure your physician is aware of any allergies, medications you currently take, if you have cardiovascular disease, diabetes, hepatic impairment, mania/hypomania, renal impairment, a seizure disorder, a history of suicidal ideation, are pregnant, or breastfeeding. Trimipramine, Surmontil use has been associated with potentially serious adverse reactions including anticholinergic effects, CNS depression, increased risk of fracture, orthostatic hypotension, serotonin syndrome, and SIADH.
What if I miss a dose?
If you miss a dose of medication, try to take it as soon as possible. However, if it is almost time for your next dose, take only that scheduled dose. Do not take double or extra doses.
How should I store this medication?
Keep out of the reach of children at all times. Store at room temperature, 59 to 86° F (15 to 30° C). Protect from light. Keep the container tightly closed. Properly dispose of any unused medication after the expiration date.
What are the possible side effects of using this medication?
The frequency of side effects is not well defined but can include the following and are based on reports for other agents in this same pharmacologic class, and may not be specifically reported for Trimipramine, Surmontil:
Cardiac arrhythmia, cerebrovascular accident, facial edema, flushing, heart block, hypertension, hypotension, myocardial infarction, palpitations, tachycardia, abnormal electroencephalogram, agitation, anxiety, ataxia, confusion, delusions, disorientation, dizziness, drowsiness, exacerbation of psychosis, extrapyramidal reaction, fatigue, hallucination, headache, hypomania, insomnia, nightmares, numbness, paresthesia, peripheral neuropathy, restlessness, seizure, tingling sensation, withdrawal syndrome, alopecia, diaphoresis, pruritus, skin photosensitivity, skin rash, urticaria, change in libido, galactorrhea, gynecomastia, hyperglycemia, hypoglycemia, SIADH, weight gain, weight loss, abdominal cramps, anorexia, constipation, diarrhea, epigastric distress, melanoglossia, nausea, paralytic ileus, parotid gland enlargement, stomatitis, unpleasant taste, vomiting, xerostomia, breast hypertrophy, difficulty in micturition, impotence, testicular swelling, urinary retention, agranulocytosis, eosinophilia, petechia, purpura, thrombocytopenia, cholestatic jaundice, increased liver enzymes, tongue edema, tremor, weakness, accommodation disturbance, angle-closure glaucoma, blurred vision, mydriasis, tinnitus, polyuria
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