FDA-filed SPL labeling · retrieved through openFDA

Trimipramine

Trimipramine is a tricyclic antidepressant used to relieve symptoms of depression.

Brand name Surmontil
Drug class Tricyclic Antidepressant
Rx Form 1 Route Oral
Dr. Brian Staiger, PharmD, BCPS
Reviewed by Last reviewed Jul 10, 2026
🧬 Where this information comes from Click to expand

The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 5 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →

At a glance
Linked label effectiveMar 17, 2026
Clinical labels in scope 5
AvailabilityRx
Earliest approval/marketing year 1979
FDA-listed product records 17
Boxed warningYes
How we combine label and product data →
No current FDA shortage listed · checked Sep 15, 2026
Trimipramine at a glance The quick version — the full detail is in the Patient Information Guide below.
💊
HelloPharmacist Editorial Team Bottom Line
Trimipramine is a tricyclic antidepressant used to relieve symptoms of depression, particularly endogenous depression. It has a sedating effect that can be helpful for some patients, but it requires close monitoring — especially early in treatment — for mood changes and suicidal thinking. Work with your prescriber to find the right dose, and never stop taking it abruptly without guidance.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert

Antidepressants, including trimipramine, increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults (ages 18–24) with depression and other psychiatric conditions. This risk was seen mainly in short-term studies. Adults over 24 did not show an increased risk, and adults 65 and older actually showed a reduced risk compared to placebo. Depression itself also raises suicide risk — so it's important to weigh the benefits of treatment against these risks. Anyone starting trimipramine should be watched closely for worsening mood, unusual changes in behavior, or any thoughts of suicide — especially in the first few weeks or after a dose change. Families and caregivers should be involved in this monitoring and should contact the prescriber right away if they notice any of these signs. Trimipramine capsules are not approved for use in children.

Read the full warning on DailyMed →

📖 Trimipramine: Patient Information Guide

A plain-language walkthrough of Trimipramine — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.

🎯What it's used for

Trimipramine capsules are used to treat depression. Here is what the supported products are approved for:

  • Trimipramine Maleate capsules — indicated for relief of symptoms of depression; endogenous depression (depression arising from within, without a clear external cause) is most likely to respond
  • Trimipramine capsules — indicated for relief of symptoms of depression; endogenous depression is more likely to be alleviated than other depressive states
⚙️How it works

Trimipramine is a tricyclic antidepressant (TCA) with a sedative component — meaning it has a calming effect in addition to its antidepressant action. Its exact mechanism in the brain is not fully understood. It does not work by stimulating the central nervous system like amphetamine-type drugs, and it does not work by blocking monoamine oxidase (an enzyme that breaks down brain chemicals like serotonin and dopamine).

💊How it's taken

Trimipramine capsules are taken by mouth. Your prescriber will start you on a low dose and increase gradually — this helps your body adjust and lowers the risk of side effects. The total daily dose can often be taken as a single capsule at bedtime, especially for maintenance therapy.

  • Older adults and adolescents are typically started on lower doses than other adults
  • It can take 10 days to 4 weeks before you feel the full antidepressant effect — this is normal; do not increase your dose to speed things up
  • After symptoms improve, your prescriber may keep you on a lower maintenance dose for around 3 months to prevent relapse
  • Never stop taking trimipramine suddenly without talking to your prescriber — tapering is important
🤒Side effects — in detail

Like most antidepressants, trimipramine can cause a range of side effects. Common ones include:

  • Drowsiness, dizziness, or fatigue
  • Dry mouth
  • Blurred vision or difficulty focusing
  • Constipation
  • Nausea, upset stomach, or vomiting
  • Weight changes
  • Increased sweating
  • Headache

More serious reactions — including irregular heartbeat, seizures, serotonin syndrome, signs of a blood disorder (fever and sore throat), or severe confusion — require prompt medical attention. Stopping the medication abruptly after long-term use can cause nausea, headache, and general discomfort; this is not a sign of addiction.

⚠️Warnings & precautions
  • Suicidal thinking: Antidepressants increase the risk of suicidal thoughts and behavior in people under 25, especially early in treatment or after dose changes. All patients should be monitored closely; families and caregivers should report any warning signs immediately.
  • Serotonin syndrome: A potentially life-threatening reaction can occur if trimipramine is combined with MAOIs, certain other antidepressants, or other serotonergic drugs. Symptoms include agitation, rapid heartbeat, high fever, muscle twitching, and confusion. Seek emergency care right away.
  • Heart effects: Trimipramine can affect heart rhythm and blood pressure. Use with extreme caution in anyone with heart disease, and it must not be used during the recovery period after a heart attack.
  • Bipolar disorder risk: Using an antidepressant alone in someone with undiagnosed bipolar disorder may trigger a manic episode. Patients should be screened for bipolar disorder before starting treatment.
  • Seizure risk: This drug lowers the seizure threshold — meaning it can make seizures more likely, especially in people with a history of seizures.
  • Angle-closure glaucoma: Trimipramine can dilate the pupils, which may trigger a dangerous pressure spike in people with narrow-angle glaucoma.
🔀What it interacts with

Trimipramine interacts with several common drugs and substances. Key ones to know about:

  • MAOIs (e.g., phenelzine, tranylcypromine, linezolid, IV methylene blue) — must not be used together or within 14 days of each other; risk of life-threatening serotonin syndrome
  • Alcohol — can significantly amplify trimipramine's sedative effects; avoid or strictly limit use
  • Other serotonergic drugs (triptans, lithium, tramadol, fentanyl, buspirone, tryptophan, St. John's Wort) — combined use increases serotonin syndrome risk
  • SSRIs (fluoxetine, sertraline, paroxetine) — inhibit an enzyme (CYP2D6) that breaks down trimipramine, raising its blood levels and side effect risk; extra caution is needed when switching between these drug classes
  • Cimetidine — slows the body's elimination of trimipramine; a dose adjustment may be needed
  • Sympathomimetic amines and drugs containing epinephrine (found in some decongestants and local anesthetics) — trimipramine can intensify their effects
  • Anticholinergic drugs — combined use may worsen dry mouth, constipation, urinary retention, and other anticholinergic effects
  • Drugs that inhibit CYP2D6 (e.g., quinidine, propafenone, flecainide) — can raise trimipramine blood levels unpredictably

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

📋Before taking it
  • Do not take trimipramine if you are currently taking an MAOI or have taken one within the last 14 days — this combination is contraindicated
  • Do not take trimipramine during the recovery period immediately following a heart attack
  • Tell your prescriber if you have any heart condition, irregular heartbeat, or history of stroke
  • Tell your prescriber if you have a history of seizures
  • Tell your prescriber if you have had trouble urinating or have an enlarged prostate
  • Tell your prescriber if you have a thyroid condition or take thyroid hormone medication
  • Tell your prescriber if you have narrow-angle glaucoma
  • Tell your prescriber if you have a personal or family history of bipolar disorder or suicide — screening is important before starting an antidepressant
  • Older adults are at higher risk for confusion, falls, and cardiovascular side effects; lower starting doses are recommended
  • Trimipramine capsules are not approved for use in children
  • Tell your prescriber about all medications, supplements, and herbal products you take, including St. John's Wort
🚑If you take too much

Taking too much trimipramine is a medical emergency. Signs of overdose can develop quickly and include dangerous heart rhythm changes, very low blood pressure, seizures, extreme confusion, and loss of consciousness or coma. If you suspect an overdose, call 911 or your local poison control center immediately — do not wait for symptoms to get worse. Hospital monitoring and treatment are required as soon as possible.

🔬Pharmacokinetics — how your body processes it

The body's handling of trimipramine was studied in a comparison of younger and older adults. A single-dose pharmacokinetic study involving 24 elderly subjects and 24 younger subjects found no clinically meaningful differences based on age or gender. Some people naturally process trimipramine more slowly due to differences in a liver enzyme called CYP2D6 — these individuals, called "poor metabolizers," can have much higher drug levels in their blood at standard doses, increasing the risk of side effects.

📦How to store it

Store at 20°-25°C (68°-77°F) . Dispense in a tight container.

📄 Written from Trimipramine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →

139

Supplements & herbs that interact with Trimipramine

139 supplements and herbal products have documented interactions with Trimipramine in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.

Severity mix
  • Major · 9
  • Moderate · 100
  • Minor · 30
Every supplement checked against Trimipramine — ranked by severity The full interaction hub: 9 major · 100 moderate · 30 minor · every one linked to its full report. Check Trimipramine against your exact supplements

Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.

3

Nutrient depletion considerations

Trimipramine has been associated with lower levels of 3 nutrients in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.

Evidence & significance mix
  • Higher significance · 1
  • Moderate · 1
  • Unrated · 1
See the full Trimipramine nutrient depletion report

Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.

🩺 Pharmacist Counseling Corner

Quick, plain-English answers to the questions patients ask most about Trimipramine — the kind of thing our pharmacy team would talk through with you at the counter.

What is trimipramine actually used for?
Trimipramine is an antidepressant used to relieve symptoms of depression. It tends to work best for what's called endogenous depression — depression that comes from within, rather than being clearly triggered by an outside event. It also has a calming, sedating effect, which some people find helpful. Your prescriber decided it was the right fit for you based on your specific situation.
How long does it take for trimipramine to start working?
It's totally normal not to feel a difference right away. Most antidepressants, including trimipramine, take anywhere from 10 days to 4 weeks before you notice a real improvement in mood. Please don't get discouraged or try to take more to speed things up — increasing the dose early doesn't make it work faster and only raises the risk of side effects. Stick with it and check in with your prescriber if you have concerns.
What side effects should I watch out for?
The most common ones are drowsiness, dry mouth, blurred vision, constipation, and dizziness — especially when you first start or after a dose increase. These often improve as your body adjusts. However, call your doctor right away if you notice a fast or irregular heartbeat, seizures, or signs of an allergic reaction. And importantly — if you ever have thoughts of harming yourself, especially in the first few weeks of treatment, get help immediately or call 988 (the Suicide & Crisis Lifeline).
Can I drink alcohol while taking trimipramine?
It's best to avoid alcohol or keep it to an absolute minimum. Trimipramine already has a sedating effect, and alcohol on top of that can make that drowsiness and impairment much more intense than you'd expect. It can also affect your heart and blood pressure. The label specifically warns that combining the two can lead to exaggerated effects, so play it safe and talk to your pharmacist or prescriber if you have questions.
Are there any medications I absolutely cannot take with trimipramine?
Yes — the most important ones are MAOIs (monoamine oxidase inhibitors), such as phenelzine, tranylcypromine, linezolid, or IV methylene blue. Combining trimipramine with these drugs — or even taking them too close together — can cause a serious, potentially life-threatening reaction called serotonin syndrome. You need at least 14 days between stopping one and starting the other. Also be sure your doctor and pharmacist know about everything you take, including herbal supplements like St. John's Wort, which can also interact.
Can I just stop taking trimipramine if I feel better?
Please don't stop on your own without talking to your prescriber first. Even if you're feeling much better, stopping an antidepressant suddenly can cause withdrawal-like symptoms — nausea, headache, and general feeling of being unwell. Your prescriber will likely recommend staying on a lower maintenance dose for about 3 months after you feel better, to help prevent your depression from coming back. If you want to stop, work with your doctor to taper off gradually.
Is Trimipramine available over the counter?
Trimipramine is dispensed by prescription according to its FDA labeling, so it isn't sold over the counter. Your prescriber and pharmacist will determine if it's appropriate for you.
When was Trimipramine first available?
Trimipramine has been available in the United States since at least 1979, based on FDA approval history (Drugs@FDA) and product marketing records.
Who makes Trimipramine?
Trimipramine is supplied by 6 manufacturers listed in the FDA NDC Directory, including Breckenridge Pharmaceutical, Inc., Bryant Ranch Prepack, Elite Laboratories, Inc..

💬 Answers drafted from Trimipramine’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →

🧰 Keep exploring

💊 How Trimipramine comes

Trimipramine is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.

Capsule

By mouth
How this form is used
What it may be used for
  • Trimipramine Maleate capsules are indicated to relieve symptoms of depression, particularly endogenous depression
  • Trimipramine capsules are indicated to relieve symptoms of depression, particularly endogenous depression
Important instructions
  • Trimipramine Maleate capsules are taken by mouth, with the dose started low and increased gradually based on response and tolerability
  • Trimipramine capsules may be taken as a single dose at bedtime for convenience and to support adherence
  • Trimipramine Maleate capsules require a waiting period of at least 14 days before or after stopping an MAOI intended to treat psychiatric disorders
  • Trimipramine capsules should not be started in a patient currently taking linezolid or intravenous methylene blue due to risk of serotonin syndrome
Available strengths 3 strengths
15 FDA-listed product records

📊 Trimipramine across the U.S. market

How Trimipramine appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.

1
Dose forms
6
Manufacturers
2
Brand names
17
FDA-listed product records
1979
First marketed

Also listed with the FDA, not a patient dose form: Powder (2) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.

Breckenridge Pharmaceutical, Inc.35%
Bryant Ranch Prepack18%
Elite Laboratories, Inc.18%
Epic Pharma, LLC18%
Lundbeck Pharmaceuticals Italy S.p.A.6%
Sanofi Winthrop Industrie6%

Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.

🔍 Compare Trimipramine products

A representative set of FDA-listed product records for Trimipramine — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)

Showing 17 of 17 products — FDA National Drug Code Directory. See every product, package size and price: browse all 17 Trimipramine NDCs →

RxNorm Concept Web — From Ingredient to Every Form and Strength

This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.

Ingredient (IN) Trimipramine RxCUI 10834 2 dose forms · 5 strengths
  1. Dose form (SCDF) Oral Capsule RxCUI 374238 In current FDA listings
    Clinical drug / strength (SCD) 25 MG RxCUI 313498 50 MG RxCUI 313499 100 MG RxCUI 313496
  2. Dose form (SCDF) Oral Tablet RxCUI 374239 No current FDA listing
    Clinical drug / strength (SCD) 10 MG RxCUI 250033 25 MG RxCUI 199820

Look up RxCUI 10834 in the RxCUI Atlas →

RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.

🏷️ Sold under these brand names

Surmontil

🏭 Manufacturers & labelers

Breckenridge Pharmaceutical, Inc. 6 Bryant Ranch Prepack 3 Elite Laboratories, Inc. 3 Epic Pharma, LLC 3 Lundbeck Pharmaceuticals Italy S.p.A. 1 Sanofi Winthrop Industrie 1

RxNorm drug class

Trimipramine belongs to the Tricyclic Antidepressant class.

Pharmacologic class Tricyclic Antidepressant
Drug family (ATC) Non-selective monoamine reuptake inhibitors

Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.

🔬 Where this comes from

Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.

📄
FDA-filed drug labels (SPL) Uses, dosing, warnings & side effects from SPL records retrieved through openFDA; the linked representative set can be verified on DailyMed. ✓ Linked label effective Mar 17, 2026
🏭
Forms, brands & labelersAggregated from ingredient-matched FDA National Drug Code Directory product records for Trimipramine.
📈
Real-world reportsThe FDA Adverse Event Reporting System (FAERS), served through openFDA.
🚨
Recalls & shortagesopenFDA drug-enforcement reports and the FDA drug-shortage database.
🧾 Clinical label set — FDA-filed SPL labels retained for Trimipramine after exact ingredient or ingredient-combination matching and applicable route/form matching
Clinical labels in scope
5
NDC products indexed
17
Distinct labelers/manufacturers represented
6
Linked representative label
Breckenridge Pharmaceutical, Inc.
Linked label effective
Mar 17, 2026
Composite sections available
18
Linked SPL Set ID
4f31df66-7dc2-1f04-e054-00144ff88e88
Linked SPL Document ID
e1cadaf3-e932-4bfb-a8fa-57fb52f7dc67
Open the linked representative label on DailyMed ↗

How we combine label and product data

HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 5 FDA-filed SPL label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.

For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Breckenridge Pharmaceutical, Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.

This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.