Trimipramine
Trimipramine is a tricyclic antidepressant capsule used to relieve the symptoms of depression.
🧬 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 →
Trimipramine (Surmontil) is an older tricyclic antidepressant, available as a generic, that relieves depression and has a calming, sedating effect, though exactly how it works is not known; today it is usually a later choice after newer antidepressants. Like other tricyclics it is harder to tolerate than newer options, and drowsiness, dry mouth, constipation and dizziness are what most people notice. Its boxed warning covers suicidal thoughts and behavior in children, teens and young adults, so anyone starting it should be watched for worsening mood or unusual behavior, especially early and after dose changes, with changes reported right away.
Clinical pearls
- Never combine it with an MAOI antidepressant, and allow at least 14 days between stopping one and starting the other.
- Bedtime dosing makes use of the sedation; skip alcohol, which exaggerates its effects, and test your alertness before driving.
- Tell your dentist you take it, and check before using decongestants, because epinephrine numbing shots and decongestants can have amplified effects.
- Tell every prescriber about heart disease or a recent heart attack, since trimipramine needs extreme caution there.
⚠️ FDA Boxed Warning — the FDA’s strongest safety alert ▾
Antidepressants, including trimipramine, can increase suicidal thoughts and behavior in children, teens, and young adults. This was seen in short-term studies of depression and other psychiatric conditions. It was not seen in adults over 24, and risk was lower in adults 65 and older.
Depression itself raises suicide risk. Anyone starting an antidepressant should be watched closely for worsening mood, suicidal thoughts, or unusual behavior changes. Families and caregivers should stay in close contact with the prescriber. Trimipramine capsules are not approved for use in children.
Patient information guide A plain-language walkthrough of Trimipramine, written from its FDA label.
What Trimipramine is used for
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Trimipramine is used for depression.
- Trimipramine oral capsules: relief of symptoms of depression
- Trimipramine Maleate oral capsules: relief of symptoms of depression
How Trimipramine works
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Trimipramine is an antidepressant with a sedative, anxiety-reducing effect. How it works in the central nervous system is not known. It is not a stimulant and does not work by inhibiting monoamine oxidase.
Trimipramine dosage
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Trimipramine is taken by mouth as a capsule. Your prescriber starts low and raises the dose slowly.
- The daily amount may be divided, or taken at bedtime.
- Older adults and adolescents usually get lower doses.
- Benefit often takes 10 days to 4 weeks. A higher dose will not speed this up.
- After you feel better, treatment usually continues for about three months to prevent relapse.
Follow your prescriber and pharmacy label.
Dosing details from the FDA-approved label
From the Trimipramine prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Usual Adult Dose - Outpatients and Office Patients
- Initially, 75 mg/day in divided doses, increased to 150 mg/day
- Maintenance therapy is in the range of 50 to 150 mg/day
- The total dosage requirement may be given at bedtime
- Maximum: Dosages over 200 mg/day are not recommended
- Lower dosages are recommended for outpatients as compared to hospitalized patients
- Usual Adult Dose - Hospitalized Patients
- Initially, 100 mg/day in divided doses
- May be increased gradually in a few days to 200 mg/day, depending upon individual response and tolerance
- If improvement does not occur in 2 to 3 weeks, the dose may be increased to the maximum recommended dose
- Maximum: 250 to 300 mg/day
- Adolescent and Geriatric Patients
- Initially, 50 mg/day, with gradual increments up to 100 mg/day, depending upon patient response and tolerance
- Lower dosages are recommended for elderly patients and adolescents
- Maintenance (following remission)
- Lowest dose that will maintain remission, preferably administered as a single dose at bedtime
- Continue maintenance therapy for about three months to minimize relapse
Read the label’s full dosing text
DOSAGE AND ADMINISTRATION Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerance. Lower dosages are recommended for elderly patients and adolescents. Lower dosages are also recommended for outpatients as compared to hospitalized patients who will be under close supervision. It is not possible to prescribe a single dosage schedule of trimipramine capsules that will be therapeutically effective in all patients. The physical psychodynamic factors contributing to depressive symptomatology are very complex; spontaneous remissions or exacerbations of depressive symptoms may occur with or without drug therapy. Consequently, the recommended dosage regimens are furnished as a guide which may be modified by factors such as the age of the patient, chronicity and severity of the disease, medical condition of the patient, and degree of psychotherapeutic support. Most antidepressant drugs have a lag period of ten days to four weeks before a therapeutic response is noted. Increasing the dose will not shorten this period but rather increase the incidence of adverse reactions. Usual Adult Dose Outpatients and Office Patients Initially, 75 mg/day in divided doses, increased to 150 mg/day. Dosages over 200 mg/day are not recommended. Maintenance therapy is in the range of 50 to 150 mg/day. For convenient therapy and to facilitate patient compliance, the total dosage requirement may be given at bedtime. Hospitalized Patients Initially, 100 mg/day in divided doses. This may be increased gradually in a few days to 200 mg/day, depending upon individual response and tolerance. If improvement does not occur in 2 to 3 weeks, the dose may be increased to the maximum recommended dose of 250 to 300 mg/day. Adolescent and Geriatric Patients Initially, a dose of 50 mg/day is recommended, with gradual increments up to 100 mg/day, depending upon patient response and tolerance. Maintenance Following remission, maintenance medication may be required for a longer period of time, at the lowest dose that will maintain remission. Maintenance therapy is preferably administered as a single dose at bedtime. To minimize relapse, maintenance therapy should be continued for about three months.
Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →
Trimipramine side effects
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Many side effects come from the drug’s drying, sedating effects.
Common side effects
- Dry mouth
- Blurred vision
- Constipation
- Drowsiness
- Dizziness
- Fatigue or weakness
- Headache
- Weight gain or loss
When to get medical help
- New or worsening depression, suicidal thoughts, or unusual changes in behavior, especially early in treatment or after dose changes
- Agitation, hallucinations, fever, sweating, shaking, stiff muscles, or fast heartbeat, which can signal serotonin syndrome
- Chest pain, irregular or very fast heartbeat, or signs of a stroke
- Fever and sore throat, which may point to a blood cell problem
- Seizures
- Trouble urinating
- Swelling of the face or tongue, or a skin rash
- Yellowing of the skin or eyes
Call your doctor for fever and sore throat, chest pain or irregular heartbeat, seizures, trouble urinating, facial swelling, yellow skin or eyes, or any mood worsening or suicidal thoughts.
Trimipramine warnings and precautions
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- Suicide risk: boxed warning for children, teens, and young adults. Watch closely early on and after dose changes.
- Serotonin syndrome: potentially life-threatening, especially with MAOIs or other serotonin-raising drugs.
- Heart: extreme caution with heart disease because of rhythm problems, heart attack, and stroke risk.
- Eyes: may trigger an angle-closure glaucoma attack in people with narrow angles.
- Seizures: can lower the seizure threshold.
- Bipolar disorder: not approved for bipolar depression, and antidepressants alone may trigger a manic episode.
- Alertness: may impair driving and machinery use.
Trimipramine interactions
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Several medicines can change how trimipramine works or add to its risks.
- MAOIs, linezolid, and intravenous methylene blue: serotonin syndrome risk
- Other serotonergic drugs (triptans, tramadol, fentanyl, lithium, buspirone, tryptophan, St. John’s wort): higher serotonin syndrome risk
- SSRIs, quinidine, and other CYP2D6 blockers: can raise trimipramine levels
- Cimetidine: can raise levels, so doses may need adjusting
- Alcohol: exaggerated effects
- Decongestants, epinephrine-containing anesthetics, and anticholinergics: amplified effects
- Guanethidine: its effect may be blocked
Interactions listed in the FDA-approved label
From the Trimipramine prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Cimetidine: Cimetidine inhibits the elimination of tricyclic antidepressants. Downward adjustment of trimipramine maleate dosage may be required if cimetidine therapy is initiated; upward adjustment if cimetidine therapy is discontinued.
- Alcohol: Concomitant use of alcoholic beverages may be associated with exaggerated effects. Patients should be warned.
- Catecholamines/sympathomimetic amines, local decongestants, local anesthetics containing epinephrine: Tricyclic antidepressants can potentiate the effects of catecholamines. Particular care should be exercised when administering tricyclic antidepressants with these.
- Anticholinergics (atropine or drugs with an anticholinergic effect): Atropine-like effects may be more pronounced in patients receiving anticholinergic therapy. Particular care should be exercised when administering with these drugs.
- Drugs that inhibit cytochrome P450 2D6 (quinidine, other antidepressants, phenothiazines, propafenone, flecainide): Inhibition of P450 2D6 can raise tricyclic antidepressant plasma concentrations, and a patient stable on a TCA dose may become abruptly toxic. May require lower doses of the TCA or the other drug; an increased TCA dose may be required when the other drug is withdrawn; monitor TCA plasma levels.
- Selective serotonin reuptake inhibitors (fluoxetine, sertraline, paroxetine): All SSRIs inhibit P450 2D6, though they may vary in the extent of inhibition. Caution is indicated in co-administration and in switching from one class to the other; sufficient time must elapse before initiating TCA treatment in a patient withdrawn from fluoxetine (at least 5 weeks may be necessary).
- Monoamine Oxidase Inhibitors (MAOIs): Label refers to the CONTRAINDICATIONS, WARNINGS and DOSAGE AND ADMINISTRATION sections. At least 14 days should elapse between stopping an MAOI intended to treat psychiatric disorders and starting trimipramine, and at least 14 days after stopping trimipramine before starting such an MAOI.
- Linezolid or intravenous methylene blue: Increased risk of serotonin syndrome. Do not start trimipramine in a patient being treated with these; if urgent treatment is needed, stop trimipramine promptly and monitor for serotonin syndrome for 2 weeks or until 24 hours after the last dose, whichever comes first.
- Serotonergic drugs: Label refers to the CONTRAINDICATIONS, WARNINGS and DOSAGE AND ADMINISTRATION sections.
Read the label’s full interactions text
Drug Interactions Cimetidine There is evidence that cimetidine inhibits the elimination of tricyclic antidepressants. Downward adjustment of trimipramine maleate dosage may be required if cimetidine therapy is initiated; upward adjustment if cimetidine therapy is discontinued. Alcohol Patients should be warned that the concomitant use of alcoholic beverages may be associated with exaggerated effects. Catecholamines/Anticholinergics It has been reported that tricyclic antidepressants can potentiate the effects of catecholamines. Similarly, atropine-like effects may be more pronounced in patients receiving anticholinergic therapy. Therefore, particular care should be exercised when it is necessary to administer tricyclic antidepressants with sympathomimetic amines, local decongestants, local anesthetics containing epinephrine, atropine or drugs with an anticholinergic effect. In resistant cases of depression in adults, a dose of 2.5 mg/kg/day may have to be exceeded. If a higher dose is needed, ECG monitoring should be maintained during the initiation of therapy and at appropriate intervals during stabilization of dose Drugs Metabolized by P450 2D6 The biochemical activity of the drug metabolizing isozyme cytochrome P450 2D6 (debrisoquin hydroxylase) is reduced in a subset of the caucasian population (about 7 to 10% of caucasians are so called “poor metabolizers”); reliable estimates of the prevalence of reduced P450 2D6 isozyme activity among Asian, African, and other populations are not yet available. Poor metabolizers have higher than expected plasma concentrations of tricyclic antidepressants (TCAs) when given usual doses. Depending on the fraction of drug metabolized by P450 2D6, the increase in plasma concentration may be small, or quite large (8 fold increase in plasma AUC of the TCA). In addition, certain drugs inhibit the activity of the isozyme and make normal metabolizers resemble poor metabolizers.
Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Trimipramine
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- Do not use with or within 14 days of an MAOI.
- Do not use during the acute recovery period after a heart attack.
- Tell your doctor about allergy to tricyclic antidepressants.
- Not approved for children.
- Lower doses are recommended for adolescents and older adults.
- Tell your doctor about heart disease, glaucoma, urinary retention, seizures, thyroid problems, or bipolar disorder.
Trimipramine overdose
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Overdose with tricyclic antidepressants can be fatal. Signs include heart rhythm problems, very low blood pressure, seizures, confusion, and coma. Get emergency help or call poison control immediately, because symptoms develop quickly and hospital monitoring is needed.
What Trimipramine does in the body
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Trimipramine is an antidepressant with a calming, anxiety-reducing sedative component. It does not act mainly by stimulating the central nervous system. It also has anticholinergic effects, which cause dry mouth, constipation, and urinary retention.
How your body processes Trimipramine
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In a single-dose study of 24 older and 24 younger people, there were no clinically relevant differences in how the body handled trimipramine based on age or gender. Some people break down tricyclic antidepressants more slowly through the CYP2D6 enzyme, which can lead to higher drug levels.
How to store Trimipramine
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Store at 20°-25°C (68°-77°F) . Dispense in a tight container.
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
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.
- Major · 9
- Moderate · 100
- Minor · 30
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.
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.
- Higher significance · 1
- Moderate · 1
- Unrated · 1
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
Trimipramine: pharmacist answers to common questions
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 for?
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How should I take it?
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What side effects should I expect?
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Is there a mood-related warning I should know about?
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What shouldn't I mix with it?
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Can I stop it suddenly?
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Is Trimipramine available over the counter?
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When was Trimipramine first available?
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Who makes Trimipramine?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Trimipramine on HelloPharmacist
Trimipramine forms and strengths (how it 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.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Trimipramine inactive ingredients by manufacturer.
Capsule
How this form is used
- Trimipramine capsules are indicated for the relief of symptoms of depression.
- Trimipramine Maleate capsules are indicated for the relief of symptoms of depression.
- Trimipramine capsules are started at a low dose and raised gradually based on response.
- Trimipramine capsules may be given as a single bedtime dose for maintenance therapy.
- Trimipramine Maleate capsules often take 10 days to 4 weeks to show a benefit, and a higher dose will not speed this up.
Trimipramine on the U.S. market: products, makers and brands
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.
3 companies list 9 Trimipramine product records with the FDA, mostly as capsule; the earliest marketing or approval year on record is 1979. Brand names on the directory include Surmontil; the rest are generics.
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.
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.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Capsule | ||||
| 25 mg | Oral | Breckenridge Pharmaceutical, Inc. | ANDA | View NDC → |
| 50 mg | Oral | Breckenridge Pharmaceutical, Inc. | ANDA | View NDC → |
| 100 mg | Oral | Breckenridge Pharmaceutical, Inc. | ANDA | View NDC → |
| 25 mg | Oral | Bryant Ranch Prepack | ANDA | View NDC → |
| 50 mg | Oral | Bryant Ranch Prepack | ANDA | View NDC → |
| 100 mg | Oral | Bryant Ranch Prepack | ANDA | View NDC → |
| 25 mg | Oral | Elite Laboratories, Inc. | ANDA | View NDC → |
| 50 mg | Oral | Elite Laboratories, Inc. | ANDA | View NDC → |
| 100 mg | Oral | Elite Laboratories, Inc. | ANDA | View NDC → |
Showing 9 of 9 products — FDA National Drug Code Directory. See every product, package size and price: browse all 9 Trimipramine NDCs →
Trimipramine side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Trimipramine — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Trimipramine in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Trimipramine FDA approval history
How Trimipramine went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Trimipramine recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list no Trimipramine recalls since July 2021.
✅No Trimipramine recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
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.
RxCUI 10834 2 dose forms · 5 strengths
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Dose form (SCDF) Oral Capsule RxCUI 374238In current FDA listings -
Dose form (SCDF) Oral Tablet RxCUI 374239No current FDA listingClinical drug / strength (SCD) 10 MGRxCUI 25003325 MGRxCUI 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.
Trimipramine supply and shortage status
Whether Trimipramine is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
Trimipramine brand names
Trimipramine is sold under one brand name in the FDA directory — Surmontil. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Trimipramine: manufacturers and labelers
3 companies list Trimipramine products with the FDA. By number of product records, the largest are Breckenridge Pharmaceutical, Inc., Bryant Ranch Prepack, Elite Laboratories, Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Trimipramine drug class (RxNorm)
Trimipramine belongs to the Tricyclic Antidepressant class.
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.
Sources for this Trimipramine page
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.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Breckenridge Pharmaceutical, Inc. is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →