Trimipramine
- Atc Codes:N06AA06
- CAS Codes:739-71-9#521-78-8
- PHARMGKB ID:739-71-9#521-78-8
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Finland: Surmontil; France: Surmontil; Germany: Herphonal, Mitramin, Pritamip, Pritax, Stangyl, Surmonil, Surmontil, Tipram, Triblet, Trimant, Trimidura, Trimijet, Trimineurin, Trimipramin, Trimitip, Trisif; Hungary: Sapilent; Ireland: Surmontil; Italy: Surmontil; Luxembourg: Surmontil; Malta: Surmontil; Portugal: Surmontil; Spain: Surmontil; UK: Surmontil.
North America
Canada: Apo-Trimip, Trimipramine; USA: Surmontil, Trimipramine.
Asia
Japan: Surmontil.
Drug combinations
Chemistry
Trimipramine: C~20~H~26~N~2~. Mw: 294.43. (1) 5H-Dibenz[b,f]azepine-5-propanamine, 10,11-dihydro-N,N,β-trimethyl-; (2) 5-[3-(Dimethylamino)-2-methylpropyl]-10,11-dihydro-5H-dibenz[b,f]azepine. CAS-739-71-9 (1966).
Trimipramine Maleate: C~20~H~26~N~2~ C~4~H~4~O~4~. Mw: 410.51. 5H-Dibenz[b,f]azepine-5-propanamine, 10,11-dihydro-N,N,β-trimethyl-, (Z)-2-butenedioate (1:1). CAS-521-78-8 (1966).
Pharmacologic Category
Antidepressants; Tricyclics and Other Norepinephrine-reuptake Inhibitors. (ATC-Code: N06AA06).
Mechanism of action
Increases synaptic concentration of serotonin and/or norepinephrine in CNS by inhibition of their reuptake by presynaptic neuronal membrane.
Therapeutic use
Treatment of depression.
Pregnancy and lactiation implications
Use with caution in pregnancy. Enters breast milk (contraindicated in nursing women).
Unlabeled use
Contraindications
Hypersensitivity to trimipramine, any component of the formulation, or other dibenzodiazepines. Use of MAOIs within 14 days. Use during acute recovery phase of MI.
Warnings and precautions
Therapy should not be discontinued abruptly in patients receiving high doses for prolonged periods. Use with caution in hyperthyroidism or patients receiving thyroid supplementation. May worsen psychosis or precipitate shift to mania or hypomania in bipolar disorder. Monotherapy in bipolar disorder should be avoided. Trimipramine not FDA approved for treatment of bipolar depression. May cause anticholinergic effects (constipation, xerostomia, blurred vision, urinary retention). Use with caution in decreased gastrointestinal motility, paralytic ileus, urinary retention, BPH, xerostomia, or visual problems. Degree of anticholinergic blockade produced by this agent is very high relative to other antidepressants. Not FDA approved for use in children. Use with caution in history of cardiovascular disease (including previous MI, stroke, tachycardia, or conduction abnormalities); risk of conduction abnormalities with this agent is high relative to other antidepressants. May cause orthostatic hypotension (risk high relative to other antidepressants). Use with caution in risk of this effect or in patients who would not tolerate transient hypotensive episodes (cerebrovascular disease, cardiovascular disease, hypovolemia, or concurrent medication use which may predispose to hypotension/bradycardia). Use with caution in diabetes mellitus (may alter glucose regulation). May cause sedation (degree of sedation very high relative to other antidepressants). Use with caution in hepatic and renal impairment. Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) with major depressive disorder and other psychiatric disorders. Trimipramine may increase risks associated with electroconvulsive therapy. Use with caution in risk of seizures, including patients with history of seizures, head trauma, brain damage, alcoholism, or concurrent therapy with medications which may lower seizure threshold. Effects may be potentiated when used with other sedative drugs or ethanol. Use with caution in the elderly. Decreased lower esophageal sphincter tone may cause GE reflux.