Dosing & Uses
Dosage Forms & Strengths
capsule
- 25mg
- 50mg
- 100mg
Depresssion
Outpatient
- Initial: 50-75 mg PO qDay in divided doses; gradually titrate upward q2-3Weeks
- Maintentance: 50-150 mg PO qDay; may increase up to 200 mg/day if needed
- Adolscents: Not to exceed 100 mg/day
Inpatient
- 100 mg PO qDay; initially, may increase over a few days up to 200 mg/day
- May increase up to 250-300 mg/day if no improvement in 2-3 weeks
Dosage Forms & Strengths
capsule
- 25mg
- 50mg
- 100mg
Depression
<12 years: Safety and efficacy not established
≥12 years: 50 mg/day initially; titrate to 100 mg/day
Administer lowest effective dose for maintenance
Avoid; strong anticholinergic and sedative effects; may cause orthostatic hypotension (Beers criteria)
Consider alternatives; if must use, initiate with lower initial dose
50 mg/day PO initially; may increase up to 100 mg/day
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (15)
- disopyramide
trimipramine and disopyramide both increase QTc interval. Contraindicated.
- ibutilide
trimipramine and ibutilide both increase QTc interval. Contraindicated.
- indapamide
trimipramine and indapamide both increase QTc interval. Contraindicated.
- iobenguane I 123
trimipramine decreases effects of iobenguane I 123 by pharmacodynamic antagonism. Contraindicated. If clinically appropriate, discontinue drugs that decrease uptake of NE for at least 5 half-lives; may cause false-negative imaging results.
- isocarboxazid
isocarboxazid and trimipramine both increase serotonin levels. Contraindicated.
- pentamidine
trimipramine and pentamidine both increase QTc interval. Contraindicated.
- phenelzine
phenelzine and trimipramine both increase serotonin levels. Contraindicated.
- pimozide
trimipramine and pimozide both increase QTc interval. Contraindicated.
- procainamide
trimipramine and procainamide both increase QTc interval. Contraindicated.
- procarbazine
procarbazine and trimipramine both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.
- quinidine
quinidine and trimipramine both increase QTc interval. Contraindicated.
- safinamide
trimipramine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.
- selegiline
selegiline and trimipramine both increase serotonin levels. Contraindicated. Concurrent use or use within 14 days of selegiline treatment is contraindicated
- sotalol
trimipramine and sotalol both increase QTc interval. Contraindicated.
- tranylcypromine
tranylcypromine and trimipramine both increase serotonin levels. Contraindicated.
Serious - Use Alternative (148)
- abametapir
abametapir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.
- adagrasib
adagrasib, trimipramine. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- albuterol
trimipramine, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- amiodarone
trimipramine and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.
- amitriptyline
amitriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
amitriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - amoxapine
amoxapine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
amoxapine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - apalutamide
apalutamide will decrease the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP2C19 inducer, with drugs that are CYP2C19 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered.
apalutamide will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed. - arformoterol
trimipramine, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- arsenic trioxide
trimipramine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
trimipramine and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- benzphetamine
trimipramine, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- buprenorphine
buprenorphine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- buspirone
trimipramine and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.
- calcium/magnesium/potassium/sodium oxybates
trimipramine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- chlorpromazine
chlorpromazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
citalopram and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Citalopram may increase TCA levels. Increased risk of serotonin syndrome or neuroleptic malignant syndrome. Potential risk for QT prolongation. ECG monitoring is recommended.
citalopram and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. - clarithromycin
trimipramine and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.
- clomipramine
clomipramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
clomipramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - clonidine
trimipramine decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.
- cyclobenzaprine
trimipramine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.
- dacomitinib
dacomitinib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid use with CYP2D6 substrates where minimal increases in concentration of the CYP2D6 substrate may lead to serious or life-threatening toxicities.
- desipramine
desipramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
desipramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - desvenlafaxine
trimipramine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
- dexfenfluramine
trimipramine, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dexmethylphenidate
trimipramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dextroamphetamine
trimipramine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dextromethorphan
trimipramine and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.
- diethylpropion
trimipramine, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dobutamine
trimipramine, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dofetilide
trimipramine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
- dolasetron
dolasetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- donepezil
donepezil and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- dopamine
trimipramine, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- dopexamine
trimipramine, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- doxepin
doxepin and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
doxepin and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - dronedarone
trimipramine and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.
- droperidol
trimipramine and droperidol both increase QTc interval. Avoid or Use Alternate Drug.
- duloxetine
duloxetine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- encorafenib
encorafenib and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- ephedrine
trimipramine, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- epinephrine
epinephrine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
trimipramine, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - epinephrine racemic
epinephrine racemic and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
trimipramine, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - erythromycin base
trimipramine and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
trimipramine and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin lactobionate
trimipramine and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.
- erythromycin stearate
trimipramine and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.
- escitalopram
escitalopram and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- fenfluramine
trimipramine, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- fexinidazole
fexinidazole and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
fexinidazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates. - fluconazole
trimipramine and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.
- fluoxetine
fluoxetine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- fluphenazine
fluphenazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- fluvoxamine
fluvoxamine will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug.
- formoterol
trimipramine and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
trimipramine, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. - fosamprenavir
fosamprenavir increases levels of trimipramine by decreasing metabolism. Avoid or Use Alternate Drug.
- fosphenytoin
fosphenytoin will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- givosiran
givosiran will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2D6 substrates with givosiran. If unavoidable, decrease the CYP2D6 substrate dosage in accordance with approved product labeling.
- granisetron
granisetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- guanfacine
trimipramine decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.
- haloperidol
trimipramine and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- idelalisib
idelalisib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates
- imipramine
imipramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
imipramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - iobenguane I 131
trimipramine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.
- isoproterenol
trimipramine, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- itraconazole
trimipramine and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
ivosidenib will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. - ketoconazole
trimipramine and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- levalbuterol
trimipramine, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- levoketoconazole
trimipramine and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
- levomilnacipran
levomilnacipran and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- linezolid
linezolid and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.
- lisdexamfetamine
trimipramine, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- lofepramine
lofepramine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
lofepramine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - lonafarnib
lonafarnib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.
lonafarnib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling. - lumefantrine
trimipramine and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- maprotiline
maprotiline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
maprotiline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - mefloquine
mefloquine increases toxicity of trimipramine by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.
- meperidine
trimipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- metaproterenol
trimipramine, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methamphetamine
trimipramine, methamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methylene blue
methylene blue and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
- methylenedioxymethamphetamine
trimipramine, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- metoclopramide intranasal
trimipramine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- midodrine
trimipramine, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- milnacipran
milnacipran and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- mirtazapine
mirtazapine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
mobocertinib and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- moxifloxacin
trimipramine and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.
- nefazodone
nefazodone and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
nefazodone will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. - netupitant/palonosetron
netupitant/palonosetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- nilotinib
trimipramine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- norepinephrine
trimipramine, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- nortriptyline
nortriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
nortriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - octreotide
trimipramine and octreotide both increase QTc interval. Avoid or Use Alternate Drug.
- octreotide (Antidote)
trimipramine and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.
- olopatadine intranasal
trimipramine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ondansetron
ondansetron and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
ondansetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. - ozanimod
ozanimod increases toxicity of trimipramine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
- palonosetron
palonosetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- paroxetine
paroxetine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- perphenazine
perphenazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- phendimetrazine
trimipramine, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phentermine
trimipramine, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine
trimipramine, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine PO
trimipramine, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenytoin
phenytoin will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- pirbuterol
trimipramine, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- pitolisant
trimipramine decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.
- promazine
promazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- promethazine
promethazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- propylhexedrine
trimipramine, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- protriptyline
protriptyline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
protriptyline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - pseudoephedrine
trimipramine increases effects of pseudoephedrine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- rasagiline
rasagiline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. Severe CNS toxicity associated with hyperpyrexia has been reported with the combined treatment of an antidepressant and rasagiline. Avoid combination within 14 days of MAOI use.
- ribociclib
ribociclib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
ribociclib increases toxicity of trimipramine by QTc interval. Avoid or Use Alternate Drug. - rifapentine
rifapentine will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- salmeterol
trimipramine, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- selegiline transdermal
selegiline transdermal and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- selinexor
selinexor, trimipramine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- serdexmethylphenidate/dexmethylphenidate
trimipramine, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- sertraline
sertraline and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
sertraline and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. - sodium oxybate
trimipramine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- St John's Wort
trimipramine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.
- tedizolid
tedizolid, trimipramine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.
- terbutaline
trimipramine, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- thioridazine
thioridazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- tipranavir
tipranavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
- trazodone
trazodone and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
trazodone and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug. - trifluoperazine
trifluoperazine and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
- tucatinib
tucatinib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.
- umeclidinium bromide/vilanterol inhaled
trimipramine increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
trimipramine and umeclidinium bromide/vilanterol inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiated - vandetanib
trimipramine, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and trimipramine both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- venlafaxine
venlafaxine and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.
- vilanterol/fluticasone furoate inhaled
trimipramine and vilanterol/fluticasone furoate inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Exercise extreme caution if vilanterol coadministered with MAOIs or TCAs, or within 2 weeks of discontinuation of these drugs; adrenergic agonist effects on the cardiovascular system may be potentiated
trimipramine increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated. - vortioxetine
trimipramine, vortioxetine. Either increases effects of the other by serotonin levels. Avoid or Use Alternate Drug.
- voxelotor
voxelotor will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.
- xylometazoline
trimipramine, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- yohimbe
yohimbe, trimipramine. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.
- yohimbine
trimipramine, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- ziprasidone
trimipramine and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.
Monitor Closely (374)
- 5-HTP
trimipramine and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.
- abiraterone
abiraterone increases levels of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Avoid coadministration of abiraterone with substrates of CYP2D6. If alternative therapy cannot be used, exercise caution and consider a dose reduction of the CYP2D6 substrate.
- abobotulinumtoxinA
abobotulinumtoxinA increases effects of trimipramine by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .
- aclidinium
aclidinium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- albuterol
trimipramine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and trimipramine both increase QTc interval. Use Caution/Monitor. - alfentanil
alfentanil and trimipramine both increase sedation. Use Caution/Monitor.
- alfuzosin
trimipramine and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and trimipramine both increase QTc interval. Use Caution/Monitor. - almotriptan
almotriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- alprazolam
alprazolam and trimipramine both increase sedation. Use Caution/Monitor.
- amifampridine
trimipramine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amisulpride
trimipramine and amisulpride both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended if coadministered.
- amitriptyline
amitriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
amitriptyline and trimipramine both increase sedation. Use Caution/Monitor. - amobarbital
amobarbital and trimipramine both increase sedation. Use Caution/Monitor.
- amoxapine
amoxapine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
amoxapine and trimipramine both increase sedation. Use Caution/Monitor. - anagrelide
anagrelide and trimipramine both increase QTc interval. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- apomorphine
trimipramine and apomorphine both increase sedation. Use Caution/Monitor.
apomorphine and trimipramine both increase QTc interval. Use Caution/Monitor. - arformoterol
trimipramine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
arformoterol and trimipramine both increase QTc interval. Use Caution/Monitor. - aripiprazole
aripiprazole and trimipramine both increase sedation. Use Caution/Monitor.
aripiprazole and trimipramine both increase QTc interval. Use Caution/Monitor. - armodafinil
trimipramine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- asenapine
asenapine and trimipramine both increase QTc interval. Use Caution/Monitor.
- asenapine transdermal
asenapine transdermal and trimipramine both increase QTc interval. Use Caution/Monitor.
- atazanavir
atazanavir increases levels of trimipramine by unspecified interaction mechanism. Use Caution/Monitor.
atazanavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - atomoxetine
atomoxetine and trimipramine both increase QTc interval. Use Caution/Monitor.
- atracurium
atracurium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- azelastine
azelastine and trimipramine both increase sedation. Use Caution/Monitor.
- azithromycin
trimipramine and azithromycin both increase QTc interval. Use Caution/Monitor.
- baclofen
baclofen and trimipramine both increase sedation. Use Caution/Monitor.
- bedaquiline
trimipramine and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- belladonna alkaloids
belladonna alkaloids and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
belladonna and opium and trimipramine both increase sedation. Use Caution/Monitor. - benperidol
benperidol and trimipramine both increase sedation. Use Caution/Monitor.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, trimipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- benzphetamine
trimipramine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- benztropine
benztropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- bethanechol
bethanechol increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brompheniramine
brompheniramine and trimipramine both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and trimipramine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and trimipramine both increase sedation. Use Caution/Monitor.
- buprenorphine subdermal implant
trimipramine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
- buprenorphine, long-acting injection
trimipramine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
- bupropion
trimipramine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.
bupropion will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. - butabarbital
butabarbital and trimipramine both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and trimipramine both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and trimipramine both increase sedation. Use Caution/Monitor.
- caffeine
trimipramine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cannabidiol
cannabidiol will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol.
- carbachol
carbachol increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbamazepine
carbamazepine will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and trimipramine both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and trimipramine both increase sedation. Use Caution/Monitor.
- cenobamate
cenobamate will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider a dose reduction of CYP2C19 substrates, as clinically appropriate, when used concomitantly with cenobamate.
cenobamate, trimipramine. Either increases effects of the other by sedation. Use Caution/Monitor. - ceritinib
ceritinib and trimipramine both increase QTc interval. Use Caution/Monitor.
ceritinib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - cevimeline
cevimeline increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and trimipramine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and trimipramine both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and trimipramine both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and trimipramine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
chlorzoxazone and trimipramine both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and trimipramine both increase sedation. Use Caution/Monitor.
- cisatracurium
cisatracurium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clarithromycin
clarithromycin will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- clemastine
clemastine and trimipramine both increase sedation. Use Caution/Monitor.
- clobazam
clobazam will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Lower doses of drugs metabolized by CYP2D6 may be required when used concomitantly.
trimipramine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression). - clomipramine
clomipramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
clomipramine and trimipramine both increase sedation. Use Caution/Monitor. - clonazepam
clonazepam and trimipramine both increase sedation. Use Caution/Monitor.
- clorazepate
clorazepate and trimipramine both increase sedation. Use Caution/Monitor.
- clozapine
clozapine and trimipramine both increase sedation. Use Caution/Monitor.
clozapine and trimipramine both increase QTc interval. Use Caution/Monitor. - cobicistat
cobicistat will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Carefully titrate antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitoring for antidepressant response
cobicistat will increase the level or effect of trimipramine by Other (see comment). Use Caution/Monitor. Carefully titrate dose of the antidepressant to the desired effect, including using the lowest feasible initial or maintenance dose, and monitor its response during coadministration with TCAs and cobicistat.
cobicistat will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - cocaine topical
trimipramine and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.
- codeine
codeine and trimipramine both increase sedation. Use Caution/Monitor.
- crizotinib
crizotinib and trimipramine both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
crizotinib increases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A. - crofelemer
crofelemer increases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.
- cyclizine
cyclizine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclizine and trimipramine both increase sedation. Use Caution/Monitor. - cyclobenzaprine
cyclobenzaprine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
cyclobenzaprine and trimipramine both increase sedation. Use Caution/Monitor. - cyproheptadine
cyproheptadine and trimipramine both increase sedation. Use Caution/Monitor.
- dabrafenib
dabrafenib will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
- dantrolene
dantrolene and trimipramine both increase sedation. Use Caution/Monitor.
- daridorexant
trimipramine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darifenacin
darifenacin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- darunavir
darunavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dasatinib
trimipramine and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- debrisoquine
trimipramine decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.
- degarelix
degarelix and trimipramine both increase QTc interval. Use Caution/Monitor.
- desflurane
desflurane and trimipramine both increase sedation. Use Caution/Monitor.
desflurane and trimipramine both increase QTc interval. Use Caution/Monitor. - desipramine
desipramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
desipramine and trimipramine both increase sedation. Use Caution/Monitor. - deutetrabenazine
trimipramine and deutetrabenazine both increase sedation. Use Caution/Monitor.
deutetrabenazine and trimipramine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexchlorpheniramine
dexchlorpheniramine and trimipramine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
trimipramine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely. - dexmedetomidine
dexmedetomidine and trimipramine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
trimipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
trimipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.
trimipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. - dextroamphetamine transdermal
trimipramine will increase the level or effect of dextroamphetamine transdermal by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in dextroamphetamine levels in brain; May be potentiate cardiovascular effects. Monitor frequently and adjust or use an alternant based on clinical response.
- dextromoramide
dextromoramide and trimipramine both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and trimipramine both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and trimipramine both increase sedation. Use Caution/Monitor.
- diazepam intranasal
diazepam intranasal, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.
- dicyclomine
dicyclomine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- diethylpropion
trimipramine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and trimipramine both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and trimipramine both increase sedation. Use Caution/Monitor.
- dihydroergotamine
trimipramine and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dihydroergotamine intranasal
trimipramine and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.
- diltiazem
diltiazem will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate and trimipramine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
diphenhydramine and trimipramine both increase sedation. Use Caution/Monitor. - diphenoxylate hcl
diphenoxylate hcl and trimipramine both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and trimipramine both increase sedation. Use Caution/Monitor.
- dobutamine
trimipramine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dofetilide
dofetilide increases toxicity of trimipramine by QTc interval. Use Caution/Monitor.
- dolasetron
trimipramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- donepezil
donepezil increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopamine
trimipramine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
trimipramine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
doxepin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
doxepin and trimipramine both increase sedation. Use Caution/Monitor. - doxylamine
doxylamine and trimipramine both increase sedation. Use Caution/Monitor.
- droperidol
droperidol and trimipramine both increase sedation. Use Caution/Monitor.
- duvelisib
duvelisib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.
- echothiophate iodide
echothiophate iodide increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- efavirenz
efavirenz will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
efavirenz will decrease the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
efavirenz and trimipramine both increase QTc interval. Use Caution/Monitor. - elagolix
elagolix will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak CYP2C19 inhibitor. Caution with sensitive CYP2C19 substrates.
elagolix decreases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed. - eletriptan
eletriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- eliglustat
eliglustat increases levels of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the concomitant drug and titrate to clinical effect.
eliglustat and trimipramine both increase QTc interval. Use Caution/Monitor. - elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.
elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP2D6 inhibitor; caution with CYP2D6 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. - encorafenib
encorafenib, trimipramine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.
- entrectinib
entrectinib and trimipramine both increase QTc interval. Use Caution/Monitor.
- ephedrine
trimipramine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine increases effects of ephedrine by unknown mechanism. Use Caution/Monitor. - epinephrine
trimipramine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine increases effects of epinephrine by unknown mechanism. Use Caution/Monitor. - epinephrine inhaled
trimipramine and epinephrine inhaled both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Tricyclic antidepressants may potentiate epinephrine effect on cardiovascular system.
- epinephrine racemic
trimipramine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor. - ergotamine
trimipramine and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.
- eribulin
eribulin and trimipramine both increase QTc interval. Use Caution/Monitor.
- escitalopram
escitalopram increases toxicity of trimipramine by QTc interval. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, trimipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- eslicarbazepine acetate
eslicarbazepine acetate will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- estazolam
estazolam and trimipramine both increase sedation. Use Caution/Monitor.
- ethanol
trimipramine and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and trimipramine both increase sedation. Use Caution/Monitor.
- ezogabine
ezogabine, trimipramine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fedratinib
fedratinib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.
fedratinib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2C19 substrates as necessary.
fedratinib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP2D6 substrates as necessary. - fenfluramine
trimipramine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
fenfluramine, trimipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome. - fesoterodine
fesoterodine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fexinidazole
fexinidazole will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor.
- fingolimod
fingolimod and trimipramine both increase QTc interval. Use Caution/Monitor.
- flavoxate
flavoxate and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flecainide
trimipramine and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.
- fluoxetine
trimipramine and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- fluphenazine
fluphenazine and trimipramine both increase sedation. Use Caution/Monitor.
- flurazepam
flurazepam and trimipramine both increase sedation. Use Caution/Monitor.
- fluvoxamine
fluvoxamine and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely.
- formoterol
trimipramine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- foscarnet
trimipramine and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.
- frovatriptan
frovatriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- gabapentin
gabapentin, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- galantamine
galantamine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ganaxolone
trimipramine and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and trimipramine both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and trimipramine both increase QTc interval. Use Caution/Monitor.
- glycopyrrolate
glycopyrrolate and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
trimipramine increases levels of glycopyrrolate by unknown mechanism. Use Caution/Monitor. - glycopyrrolate inhaled
glycopyrrolate inhaled and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
trimipramine increases levels of glycopyrrolate inhaled by unknown mechanism. Use Caution/Monitor. - glycopyrronium tosylate topical
glycopyrronium tosylate topical, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- granisetron
granisetron and trimipramine both increase QTc interval. Use Caution/Monitor.
- haloperidol
haloperidol and trimipramine both increase sedation. Use Caution/Monitor.
- henbane
henbane and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocodone
hydrocodone, trimipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- hydromorphone
hydromorphone and trimipramine both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and trimipramine both increase sedation. Use Caution/Monitor.
hydroxyzine and trimipramine both increase QTc interval. Use Caution/Monitor. - hyoscyamine
hyoscyamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
trimipramine and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.
iloperidone and trimipramine both increase sedation. Use Caution/Monitor.
iloperidone increases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. - imipramine
imipramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
imipramine and trimipramine both increase sedation. Use Caution/Monitor. - indacaterol, inhaled
indacaterol, inhaled, trimipramine. QTc interval. Use Caution/Monitor. Indacaterol should be administered with extreme caution to patients treated with TCAs. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- indinavir
indinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ipratropium
ipratropium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.
- isoflurane
isoflurane and trimipramine both increase QTc interval. Use Caution/Monitor.
- isoniazid
trimipramine and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.
- isoproterenol
trimipramine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- istradefylline
istradefylline will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.
- itraconazole
itraconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ketamine
ketamine and trimipramine both increase sedation. Use Caution/Monitor.
- ketoconazole
ketoconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- ketotifen, ophthalmic
trimipramine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- L-tryptophan
trimipramine and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.
- lapatinib
trimipramine and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.
- lasmiditan
lasmiditan, trimipramine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
trimipramine increases effects of lasmiditan by serotonin levels. Use Caution/Monitor. Coadministration may increase risk of serotonin syndrome. - lemborexant
lemborexant, trimipramine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- lenacapavir
lenacapavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.
- levalbuterol
trimipramine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
trimipramine and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- levoketoconazole
levoketoconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- levorphanol
levorphanol and trimipramine both increase sedation. Use Caution/Monitor.
- levothyroxine
levothyroxine increases effects of trimipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- liothyronine
liothyronine increases effects of trimipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- liotrix
liotrix increases effects of trimipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- lisdexamfetamine
trimipramine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine, lisdexamfetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue along with concomitant serotonergic drug(s). - lithium
trimipramine and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.
lithium and trimipramine both increase QTc interval. Use Caution/Monitor. - lofepramine
lofepramine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
lofepramine and trimipramine both increase sedation. Use Caution/Monitor. - lofexidine
trimipramine and lofexidine both increase sedation. Use Caution/Monitor.
trimipramine decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. - lopinavir
lopinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- loprazolam
loprazolam and trimipramine both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and trimipramine both increase sedation. Use Caution/Monitor.
- lorcaserin
lorcaserin will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- lormetazepam
lormetazepam and trimipramine both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and trimipramine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled and trimipramine both increase sedation. Use Caution/Monitor.
- lsd
trimipramine and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.
- lumacaftor/ivacaftor
lumacaftor/ivacaftor, trimipramine. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .
- lurasidone
lurasidone, trimipramine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
lurasidone, trimipramine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed. - maprotiline
maprotiline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
maprotiline and trimipramine both increase sedation. Use Caution/Monitor. - maraviroc
maraviroc, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- marijuana
trimipramine and marijuana both increase sedation. Use Caution/Monitor.
- meclizine
meclizine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- melatonin
trimipramine and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and trimipramine both increase sedation. Use Caution/Monitor.
- meprobamate
trimipramine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
trimipramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and trimipramine both increase sedation. Use Caution/Monitor.
- methadone
trimipramine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
methadone and trimipramine both increase sedation. Use Caution/Monitor. - methamphetamine
trimipramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and trimipramine both increase sedation. Use Caution/Monitor.
- methscopolamine
methscopolamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- methylenedioxymethamphetamine
trimipramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methylphenidate
trimipramine, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- methylphenidate transdermal
methylphenidate transdermal will increase the level or effect of trimipramine by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate.
- midazolam
midazolam and trimipramine both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, trimipramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
trimipramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mifepristone
mifepristone, trimipramine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
mifepristone will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - mirabegron
mirabegron will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.
- mirtazapine
trimipramine and mirtazapine both increase sedation. Use Caution/Monitor.
trimipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. - mitotane
mitotane decreases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.
- modafinil
trimipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and trimipramine both increase sedation. Use Caution/Monitor.
trimipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. - motherwort
trimipramine and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
trimipramine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
trimipramine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and trimipramine both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- nefopam
nefopam, trimipramine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.
- nelfinavir
nelfinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- neostigmine
neostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- norepinephrine
trimipramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
trimipramine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor. - nortriptyline
nortriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
nortriptyline and trimipramine both increase sedation. Use Caution/Monitor. - ofloxacin
trimipramine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- olanzapine
olanzapine and trimipramine both increase sedation. Use Caution/Monitor.
olanzapine and trimipramine both increase QTc interval. Use Caution/Monitor. - oliceridine
trimipramine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.
trimipramine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics. - olodaterol inhaled
trimipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- onabotulinumtoxinA
onabotulinumtoxinA and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- opium tincture
opium tincture and trimipramine both increase sedation. Use Caution/Monitor.
- orphenadrine
trimipramine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
orphenadrine and trimipramine both increase sedation. Use Caution/Monitor. - osimertinib
osimertinib and trimipramine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxazepam
oxazepam and trimipramine both increase sedation. Use Caution/Monitor.
- oxybutynin
oxybutynin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxycodone
oxycodone and trimipramine both increase sedation. Use Caution/Monitor.
- oxymetazoline intranasal
trimipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.
- oxymorphone
oxymorphone and trimipramine both increase sedation. Use Caution/Monitor.
- ozanimod
ozanimod and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
trimipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
paliperidone and trimipramine both increase sedation. Use Caution/Monitor. - pancuronium
pancuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- papaveretum
papaveretum and trimipramine both increase sedation. Use Caution/Monitor.
- papaverine
trimipramine and papaverine both increase sedation. Use Caution/Monitor.
- paroxetine
trimipramine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.
- pasireotide
trimipramine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- pazopanib
trimipramine and pazopanib both increase QTc interval. Use Caution/Monitor.
- peginterferon alfa 2b
peginterferon alfa 2b, trimipramine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.
- pentazocine
pentazocine and trimipramine both increase sedation. Use Caution/Monitor.
trimipramine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely. - pentobarbital
pentobarbital and trimipramine both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine and trimipramine both increase sedation. Use Caution/Monitor.
- phendimetrazine
trimipramine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital and trimipramine both increase sedation. Use Caution/Monitor.
phenobarbital will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - phentermine
trimipramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
trimipramine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine ophthalmic
trimipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
- phenylephrine PO
trimipramine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
trimipramine and pholcodine both increase sedation. Use Caution/Monitor.
- physostigmine
physostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
pimozide and trimipramine both increase sedation. Use Caution/Monitor.
- pirbuterol
trimipramine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
trimipramine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.
posaconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - pralidoxime
pralidoxime and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pregabalin
pregabalin, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primidone
primidone and trimipramine both increase sedation. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and trimipramine both increase QTc interval. Use Caution/Monitor.
prochlorperazine and trimipramine both increase sedation. Use Caution/Monitor. - promethazine
promethazine and trimipramine both increase sedation. Use Caution/Monitor.
- propantheline
propantheline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- propofol
propofol and trimipramine both increase sedation. Use Caution/Monitor.
- propylhexedrine
trimipramine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
protriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
protriptyline and trimipramine both increase sedation. Use Caution/Monitor. - pyridostigmine
pyridostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quazepam
quazepam and trimipramine both increase sedation. Use Caution/Monitor.
- quetiapine
quetiapine and trimipramine both increase sedation. Use Caution/Monitor.
quetiapine, trimipramine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT. - quinine
trimipramine and quinine both increase QTc interval. Use Caution/Monitor.
- ramelteon
trimipramine and ramelteon both increase sedation. Use Caution/Monitor.
- ranolazine
trimipramine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.
- rapacuronium
rapacuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- remifentanil
trimipramine, remifentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May also increase risk of serotonin syndrome.
- remimazolam
remimazolam, trimipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- rifabutin
rifabutin decreases levels of trimipramine by increasing metabolism. Use Caution/Monitor.
- rifampin
rifampin will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rilpivirine
rilpivirine increases toxicity of trimipramine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.
- risperidone
trimipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
risperidone and trimipramine both increase sedation. Use Caution/Monitor. - ritonavir
ritonavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- rizatriptan
rizatriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- rocuronium
rocuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- rolapitant
rolapitant will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.
- romidepsin
trimipramine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.
- rucaparib
rucaparib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.
- salmeterol
trimipramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- SAMe
trimipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.
- saquinavir
saquinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- scopolamine
scopolamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scullcap
trimipramine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and trimipramine both increase sedation. Use Caution/Monitor.
secobarbital will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May also enhance CNS depressant effect of trimipramine - selpercatinib
selpercatinib increases toxicity of trimipramine by QTc interval. Use Caution/Monitor.
- sevoflurane
sevoflurane and trimipramine both increase sedation. Use Caution/Monitor.
sevoflurane and trimipramine both increase QTc interval. Use Caution/Monitor. - shepherd's purse
trimipramine and shepherd's purse both increase sedation. Use Caution/Monitor.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
trimipramine, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.
- solifenacin
solifenacin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
solifenacin and trimipramine both increase QTc interval. Use Caution/Monitor. - sorafenib
sorafenib and trimipramine both increase QTc interval. Use Caution/Monitor.
- sparsentan
sparsentan will decrease the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates.
- stiripentol
stiripentol, trimipramine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.
stiripentol will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.
stiripentol, trimipramine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence. - succinylcholine
succinylcholine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- sufentanil
sufentanil and trimipramine both increase sedation. Use Caution/Monitor.
- sufentanil SL
sufentanil SL, trimipramine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
- sulfamethoxazole
trimipramine and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.
- sumatriptan
sumatriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- sumatriptan intranasal
sumatriptan intranasal and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
- suvorexant
suvorexant and trimipramine both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary
- tacrolimus
tacrolimus and trimipramine both increase QTc interval. Use Caution/Monitor.
- tapentadol
tapentadol and trimipramine both increase sedation. Use Caution/Monitor.
trimipramine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely. - tecovirimat
tecovirimat will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.
tecovirimat will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. - telavancin
trimipramine and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.
- temazepam
temazepam and trimipramine both increase sedation. Use Caution/Monitor.
- terbinafine
terbinafine will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Assess need to reduce dose of CYP2D6-metabolized drug.
- terbutaline
trimipramine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tetrabenazine
tetrabenazine and trimipramine both increase QTc interval. Use Caution/Monitor.
- thioridazine
thioridazine and trimipramine both increase sedation. Use Caution/Monitor.
- thiothixene
thiothixene and trimipramine both increase sedation. Use Caution/Monitor.
- thyroid desiccated
thyroid desiccated increases effects of trimipramine by Other (see comment). Use Caution/Monitor. Comment: Increased catecholamine receptor sensitivity; may increase CNS and cardiovascular effects, including arrhythmias.
- tiotropium
tiotropium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tolterodine
tolterodine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- topiramate
trimipramine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and trimipramine both increase sedation. Use Caution/Monitor.
trimipramine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely. - trazodone
trazodone and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
trazodone and trimipramine both increase sedation. Use Caution/Monitor. - triazolam
triazolam and trimipramine both increase sedation. Use Caution/Monitor.
- triclabendazole
triclabendazole will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole.
- triclofos
triclofos and trimipramine both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and trimipramine both increase sedation. Use Caution/Monitor.
- trihexyphenidyl
trihexyphenidyl and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimethoprim
trimipramine and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.
- triprolidine
triprolidine and trimipramine both increase sedation. Use Caution/Monitor.
- tropisetron
trimipramine and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.
- trospium chloride
trospium chloride and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- valbenazine
valbenazine and trimipramine both increase QTc interval. Use Caution/Monitor.
- valerian
valerian and trimipramine both increase sedation. Use Caution/Monitor.
- vecuronium
vecuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- venlafaxine
trimipramine and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.
- voclosporin
voclosporin, trimipramine. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
trimipramine and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.
voriconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. - xylometazoline
trimipramine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
trimipramine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
trimipramine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
ziprasidone and trimipramine both increase sedation. Use Caution/Monitor.
- zolmitriptan
zolmitriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.
Minor (75)
- acarbose
trimipramine increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- acetazolamide
acetazolamide will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- amobarbital
amobarbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- anastrozole
anastrozole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- atropine
trimipramine increases levels of atropine by unknown mechanism. Minor/Significance Unknown.
- atropine IV/IM
trimipramine increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.
- azithromycin
azithromycin increases toxicity of trimipramine by QTc interval. Minor/Significance Unknown.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- brimonidine
trimipramine decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- butabarbital
butabarbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- butalbital
butalbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- carbamazepine
carbamazepine decreases levels of trimipramine by increasing metabolism. Minor/Significance Unknown.
- chloroquine
chloroquine increases toxicity of trimipramine by QTc interval. Minor/Significance Unknown.
- chlorpromazine
trimipramine, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, chlorpromazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - chlorpropamide
trimipramine increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.
- conjugated estrogens
conjugated estrogens, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- conjugated estrogens, vaginal
conjugated estrogens, vaginal, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- cyclophosphamide
cyclophosphamide will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- desflurane
desflurane, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- dexmethylphenidate
dexmethylphenidate increases effects of trimipramine by decreasing metabolism. Minor/Significance Unknown.
- estradiol
estradiol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- estrogens conjugated synthetic
estrogens conjugated synthetic, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- estrogens esterified
estrogens esterified, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens may inhibit hepatic metabolism of tricyclic antidepressants. However, interactions are not common.
- estropipate
estropipate, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- ethinylestradiol
ethinylestradiol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.
- etomidate
etomidate, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- eucalyptus
trimipramine and eucalyptus both increase sedation. Minor/Significance Unknown.
- fluphenazine
trimipramine, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, fluphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - glimepiride
trimipramine increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.
- glipizide
trimipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
trimipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.
- hydroxyprogesterone caproate (DSC)
hydroxyprogesterone caproate (DSC), trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- insulin aspart
trimipramine increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin detemir
trimipramine increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glargine
trimipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glulisine
trimipramine increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin lispro
trimipramine increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin NPH
trimipramine increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin regular human
trimipramine increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.
- isoproterenol
isoproterenol, trimipramine. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.
- ketamine
ketamine, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- larotrectinib
larotrectinib will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.
- lithium
lithium, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.
- mestranol
mestranol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- metformin
trimipramine increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.
- miglitol
trimipramine increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.
- nateglinide
trimipramine increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- panax ginseng
panax ginseng increases effects of trimipramine by pharmacodynamic synergism. Minor/Significance Unknown.
- pentobarbital
pentobarbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- perphenazine
trimipramine, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, perphenazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - phenobarbital
phenobarbital, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- pioglitazone
trimipramine increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- pleurisy root
pleurisy root decreases effects of trimipramine by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.
- primidone
primidone, trimipramine. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.
- prochlorperazine
trimipramine, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, prochlorperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - progesterone micronized
progesterone micronized, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.
- promazine
trimipramine, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, promazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - promethazine
trimipramine, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, promethazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - propofol
propofol, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- repaglinide
trimipramine increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- rosiglitazone
trimipramine increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- sage
trimipramine and sage both increase sedation. Minor/Significance Unknown.
- saxagliptin
trimipramine increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of trimipramine by decreasing metabolism. Minor/Significance Unknown.
- sevoflurane
sevoflurane, trimipramine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.
- sitagliptin
trimipramine increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- sulfamethoxazole
sulfamethoxazole decreases levels of trimipramine by unspecified interaction mechanism. Minor/Significance Unknown.
- thioridazine
trimipramine, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, thioridazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - tolazamide
trimipramine increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- tolbutamide
trimipramine increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.
- trifluoperazine
trimipramine, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.
trimipramine, trifluoperazine. Either increases levels of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects. - vasopressin
trimipramine increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.
- verapamil
verapamil increases levels of trimipramine by decreasing metabolism. Minor/Significance Unknown.
- vildagliptin
trimipramine increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- zolpidem
zolpidem, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.
Adverse Effects
Frequency Not Defined
Sedation (less than amitriptyline, but greater than imipramine)
Fatigue
Dry mouth
Constipation
Blurred vision
Weakness
Lethargy
Headache
Agitation
Insomnia
Nausea/vomiting
Anxiety
Sweating
Confusion
EPS
Dizziness
Tinnitus
Paresthesia
Orthostatic hypotension
ECG changes
Tachycardia
Incr LFTs
Sexual dysfunction
Rash
Seizure (rare)
Agranulocytosis, thrombocytopenia, eosinophilia, leukopenia (rare)
SIADH (rare)
Warnings
Black Box Warnings
In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 yr of age) taking antidepressants for major depressive disorders and other psychiatric illnesses
This increase was not seen in patients aged >24 years; a slight decrease in suicidal thinking was seen in adults >65 years
In children and young adults, risks must be weighed against the benefits of taking antidepressants
Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments
The patient’s family should communicate any abrupt changes in behavior to the healthcare provider
Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy
This drug is not approved for use in pediatric patients
Contraindications
Hypersensitivity
Severe cardiovascular disorder
Narrow angle glaucoma
Any drugs or conditions that prolong QT interval
Acute recovery post-MI
Coadministration with serotonergic drugs
- Do not use MAOIs concomitantly or within 14 days before initiating trimipraminw or within 14 days after discontinuing trimipramine
- Symptoms include tremor, myoclonus, diaphoresis, nausea, vomiting, flushing, dizziness, hyperthermia with features resembling neuroleptic malignant syndrome, seizures, rigidity, autonomic instability with possible rapid fluctuations of vital signs, and mental status changes that include extreme agitation progressing to delirium and coma
- Starting trimipramine in a patient who is being treated with linezolid or IV methylene blue is contraindicated because of an increased risk of serotonin syndrome
- If linezolid or IV methylene blue must be administered, discontinue trimipramine immediately and monitor for CNS toxicity; may resume imipramine 24 hr after last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first
Cautions
BPH, urinary/GI retention, increases IOP, hyperthyroidism, open-angle glaucoma, seizure disorder, brain tumor, respiratory impairment
Clinical worsening and suicide ideation may occur despite medication
Risk of anticholinergic side-effects
Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy
Pregnancy & Lactation
Pregnancy Category: C
Lactation: avoid
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Neurotransmitter (esp NE & serotonin) reuptake inhibitor; inhibits reuptake by neuronal membrane; may also downregulate beta-adrenergic receptors and serotonin receptors
Pharmacokinetics
Half-Life elimination: 16-40 hr
Peak Plasma Time: 2 hr
Metabolism: Hepatic
Bioavailability: 18-63%
Excretion: Urine
Vd: 17-48 L/kg
Protein binding: 95%
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
trimipramine oral - | 50 mg capsule | ![]() | |
trimipramine oral - | 100 mg capsule | ![]() | |
trimipramine oral - | 25 mg capsule | ![]() | |
trimipramine oral - | 100 mg capsule | ![]() | |
trimipramine oral - | 50 mg capsule | ![]() | |
trimipramine oral - | 25 mg capsule | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
trimipramine oral
TRIMIPRAMINE - ORAL
(trye-MI-pra-meen)
COMMON BRAND NAME(S): Surmontil
WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
USES: This medication is used to treat depression. It may help improve your mood and sense of well-being and allow you to enjoy everyday life more. Trimipramine is a tricyclic antidepressant. It works by restoring the balance of certain natural substances (neurotransmitters) in the brain.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking trimipramine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually 1 to 3 times daily. If taking this medication once daily, take it at bedtime to decrease the risk of drowsiness. The dosage is based on your medical condition and response to treatment. Your doctor may start you at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.This medication does not work right away. It may take 2 to 4 weeks before you experience the full benefits.Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same time(s) each day.Keep taking this medication even if you feel well. Do not suddenly stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Nausea, headache and a feeling of being ill may also occur. Your dose may need to be gradually decreased.Inform your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: See also the Warning section.Dizziness, drowsiness, difficulty urinating, headache, weakness, changes in appetite/weight, dry mouth, blurred vision, and constipation may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, mental/mood changes (such as confusion, depression, nervousness), numbness/tingling of the hands/feet, ringing in the ears, sexual problems, shakiness (tremors), severe vomiting/constipation, severe headache, pain/redness/swelling of arms or legs.Get medical help right away if you have any very serious side effects, including: slow/fast/irregular heartbeat, severe dizziness, fainting, seizures, trouble speaking, weakness on one side of the body, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night), chest pain, jaw/left arm pain.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.This medication may rarely cause serious blood problems (such as agranulocytosis, thrombocytopenia) or liver problems. Tell your doctor right away if you notice any of the following rare but very serious side effects: easy bleeding/bruising, signs of infection (such as sore throat that doesn't go away, fever), severe stomach/abdominal pain, dark urine, yellowing of the eyes/skin.A very serious allergic reaction to this product is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: See also the Warning section.Before taking trimipramine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (such as amitriptyline, imipramine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (such as agranulocytosis, thrombocytopenia), breathing problems (such as asthma, chronic obstructive pulmonary disorder-COPD), diabetes, electroshock therapy, personal or family history of glaucoma (angle-closure type), heart problems (such as recent heart attack, arrhythmias, coronary artery disease), intestinal problems (such as chronic constipation, ileus), kidney problems, liver problems, other mental/mood conditions (such as bipolar disorder, psychosis), family history of mental/mood conditions (such as suicide, bipolar disorder), seizures, conditions that may increase your risk of seizures (such as bulimia, organic brain disease, alcohol withdrawal), overactive thyroid (hyperthyroidism), problems urinating (urinary retention, enlarged prostate).Trimipramine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using trimipramine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using trimipramine safely.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.This drug may rarely make your blood sugar rise, which can cause or worsen diabetes. If you have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Older adults may be more sensitive to the side effects of this drug, especially dizziness (more likely when standing up), drowsiness, confusion, constipation, trouble urinating or QT prolongation (see above). Drowsiness, dizziness, or confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Infants born to mothers who have taken similar medications during pregnancy may develop trouble urinating, lethargy, shaking (tremors), and seizures. Discuss the risks and benefits with your doctor.Since untreated mental/mood problems (such as depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: clonidine, certain drugs for high blood pressure (such as guanadrel, guanethidine), drugs affecting liver enzymes that remove this medication from your body (including cimetidine, haloperidol, protease inhibitors such as fosamprenavir, drugs that affect heart rhythm such as flecainide/quinidine/propafenone), drugs for motion sickness (such as meclizine, scopolamine), ritonavir, thyroid medication.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Do not take any MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Some MAO inhibitors should also not be taken for two weeks before or after treatment with this medication. Ask your doctor when to start or stop taking this medication.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Many drugs besides trimipramine may affect the heart rhythm (QT prolongation in the EKG), including disopyramide, dronedarone, among others. Before using trimipramine, report all medications you are currently using to your doctor or pharmacist.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Overdose of this medication may be fatal, and symptoms include seizures, delirium and loss of consciousness.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood counts, kidney/liver function) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised April 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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