Trimipramine is a Medicine belongs to Antidepressant group whose information about Brand can be referenced from   Book : Martindale    Page : 458   Edition : 37  

  ►   Brandname : Surmontil
  ►  Strength : Capsule with 25 mg.  Capsule with 50 mg.  Capsule with 100 mg.  Tablet with

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 539   Edition : 12   Martindale    Page : 458   Edition : 37  
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral
Reference :-   Book : Martindale    Page : 458   Edition : 37  

Dosing of Medicine differ in Adult & Pediatrics ↓

Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Depression Oral 50 75 mg Tablet Dose: Given daily, gradually increased as necessary to 150 to 300 mg daily. The recommended initial dose for the elderly in the UK is 30 to 75 mg daily, gradually increased as necessary. In the USA, the elderly and adolescents may be given 50 mg daily initially followed by gradual increments as necessary up to a maximum of 100 mg daily.

Ref :-  Book : Martindale    Page : 458   Edition : 37  



Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Depression Oral 50 mg Tablet
2

Ref :- Book : Martindale    Page : 458   Edition : 37      Page :    Edition :   
►  Side Effect : Dry mouth, Constipation, Urinary retention, Blurred Vision, Increased intraocular pressure, Hyperthermia, Drowsiness, Headache, Peripheral neuropathy, Tremor, Ataxia, Epileptiform seizures, Tinnitus, Extrapyramidal symptoms, Speech difficulties (dysarthria), Confusion, hallucinations, or delirium may occur, particularly in the elderly, and mania or hypomania, and behavioural disturbances (particularly in children), Orthostatic hypotension, Hypersensitivity reactions, Urticaria, Angioedema, Photosensitisation, Testicular enlargement, Gynaecomastia, breast enlargement, Galactorrhoea, Sexual dysfunction, Increased appetite with weight gain (or occasionally anorexia with weight loss)
Ref :-   Book : Martindale    Page : 408, 458   Edition : 37.  

►  Drug Interaction : Drug interaction of Trimipramine is with , Antipsychotics, Calcium Channel Blockers , Thyroid hormone ,  Rifampicin , Cimetidine , Methylphenidate , Epinephrine (adrenaline) , Noradrenaline/Norepinephrine , Amiodarone , Quinidine , Astemizole, Terfenadine, Pimozide , Sertindole, Thioridazine , Cisapride , Halofantrine, Sotalol
Ref :-   Book : Martindale    Page : 410, 458   Edition : 37.  


  ►    Mechanism of Drug Drug Interaction :  Drugs that inhibit or induce the cytochrome P450 isoenzyme CYP2D6 may affect tricyclic metabolism and produce marked alterations in plasma concentrations. Adverse effects may be enhanced by antimuscarinic drugs or CNS depressants, including alcohol. Barbiturates and other enzyme inducers such as rifampicin and some antiepileptics can increase the metabolism of tricyclic antidepressants and may lower plasma concentrations and reduce antidepressant response. Cimetidine, methylphenidate, antipsychotics, and calciumchannel blockers can reduce the metabolism of the tricyclics, leading to the possibility of increased plasma concentrations and accompanying toxicity. Use of tricyclics with thyroid hormones may precipitate cardiac arrhythmias. The pressor effects of sympathomimetics, especially those of the direct-acting drugs adrenaline and noradrenaline, can be enhanced by tricyclic antidepressants. Drugs that prolong the QT interval, including antiarrhythmics such as amiodarone or quinidine, the antihistamines astemizole and terfenadine, some antipsychotics (notably pimozide, sertindole, and thioridazine), cisapride, halofantrine, and sotalol, may increase the likelihood of ventricular arrhythmias when taken with tricyclic antidepressants. Different antidepressants have been used together under expert supervision in refractory cases of depression, severe adverse reactions including the serotonin syndrome may occur. For this reason an appropriate. Tricyclic antidepressants should not generally be given to patients receiving MAOIs or for at least 2 weeks (3 weeks if starting clomipramine or imipramine) after their withdrawal.
Ref :-   Book : Martindale    Page : 410,458   Edition : 37.  


►  Contraindication : The antimuscarinic effects of tricyclic antidepressants warrant care in patients with urinary retention, prostatic hyperplasia, or chronic constipation; caution has also been advised in untreated angle-closure glaucoma and in phaeochromocytoma., The epileptogenic potential of tricyclic antidepressants requires care in patients with a history of epilepsy. In addition, because of their potential cardiotoxicity, tricyclics should be used with caution in patients with cardiovascular disease and avoided in those with heart block, cardiac arrhythmias, or in the immediate recovery period after myocardial infraction, Caution has also been recommended in patients with hyperthyroidism as tricyclics may increase the risk of developing cardiac arrhythmias., Blood-sugar concentrations may be altered in diabetic patients, Because tricyclic antidepressants are metabolised and inactivated in the liver they should be used with caution in patients with hepatic impairment and avoided in severe liver disease., Patients should be closely monitored during early antidepressant therapy until significant improvement in depression is observed because suicide is an inherent risk in depressed patients, Suicidal thoughts and behaviour may also develop during early treatment with antidepressants for other disorders; the same precautions observed when treating patients with depression should therefore be followed when treating patients with other disorders., Drowsiness often occurs, particularly at the start of therapy, and patients, if affected, should not drive or operate machinery, Tricyclic antidepressants may inhibit salivation and regular dental check-ups are recommended for patients on long-term therapy, particularly when taking those with marked antimuscarinic actions., Elderly patients can be particularly sensitive to the adverse effects of tricyclic antidepressants and a reduced dose, especially initially, should be used., Tricyclic antidepressants are not recommended for depression in children
Ref :-   Book : Martindale    Page : 408, 458   Edition : 37.  
  ►  Mechanism of Action :   Inhibit reuptake of 5-HT and NE from the synaptic cleft by respectively blocking 5-HT and NE reuptake transporters, and thereby cause enhancement of postsynaptic responses
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 221   Edition : 3.  

Pathway of DIETARY Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- NA


DIETARY Substance Interactions


​   ► This Medicine interact with :- NA



ContraIndication DIETARY Substance


​   ► This Medicine contraindicate with :- NA

►   Route of Elimination :   Renal
Ref :-   Book : Martindale    Page : 458   Edition : 37.  

►    Plasma Half-life :   Min value :-   23 hours,    Max value :-   NA
Ref :-   Book : Martindale    Page : 458   Edition : 37.  

►    Peak Plasma Concentration :   Min value :-   2 hours,    Max value :-   NA
Ref :-   Book : Martindale    Page : 458   Edition : 37.