Trimipramine Maleate

Trimipramine Maleate is an FDA-approved tricyclic antidepressant used to treat depression. It is available in the form of capsules with 25 mg, 60 mg, and 100 mg strengths to be taken once or thrice orally daily with or without food. It works by balancing neurotransmitters like norepinephrine & serotonin in the brain, which helps improve mood & alleviate depression symptoms. You should be watchful of new or worsening side effects, especially mood/mental changes in young adults, adolescents, and children. For safe and efficient use of the medication, use Trimipramine Maleate exactly as your doctor prescribes and consult them if you have any concerns or queries regarding the medication dosage, usage, storage, and more.

Trimipramine Maleate is a tricyclic antidepressant primarily used to treat depression. The active ingredient, trimipramine maleate, works by balancing neurotransmitters like serotonin & norepinephrine in the brain, which helps improve mood & alleviate symptoms of depression.

This medication is available in capsule form with strengths of 25mg, 50mg, and 100mg. The recommended initial dose for adults is 75 mg daily, increased to a maintenance dosage of 50-150 mg daily, with a maximum of 200 mg daily. Children start at 50 mg daily, with a maintenance dose of 100 mg. Trimipramine should be taken orally, either with or without food, and is usually divided into one to three daily doses. For those taking it once daily, it’s advisable to take it at night to minimize drowsiness.

Common side effects of Trimipramine Maleate may include dry mouth, nausea, and increased blood pressure. Serious side effects may involve severe mood changes, vision issues, or signs of serotonin syndrome. Precautions include avoiding the use with MAO inhibitors, monitoring for mood changes, and consulting your doctor if you have a history of heart disease, seizures, or liver problems. If a dose is missed, take it as soon as remembered, but skip it if the next dose is near. Avoid double dosing. Store Trimipramine Maleate at room temperature, away from moisture, and keep out of reach of children. Dispose of unused medication properly. For any concerns or unusual symptoms, consult your healthcare provider.

It is used to treat:

• Depression

What Are the Forms & Strengths of Trimipramine Maleate?

It is available in the form of a capsule, which comes in the following strengths:

• 25 mg
• 50 mg
• 100 mg

What Are the Recommended Dosage of Trimipramine Maleate?

For Depression

For Adults

• Initial Dose: 75 mg orally every day in divided doses. 
• Maintenance Dose: 50 mg-150 mg orally every day in divided doses. 
• Maximum Dose: 200 mg orally every day in divided doses. 

For Children

• Initial Dose: 50 mg orally every day 
• Maintenance Dose: 100 mg orally every day 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

• Before using Trimipramine Maleate, you should carefully read and follow the instructions for use given in the patient information leaflet & medication guide provided by your healthcare provider or pharmacist. If you have any questions or do not understand any part of this leaflet, you should ask your doctor or pharmacist.
• Take Trimipramine Maleate exactly as your doctor prescribes. Do not take less or more of it, in large quantities, or more frequently than prescribed, as it can cause undesirable side effects.
• You should take this medication orally by mouth, in divided doses, usually once or thrice daily. You may take it with or without food.
• If you take Trimipramine once daily, you should take it at night to reduce the chances of drowsiness.
• The medication dosage is based on the condition being treated and the patient’s response to treatment.
• To lower the risk of unwelcome side effects, your doctor may suggest you start taking the medication at a low dose & gradually increase the medication dosage based on your condition and response to treatment.
• Trimipramine Maleate may not work immediately. It may take two to four weeks before you experience the full benefits of this medication.
• To get the most benefit from this medication, you should maintain consistency in dosage and try to take it around the same time every day to help you remember taking it.
• Continue using this medication even if you feel well. You should not abruptly stop taking this medication without consulting your doctor, as some conditions, including depression, may become worse when the medication is suddenly stopped. You may experience nausea, headache, and a feeling of illness. If you plan to discontinue using the medication, tell your physician. They will help you gradually taper off the medication.
• Tell your doctor if your condition does not get better or if it worsens.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

Trimipramine maleate is a tricyclic antidepressant used to treat depression. It functions by influencing the balance of neurotransmitters, such as serotonin & norepinephrine, in the brain. By inhibiting the reuptake of these neurotransmitters, Trimipramine raises their levels in the synaptic cleft, which helps improve mood and alleviate depressive symptoms. Additionally, Trimipramine has sedative properties, which can help with anxiety and insomnia often associated with depression. It may take a few weeks for patients to experience the full therapeutic effects of the medication.

Common Side Effects of Trimipramine Maleate: Similar to other medications, Trimipramine Maleate may cause side effects in some people using it. It is noteworthy to mention that not everyone using this medication will experience these side effects. They are not usually severe and disappear within a few days as your body adjusts to the medication. Some common side effects of Trimipramine Maleate are as follows:

• Dry mouth
• Nausea
• Vomiting
• Increased blood pressure
• Rash
• Itching
• Breast swelling
• Abnormal liver function tests
• Numbness or tingling sensation in your feet or hands

Mild Side Effects of Trimipramine Maleate: This medication may cause certain mild side effects in some people using it. These side effects do not usually require medical assistance. However, if they are persistent or bothersome, let your doctor know. 

• Depression
• Seizure
• Rash
• Tingly feeling
• Blurred vision
• Confusion
• Decreased urine output or volume
• Abdominal pain
• Chest pain

Serious Side Effects of Trimipramine Maleate: Your doctor has prescribed you this medication because they have judged that the benefit of Trimipramine Maleate outweighs the risks associated with its use. In rare cases, this medicine may cause serious side effects in some people using it. Get medical help immediately if you experience these side effects, which may be life-threatening if not treated properly. 

• Mental/mood changes such as confusion, depression, and nervousness
• Numbness/tingling of the hands or feet
• Ringing sensation in the ears
• Shakiness (tremors)
• Sexual problems
• Severe vomiting or constipation
• Severe headache
• Pain, redness, or swelling of arms or legs
• Severe dizziness
• Vision changes such as seeing rainbows or halos around lights at night, tunnel vision, eye pain, or swelling
• Serotonin syndrome. Its symptoms may include hallucinations, loss of coordination, severe dizziness, rapid heartbeat, fluttering in your chest, nausea, diarrhea, vomiting, unexplained fever, unusual restlessness, and twitching muscles.
• Blood problems such as thrombocytopenia or agranulocytosis
• Liver problems. Its symptoms may include stomach pain, yellowing of the eyes or skin, or dark urine.
• Severe infection. Its symptoms may include persistent sore throat or fever.
• Allergic reaction. Its symptoms may include rash, itching, severe dizziness, difficulty breathing, or swelling, particularly in the face, throat, tongue, or mouth.

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Are There Any Warnings for Trimipramine Maleate?

• You should not use this medication if you have used an MAOI drug in the past fourteen days, such as linezolid, phenelzine, selegiline, rasagiline, methylene blue injection, or tranylcypromine.
• Young adults and adolescents may experience thoughts of suicide, worsening depression, or other mental/mood changes when first taking an antidepressant such as Trimipramine Maleate. You should stay alert to mood changes or symptoms. You should report any new or worsening symptoms to your doctor. You should talk to your doctor about the risks & benefits of antidepressant medication, even if they are not receiving treatment for mental or mood conditions.
• Tell your doctor immediately if you experience worsening depression, unusual behavior changes such as suicidal thoughts/behavior, other psychiatric conditions, mental or mood changes, including panic attacks, new or worsening anxiety, difficulty sleeping, irritability, impulsive actions, severe restlessness, impulsive actions, hostile or angry feelings, severe restlessness, or very rapid speech. Stay alert for these signs and symptoms while starting a new antidepressant or changing your dose.
• This medication may cause impaired judgment, thinking, or changes in vision. You should not drive a vehicle or operate heavy machinery, and do not engage in activities that require alertness and clear vision.
• You should talk to your healthcare provider if you are pregnant, plan to get pregnant, or breastfeed while using this medication.

What Are the FDA Boxed Warning for Trimipramine Maleate?

A boxed warning has been issued for Trimipramine Maleate by the FDA due to the risk of suicidal thoughts & behaviors in children, adolescents, and young adults. A healthcare provider needs to weigh the risk of these side effects against the need for Trimipramine Maleate. For patients aged 24 and older, studies have not shown an increased risk of suicidal thoughts or behavior associated with antidepressants. There is a reduced risk for elderly patients aged 65 and older. Depression and other psychiatric disorders themselves can increase the risk of suicidality. Patients of all ages starting an antidepressant medication should be closely monitored for any signs & symptoms indicating worsening of their condition, suicidal thoughts, or unusual behavior.

• Before taking Trimipramine Maleate, you should tell your doctor if you have an allergy to it, to any other tricyclic antidepressants such as imipramine or amitriptyline, or to any other medications. This medication contains certain inactive ingredients that cause allergic reactions or other issues. Talk to your pharmacist or medical provider for the complete list of ingredients in Trimipramine Maleate.
• Before using Trimipramine Maleate, tell your healthcare provider if you have used an SSRI antidepressant in the past five weeks, such as escitalopram, citalopram, fluoxetine, paroxetine, sertraline, trazodone, vilazodone or fluvoxamine.
• Before using Trimipramine, share your complete medical and family history with your doctor, especially if you have the following conditions:
  • Breathing problems such as asthma and COPD
  • Blood problems such as agranulocytosis and thrombocytopenia
  • Diabetes
  • Electroshock therapy
  • Personal or family history of angle-closure-type glaucoma
  • Heart problems such as arrhythmias, recent heart attacks, coronary artery disease
  • Intestinal issues such as ileus and chronic constipation
  • Kidney problems
  • Liver issues
  • Personal or family history of mental/mood conditions such as suicidal thoughts/behavior, psychosis, and bipolar disorder
  • Seizures
  • Conditions that may increase the risk of seizures, such as organic brain disease, bulimia, or alcohol withdrawal
  • Hyperthyroidism
  • Urinary retention
  • Enlarged prostate
• This medication may cause a condition known as QT prolongation, which affects the heart rhythm. This condition rarely causes serious rapid, irregular heart rate and other symptoms, such as severe dizziness or fainting, that require medical attention immediately. Before using Trimipramine Maleate, tell your doctor if you have heart failure, QT prolongation in the EKG, slow heartbeat, or a family history of sudden cardiac death or QT prolongation in the EKG.
• The chances of developing QT prolongation are increased if you have certain medical conditions or are taking other medications that may cause the condition. Before using Trimipramine Maleate, tell your doctor about all the medications you are currently taking or plan to take alongside this medication, including all prescription, non-prescription, over-the-counter drugs, and herbal or vitamin supplements.
• Low magnesium or potassium levels in the bloodstream may also increase the risk of QT prolongation. The risk is greater if you use diuretics or have severe diarrhea, sweating, or vomiting. Talk to your doctor for safe and efficient medication use.
• Trimipramine Maleate may make you feel dizziness or drowsiness. Alcohol or marijuana may make you more drowsy or affect your vision. You should not drive or engage in tasks that require alertness unless you can do it safely. Limit your alcoholic beverages and avoid medications that include alcohol. Talk to your doctor if you are using marijuana.
• If you plan to undergo surgery, including a dental procedure, tell your doctor, dentist, or surgeon about all the medications you use, including Trimipramine Maleate. Your doctor may recommend you discontinue using this medication for a short duration. Also, tell them about all prescription, over-the-counter drugs & herbal or vitamin supplements you are taking.
• This medication may increase your sensitivity to the sun. You should limit your time under the sun and avoid tanning sunlamps and booths. While outdoors, use sunscreen and wear loose protective clothing. Inform your physician immediately if you have redness, skin blisters, or sunburned.
• This medication may rarely raise your blood sugar levels, which can cause or worsen diabetes. If you have diabetes mellitus type 1 or 2, you should check your blood glucose levels on a regular basis as directed by your healthcare provider and share the reports with them to determine the effects of this medication. Inform your caregiver and doctor immediately if you experience signs and symptoms of (hyperglycemia) high blood sugar, such as increased urination or thirst. Your doctor may adjust your diabetes medication dose, exercise program, or diet.
• Elderly patients may be more sensitive to the side effects caused by this medication, particularly confusion, constipation, dizziness, drowsiness, QT prolongation, or difficulty urinating. Drowsiness or confusion may increase the risk of falling. To prevent this, you should stand slowly while sitting or lying for a long time.
• During pregnancy, Trimipramine Maleate should be used only when clearly needed. Babies born to mothers who took similar drugs while pregnant may have difficulty urinating, tremors, lethargy, and seizures. Discuss the benefits & potential risks associated with medication use with your doctor.
• Since untreated mental or mood problems such as depression may be a serious condition, you should not discontinue using this medication unless instructed otherwise. If you are pregnant, plan to become pregnant, or suspect a pregnancy, immediately call your doctor and discuss the potential risks & benefits of using this medication while pregnant.
• It is unknown if Trimipramine Maleate passes into breast milk. Consult your doctor before nursing an infant while using this medication.
• This medication is not approved for use in anyone younger than 18 years of age.

Trimipramine Maleate is contraindicated for use in patients who have:

• Hypersensitivity to this medication or any of its active or inactive ingredient
• Acute porphyria
• Hepatic impairment
• Cardiovascular disease
• Use of Trimipramine maleate capsules with MAO inhibitors or within 14 days of stopping an MAOI
• Myocardial infarction

• If you have missed a dose of Trimipramine Maleate, you should take it as soon as you remember.
• However, if it is almost time to take your next dose, you may omit the missed dose and continue taking your medication according to your regular dosing schedule.
• Do not simultaneously take double or extra doses of the same medication to compensate for the missed dose.
• You can set a reminder on your phone to prevent missing doses further. Medication reminders work best for this purpose.

[Note: If you have missed a dose of your medication and are unsure about when to take the next one, immediately consult your doctor or pharmacist.]

Trimipramine maleate overdose may be life-threatening. Symptoms of a Trimipramine overdose may include severe drowsiness, hallucinations, confusion, agitation, overactive reflexes, agitation, feeling hot or cold, vomiting, vision changes, seizures, feeling like you may pass out, and coma. If someone has overdosed on the medication and is experiencing side effects such as passing out or difficulty breathing, you should seek prompt medical assistance. You can call a medic, 911, or poison control helpline. You can also head to the nearest emergency room.

[Note: If you consumed more than the recommended dose, get medical help right away, or call the Poison Help line at 1-800-222-1222.]

• You should store Trimipramine Maleate at a controlled temperature in a tightly closed container, to protect it from direct sunlight, excess heat, and moisture.
• Do not keep it in the bathroom, near the sink, or in places with high humidity.
• Keep all medications, including Trimipramine Maleate, in a safe place that is out of sight and reach of children and pets.
• You should not keep medications that are outdated or no longer needed. Discard them safely.
• Do not throw them into the household garbage bin, pour them into the drain, or flush them down the toilet unless instructed otherwise.
• Dispose of unwanted medications in such a way that prevents children, animals, and others from consuming them.
• The best way to eliminate unwanted medications is to give them in a medicine take-back program.
• To learn more about the proper ways to dispose of unwanted medications, consult your pharmacist, healthcare provider, or local waste disposal company.

[Note: Discuss with your healthcare professional about the proper disposal of any unused medicine and any questions you may have regarding its storage.]

Certain medications may interact with Trimipramine Maleate and reduce its effectiveness or increase the risk of unwanted side effects. Before using this medication, tell your doctor or healthcare provider about all the medicines you are taking or plan to take alongside Trimipramine Maleate. This information will help you and your doctor identify and manage potential drug interactions. To prevent it, your doctor may change your medication dosage of one or both medications or prescribe you another medication.

• Acenocoumarol
• Arbutamine
• Atomoxetine
• Bepridil
• Bromopride
• Cisapride
• Clorgyline
• Dicumarol
• Dronedarone
• Furazolidone
• Grepafloxacin
• Iproniazid
• Isocarboxazid
• Levoketoconazole
• Levomethadyl
• Linezolid
• Mavorixafor
• Mesoridazine
• Methylene Blue
• Metoclopramide
• Moclobemide
• Pargyline
• Phenelzine
• Phenprocoumon
• Pimozide
• Piperaquine
• Potassium Citrate
• Procarbazine
• Ranolazine
• Rasagiline
• S-Adenosylmethionine
• Safinamide
• Saquinavir
• Selegiline
• Sparfloxacin
• Terfenadine
• Thioridazine
• Tranylcypromine
• Ziprasidone

What Are the Other Trimipramine Maleate Interactions?

Apart from medications, Trimipramine Maleate may interact with certain herbs, supplements, food items, and beverages. To prevent such interactions, your doctor may make certain dietary changes. It is noteworthy to mention that this list is not exhaustive and that there may be other interactions with Trimipramine Maleate. Tell your doctor about all significant dietary habits and supplements you may be using to prevent drug interactions with Trimipramine Maleate.

• Tobacco
• Alcohol

Certain medical conditions may also affect the use of Trimipramine Maleate. Before using this medication, tell your doctor if you have any of the following conditions.

• Diabetes
• Bipolar disorder
• Glaucoma
• Schizophrenia
• Seizures
• Mania
• Urinary retention
• Heart or blood vessel disease
• Heart attack
• Hyperthyroidism
• Liver or kidney disease

[Note: This isn’t a complete list, and there could be other drugs that interact with Trimipramine Maleate. Make sure to tell your doctor about any prescription, over-the-counter medicines, and herbal products you’re taking.]

What Are the Trimipramine Maleate Alternatives?

Trimipramine Maleate is used to treat depression. While it is suitable for most patients, it may not suit some people or does not provide desirable results. If you plan to switch or start a new medication, you should consult your physician. They will prescribe the best medication for you based on your condition, needs, and medical history. Here are some of the popular alternatives to Trimipramine Maleate.

• Bupropion (bupropion hydrochloride XL)
• Cymbalta (duloxetine)
• Amitriptyline
• Amoxapine (amoxapine)
• Clomipramine
• Desipramine (desipramine hydrochloride)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.]

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