Flecainide inhibits P450 2D6, potentially causing abrupt toxicity in patients stable on trimipramine due to increased plasma concentrations.
Source: NLP:trimipramine
Trimipramine Interactions
Brand names: Trimipramine
Route: Oral
FDA Black Box Warning
Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of trimipramine capsules or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Trimipramine capsules are not approved for use in pediatric patients. (See WARNINGS - Clinical Worsening and Suicide Risk , PRECAUTIONS - Information for Patients , and PRECAUTIONS - Pediatric Use )
Contraindications
CONTRAINDICATIONS Monoamine Oxidase Inhibitors (MAOIs) The use of MAOIs intended to treat psychiatric disorders with trimipramine capsules or within 14 days of stopping treatment with trimipramine capsules is contraindicated because of an increased risk of serotonin syndrome. The use of trimipramine capsules within 14 days of stopping an MAOI intended to treat psychiatric disorders is also contraindicated (see WARNINGS and DOSAGE AND ADMINISTRATION ). Starting trimipramine capsules in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome (see WARNINGS and DOSAGE AND ADMINISTRATION ). Hypersensitivity to Tricyclic Antidepressants Cross-sensitivity between trimipramine capsules and other dibenzazepines is a possibility. Myocardial Infarction The drug is contraindicated during the acute recovery period after a myocardial infarction.
Pregnancy & Breastfeeding
Pregnancy Teratogenic Effects Pregnancy Category C Trimipramine capsules have shown evidence of embryotoxicity and/or increased incidence of major anomalies in rats or rabbits at doses 20 times the human dose. There are no adequate and well-controlled studies in pregnant women. Trimipramine capsules should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
11 interactions on record
Fluoxetine inhibits P450 2D6, potentially increasing trimipramine plasma concentrations and causing toxicity. Sufficient time must elapse when switching from fluoxetine to trimipramine due to fluoxetine's long half-life.
Source: NLP:trimipramine
Propafenone inhibits P450 2D6, potentially causing abrupt toxicity in patients stable on trimipramine due to increased plasma concentrations.
Source: NLP:trimipramine
Quinidine inhibits P450 2D6, potentially causing abrupt toxicity in patients stable on trimipramine due to increased plasma concentrations.
Source: NLP:trimipramine
Trimipramine + AlcoholModerate
Concomitant use of alcoholic beverages may be associated with exaggerated effects of trimipramine.
Source: NLP:trimipramine
Trimipramine + AtropineModerate
Atropine-like anticholinergic effects may be more pronounced when used with trimipramine; particular care should be exercised.
Source: NLP:trimipramine
Trimipramine + CimetidineModerate
Cimetidine inhibits elimination of trimipramine, requiring downward dose adjustment when initiated and upward adjustment when discontinued.
Source: NLP:trimipramine
Trimipramine + EpinephrineModerate
Local anesthetics containing epinephrine may have potentiated effects when used with trimipramine; particular care should be exercised.
Source: NLP:trimipramine
Trimipramine + ParoxetineModerate
Paroxetine inhibits P450 2D6, potentially increasing trimipramine concentrations. Caution is indicated in co-administration or switching between these drugs.
Source: NLP:trimipramine
Trimipramine + SertralineModerate
Sertraline inhibits P450 2D6, potentially increasing trimipramine concentrations. Caution is indicated in co-administration or switching between these drugs.
Source: NLP:trimipramine
Trimipramine can potentiate the effects of catecholamines and sympathomimetic amines; particular care should be exercised.
Source: NLP:trimipramine