Adult:
Initially 50-75 mg daily, increased gradually as necessary to 150-300 mg daily. May be given in divided doses during the day or as a single dose at night. Doses > 200 mg to be given in divided doses. Elderly: Initial 30-75 mg daily, increased gradually if necessary. Max: 100mg daily.
Administration
May be taken with or without food.
Precautions
Narrow-angle glaucoma; prostatic hypertrophy; history of epilepsy; hyperthyroidism; patients requiring anaesthesia. Pregnancy. Withdraw gradually to decrease risk of withdrawal symptoms. Monitor liver function in long term treatment. May impair ability to drive or operate machinery.
Potentially Life-threatening
Adverse Drug Reactions
Not to be given concurrently with, or within 2 wk of cessation of, therapy with MAOI and MAOI should be restarted at least 7-14 days after trimipramine has been stopped. Exaggerated response such as hypertension, cardiac arrhythmias with sympathomimetic drugs.
Decreased antihypertensive effects of guanethidine, guanfacine, debrisoquine, betanidine and possibly clonidine. Increased CNS depression with CNS depressants such as alcohol, sedatives, hypnotics or barbiturates. Increased trimipramine levels with protease inhibitors, SSRIs, selegiline, tramadol, quinidine, diltiazem and verapamil. Decreased trimipramine levels with barbiturates. Increased risk of arrhythmias with drugs that prolong QT intervals. Increased risk of serotonin syndrome with linezolid. Increased antimuscarinic adverse effects with nefopam. Risk of neurotoxicity and serotonin syndrome with lithium.
