Surmontil Oral

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 Surmontil Oral
Read the Medication Guide available from your pharmacist. Consult your doctor or pharmacist if you have any questions.
Take this medication by mouth with or without food, usually one to three times daily or as directed by your doctor. If taking this medication once daily, take it at bedtime to decrease the risk of drowsiness. Dosage is based on your medical condition and response to therapy. 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.
It is important to continue 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.

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 persist or worsen, notify your doctor or pharmacist promptly.
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, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a laxative (e.g., stimulant-type with stool softener).
Remember that your doctor has prescribed this medication because he or she 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 immediately if any of these unlikely but serious side effects occur: fainting, mental/mood changes (e.g., confusion, depression, hallucinations, nervousness), numbness/tingling of the hands/feet, ringing in the ears, sexual problems, shakiness (tremors), severe vomiting/constipation.
Tell your doctor immediately if any of these rare but very serious side effects occur: slow/fast/irregular heartbeat, severe headache, pain/redness/swelling of arms or legs.
Seek immediate medical attention if any of these rare but very serious side effects occur: seizures, slurred speech, weakness on one side of the body, vision changes, chest pain, jaw/left arm pain.
This medication may rarely cause serious blood problems (e.g., agranulocytosis, thrombocytopenia) or liver problems. Tell your doctor immediately if you notice any of the following rare but very serious side effects: easy bleeding/bruising, signs of infection (e.g., fever, persistent sore throat), severe stomach/abdominal pain, dark urine, yellowing of the eyes/skin.
A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: 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.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also the Warning section.
Before taking trimipramine, tell your doctor or pharmacist if you are allergic to it; or to other tricyclic antidepressants (e.g., amitriptyline); 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.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a recent heart attack.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood problems (e.g., agranulocytosis, thrombocytopenia), breathing problems (e.g., asthma, chronic obstructive pulmonary disorder-COPD), diabetes, electroshock therapy, certain eye problems (e.g., glaucoma, increased intraocular pressure), heart problems (e.g., arrhythmias, coronary artery disease, heart failure), intestinal problems (e.g., chronic constipation, ileus), kidney problems, liver problems, other mental/mood conditions (e.g., bipolar disorder, psychosis), family history of mental/mood conditions (e.g., suicide, bipolar disorder), seizures, conditions that may increase your risk of seizures (e.g., bulimia, organic brain disease, alcohol withdrawal), overactive thyroid (hyperthyroidism), problems urinating (urinary retention, enlarged prostate).
This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Before having surgery, tell your doctor or dentist that you are taking this medication.
This drug may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths and sunlamps. Use a sunscreen and wear protective clothing when outdoors.
This drug may infrequently make your blood sugar level rise, causing or worsening diabetes. If you have diabetes, check your blood sugar level regularly as directed by your doctor. Tell your doctor immediately if you have symptoms such as increased thirst or urination, unusual sweating, shakiness or hunger. Your anti-diabetic medication or diet may need to be adjusted.
Caution is advised when using this drug in the elderly because they may be more sensitive to the side effects of the drug (e.g., dizziness, confusion).
Caution is advised when using this drug in children (see also the Warning section).
This medication should be used only when clearly needed during pregnancy. 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.
It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.
This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: arbutamine, sibutramine.
Do not take this medication if you are taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) or have used MAO inhibitors within the 2 weeks before, during or after treatment with this medication. In some cases a serious, possibly fatal drug interaction may occur.
If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting trimipramine.
Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anticholinergics (e.g., atropine, belladonna alkaloids), bronchodilators/decongestants (e.g., albuterol, epinephrine, phenylephrine), clonidine, certain drugs for high blood pressure (e.g., guanadrel, guanethidine, reserpine), drugs affecting liver enzymes that remove this medication from your body (e.g., cimetidine, haloperidol, protease inhibitors such as amprenavir/fosamprenavir/ritonavir, drugs that affect heart rhythm such as flecainide/quinidine/propafenone, SSRI antidepressants such as fluoxetine/paroxetine), drugs for motion sickness (e.g., meclizine, scopolamine), stimulants (e.g., amphetamines, methylphenidate), St. Johns wort, thyroid medication.
Also report the use of drugs which might increase seizure risk (decrease seizure threshold) when combined with this medication such as bupropion, isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, tricyclic antidepressants (e.g., amitriptyline) or tramadol, among others. Consult your doctor or pharmacist for details.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine, phenytoin), medicines for sleep or anxiety (e.g., alprazolam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, trazodone)
Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, motion sickness) because they may contain drowsiness-causing ingredients, drying agents (anticholinergics) or stimulants/nasal decongestants that could increase your heart rate or blood pressure. Ask your pharmacist about the safe use of those products.
Do not use nonprescription cimetidine for stomach problems.
This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Overdose of this medication may be fatal, and symptoms include seizures, delirium and loss of consciousness.

NOTES:
Do not share this medication with others.
Laboratory and/or medical tests (e.g., blood counts, kidney function, liver function) may be performed from time to time to monitor your progress or check for side effects. Consult your doctor for more details.
Keep all medical appointments so your doctor can monitor your progress closely or check for side effects. 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 and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE:
Store at room temperature at approximately 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines 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 for more details about how to safely discard your product.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).
Information last revised September 2011. Copyright(c) 2011 First Databank, Inc.