Surmontil
Surmontil Uses, Dosage, Side Effects, Food Interaction and all others data.
Surmontil is a tricyclic antidepressant. It was thought that tricyclic antidepressants work by inhibiting the re-uptake of the neurotransmitters norepinephrine and serotonin by nerve cells. However, this response occurs immediately, yet mood does not lift for around two weeks. It is now thought that changes occur in receptor sensitivity in the cerebral cortex and hippocampus. The hippocampus is part of the limbic system, a part of the brain involved in emotions. Presynaptic receptors are affected: a1 and b1 receptors are sensitized, a2 receptors are desensitised (leading to increased noradrenaline production). Tricyclics are also known as effective analgesics for different types of pain, especially neuropathic or neuralgic pain. A precise mechanism for their analgesic action is unknown, but it is thought that they modulate anti-pain opioid systems in the CNS via an indirect serotonergic route. They are also effective in migraine prophylaxis, but not in abortion of acute migraine attack. The mechanism of their anti-migraine action is also thought to be serotonergic.
| Trade Name | Surmontil |
| Availability | Prescription only |
| Generic | Trimipramine |
| Trimipramine Other Names | Trimeprimina, Trimeprimine, Trimeproprimine, Trimipramina, Trimipramine, Trimipraminum |
| Related Drugs | Rexulti, sertraline, trazodone, Lexapro, Zoloft, citalopram, Cymbalta |
| Weight | 25mg, , 100mg, 50mg |
| Type | Tablet, Oral, Oral Capsule |
| Formula | C20H26N2 |
| Weight | Average: 294.4338 Monoisotopic: 294.209598842 |
| Protein binding | 93%-96% (to plasma proteins) |
| Groups | Approved |
| Therapeutic Class | Tricyclic & related anti-depressant drugs |
| Manufacturer | Abbott Healthcare Pvt Ltd, Sanofi Bangladesh Ltd, |
| Available Country | India, Bangladesh, United States, Portugal, Switzerland |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
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. Surmontil is a tricyclic antidepressant. It works by restoring the balance of certain natural substances (neurotransmitters) in the brain.
Surmontil is also used to associated treatment for these conditions: Depression, Insomnia, Nocturnal Enuresis
How Surmontil works
Surmontil's mechanism of action differs from other tricyclic antidepressants. Surmontil acts by decreasing the reuptake of norepinephrine and serotonin (5-HT).
Dosage
Surmontil dosage
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.
Elderly:Initial 50-75 mg daily, increased gradually if necessary. Max: 100 mg daily.
May be taken with or without food
Side Effects
Dry mouth, accommodation disturbances, tachycardia, constipation, hesitancy of micturation, drowsiness, sweating, postural hypotension, skin rashes, cholestatic jaundice, hypomania, convulsions, cardiac arrhythmias and peripheral neuropathy. Agitation, confusion (elderly).
Toxicity
Side effects include agitation, coma, confusion, convulsions, dilated pupils, disturbed concentration, drowsiness, hallucinations, high fever, irregular heart rate, low body temperature, muscle rigidity, overactive reflexes, severely low blood pressure, stupor, vomiting
Precaution
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.
Interaction
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.
Food Interaction
- Avoid alcohol. Ingesting alcohol may increase the risk of adverse effects of trimipramine such as sedation and orthostatic hypotension.
Surmontil Alcohol interaction
[Moderate] GENERALLY AVOID:
Concomitant use of ethanol and a tricyclic antidepressant (TCA) may result altered TCA plasma levels and efficacy, and additive impairment of motor skills, especially driving skills.
Acute ethanol ingestion may inhibit TCA metabolism, while chronic ingestion of large amounts of ethanol may induce hepatic TCA metabolism.
Patients should be advised to avoid alcohol during TCA therapy.
Alcoholics who have undergone detoxification should be monitored for decreased TCA efficacy.
Dosage adjustments may be required.
Surmontil Drug Interaction
Major: duloxetine, paroxetine, desvenlafaxine, bupropionModerate: lorazepam, diphenhydramine, dextroamphetamine, levothyroxine, guanfacine, acetaminophen / oxycodone, quetiapine, quetiapine, carisoprodol, alprazolamMinor: disulfiramUnknown: docusate, rosuvastatin, metronidazole topical, esomeprazole, cholecalciferol
Surmontil Disease Interaction
Major: anticholinergic effects, cardiovascular disease, pheochromocytoma, acute myocardial infarction recovery, cardiovascular disease, depression, seizure disordersModerate: bone marrow suppression, diabetes, renal/liver disease, schizophrenia/bipolar disorder, tardive dyskinesia, acute alcohol intoxication, bipolar disorder screening, glaucoma, hyper/hypoglycemia, liver/renal disease, neutropenia, schizophrenia, thyroid disorders, urinary retention
Elimination Route
Rapid absorption
Half Life
11-18 hrs
Pregnancy & Breastfeeding use
Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Contraindication
Recent MI, cardiac arrhythmias, heart block; mania; porphyria, severe liver disease. Neonates and children. Lactation.
Acute Overdose
Symptoms: Hypotensive collapse, convulsions, cardiac arrhythmias, acidosis and coma.
Management: Gastric lavage should be carried out as soon as possible. Treatment is supportive and symptomatic with ECG monitoring. Intubate and ventilate the patient before convulsions develop. If convulsions occur, treat with IV diazepam. Treatment should be continued for at least 3 days even if the patient appears to have recovered, due to the long half life of trimipramine.
Innovators Monograph
You find simplified version here Surmontil
Surmontil contains Trimipramine see full prescribing information from innovator Surmontil Monograph, Surmontil MSDS, Surmontil FDA label
FAQ
What is Surmontil used for?
Surmontil is used to treat depression.Surmontil is in a class of medications called tricyclic antidepressants. It works by increasing the amount of certain natural substances in the brain that are needed to maintain mental balance.
How safe is Surmontil?
None of the adverse reactions involved the cardiovascular system. The results demonstrate that Surmontil is effective in the treatment of depression and is not likely to produce serious or harmful cardiovascular side effects in patients with mild heart disease.
What are the common side effects of Surmontil?
Common side effects of Surmontil are include: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.
Is Surmontil safe during pregnancy?
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.This drug should not be used during the first and third trimesters of pregnancy unless the benefit outweighs the risk to the fetus.
Is Surmontil safe during breastfeeding?
The manufacturer makes no recommendation regarding use during lactation. Some experts recommend: Use is contraindicated.
Can I drink alcohol with Surmontil?
Alcohol tends to heighten the severity of Surmontil side effects and should only be used after consulting with your doctor. While you may experience normal side effects like drowsiness, fatigue and nausea, mixing alcohol with Surmontil can also lead to blackouts and seizures.
Can I drive after taking Surmontil?
Avoid driving or hazardous activity until you know how this medicine will affect you.
When should I take Surmontil?
It is usual to take Surmontil once a day, at bedtime. Some doctors, however, may recommend smaller doses taken two or three times a day.
How long does Surmontil take to work?
Surmontil starts working in 7 to 10 days, but it may take between two to four weeks for it to have its full effect.
Is Surmontil good for anxiety?
Surmontil is also an effective anxiolytic, and can be used in the treatment of anxiety.
Does Surmontil make me sleepy?
Surmontil can make you sleepy so your doctor may tell you to take the capsule at bedtime. You may have to take this medicine for a month or longer before you begin to feel better.
How do I take Surmontil ?
Take Surmontil by mouth with or without food, usually one to three times daily or as directed by your doctor. If taking this medication once daily.
Who should not take Surmontil?
You should not take Surmontil if you recently had a heart attack.
When should I take Surmontil?
Take it at bedtime to decrease the risk of drowsiness.
What happens if I miss a Surmontil?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Can I stop taking Surmontil suddenly?
Do not stop using Surmontil suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using Surmontil.
Can I overdose on Surmontil?
An overdose of trimipramine can be fatal.
Overdose symptoms may include irregular heartbeats, severe drowsiness, confusion, hallucinations, agitation, stiff muscles, overactive reflexes, vomiting, feeling hot or cold, vision problems, feeling like you might pass out, seizures, or coma.
