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Revision as of 03:31, 14 May 2026

TCA, Antidepressant
Trimipramine
Surmontil

Experience

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Problems

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Titration strategies

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Effects

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Interactions

Pharmacogenomic + mechanism interactions20 edges
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
Phenotype:CYP2C19 normal metabolizer monitor CPIC Strong 70 / 100
CPIC rec 8095096 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 normal metabolizer monitor CPIC Strong 70 / 100
CPIC rec 8095096 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 intermediate metabolizer avoid FDA Label 35 / 100
CPIC rec 8095059 [Optional]: Avoid trimipramine use; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
Phenotype:CYP2C19 poor metabolizer avoid CPIC B 35 / 100
CPIC rec 8095059 [Optional]: Avoid trimipramine use; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:cyp2c19 lpm avoid CPIC B 35 / 100
CPIC rec 8095079 [Optional]: Avoid trimipramine use; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 ultrarapid metabolizer avoid FDA Label 35 / 100
CPIC rec 8095153 [Optional]: Avoid trimipramine use; If trimipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
Phenotype:CYP2C19 normal metabolizer avoid CPIC B 35 / 100
CPIC rec 8095153 [Optional]: Avoid trimipramine use; If trimipramine is warranted, consider titrating to a higher target dose (compared to normal metabolizers). Utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 normal metabolizer avoid FDA Label 35 / 100
CPIC rec 8095097 [Optional]: Avoid trimipramine use. If trimipramine is warranted, consider a 50% reduction of recommended starting dose. Utilize therapeutic drug monitoring to guide dose adjustments. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
Phenotype:CYP2D6 poor metabolizer avoid FDA Label 35 / 100
CPIC rec 8095132 [Optional]: Avoid trimipramine use. If a trimipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
CPIC rec 8095132 [Optional]: Avoid trimipramine use. If a trimipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2C19 rapid metabolizer avoid CPIC B 35 / 100
CPIC rec 8095135 [Optional]: Avoid trimipramine use; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
CPIC rec 8095136 [Optional]: Avoid trimipramine use; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:cyp2c19 lim avoid CPIC B 35 / 100
CPIC rec 8095138 [Optional]: Avoid trimipramine use. If a trimipramine is warranted, consider a 50% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 intermediate metabolizer prefer alternative FDA Label 30 / 100
CPIC rec 8095063 [Optional]: Consider alternative drug not metabolized by CYP2C19; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
Phenotype:CYP2C19 rapid metabolizer prefer alternative CPIC B 30 / 100
CPIC rec 8095063 [Optional]: Consider alternative drug not metabolized by CYP2C19; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2C19 ultrarapid metabolizer prefer alternative CPIC B 30 / 100
CPIC rec 8095067 [Optional]: Consider alternative drug not metabolized by CYP2C19; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2D6 normal metabolizer prefer alternative FDA Label 30 / 100
CPIC rec 8095102 [Optional]: Consider alternative drug not metabolized by CYP2C19; If trimipramine is warranted, utilize therapeutic drug monitoring to guide dose adjustment. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040] FDA labeling (Precautions)
Phenotype:CYP2D6 intermediate metabolizer monitor CPIC B 20 / 100
CPIC rec 8095051 [Optional]: Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:CYP2C19 intermediate metabolizer monitor CPIC B 20 / 100
CPIC rec 8095051 [Optional]: Consider a 25% reduction of recommended starting dose. Utilizing therapeutic drug monitoring to guide dose adjustments is strongly recommended. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
Phenotype:cyp2c19 lim monitor CPIC B 20 / 100
CPIC rec 8095121 [Optional]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]

Patient experience

Fluoxetine via Category:Antidepressants👤 exp n/a/5 outcome n/a (n=1)⚕️ exp 1.0/5 outcome +33.0 (n=1)

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Summary
Classes
TCA, Antidepressant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Weak SRI; primarily H1/D2/alpha antagonist