Trimipramine
Checked
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TCA, Antidepressant
Trimipramine
Surmontil
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8095096 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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CPIC rec 8095096 [Strong]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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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)
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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]
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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]
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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)
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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]
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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)
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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)
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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]
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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]
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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]
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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]
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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)
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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]
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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]
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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)
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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]
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Clinical relevance: does this interaction matter in practice?trivialcritical
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Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
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]
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CPIC rec 8095121 [Optional]: Initiate therapy with recommended starting dose. CPIC pair-level B (CYP2D6, CYP2C19 and Tricyclic Antidepressants) [PMID 23486447, 27997040]
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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