Surmontil (Trimipramine Maleate)

You should not take SURMONTIL if you have recently had a heart attack.

Do not use SURMONTIL if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using SURMONTIL. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Do not give this medicine to anyone under 18 years old without medical advice. SURMONTIL is not approved for use in children.

You should not use SURMONTIL if you are allergic to it, or if you have:

• if you have recently had a heart attack; or
• if you are allergic to antidepressants such as amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, or protriptyline.

To make sure SURMONTIL is safe for you, tell your doctor if you have:

• heart disease, or a history of heart attack;
• bipolar disorder (manic-depression), schizophrenia or other mental illness;
• liver disease;
• history of seizures;
• narrow-angle glaucoma;
• a thyroid disorder; or
• problems with urination.

It is not known whether SURMONTIL will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether SURMONTIL passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone under 18 years old without medical advice. SURMONTIL is not approved for use in children.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• a light-headed feeling, like you might pass out;
• new or worsening chest pain, pounding heartbeats or fluttering in your chest;
• confusion, hallucinations, unusual thoughts or behavior;
• seizure (convulsions);
• painful or difficult urination; or
• restless muscle movements in your eyes, tongue, jaw, or neck.

Older adults may be more likely to have side effects from this medicine.

Common side effects may include:

• headache, vision changes;
• sleep problems (insomnia);
• drowsiness, dizziness;
• numbness or tingly feeling;
• upset stomach;
• breast swelling (in men or women); or
• decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Do not drink alcohol. SURMONTIL can increase the effects of alcohol, which could be dangerous.

Grapefruit and grapefruit juice may interact with SURMONTIL and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid exposure to sunlight or tanning beds. SURMONTIL can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking SURMONTIL with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Before taking SURMONTIL, tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline.

You must wait at least 5 weeks after stopping fluoxetine (Prozac) before you can take SURMONTIL.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with SURMONTIL, especially:

• any other antidepressant;
• cimetidine (Tagamet);
• cold medicine that contains a decongestant (such as phenylephrine or pseudoephedrine); or
• heart rhythm medicine.

This list is not complete. Other drugs may interact with SURMONTIL, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you need surgery, tell the surgeon ahead of time that you are using SURMONTIL. You may need to stop using the medicine for a short time.

Do not stop using SURMONTIL suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using SURMONTIL.

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve during treatment.

Store at room temperature away from moisture and heat.

Seek emergency medical attention or call the Poison Help line. An overdose of SURMONTIL can be fatal.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.