The active ingredient in Surmontil is trimipramine maleate. It affects certain chemicals in the brain, including norepinephrine and serotonin, which influence mood and emotional balance. By helping to restore these chemical levels, Surmontil can relieve symptoms of depression and stabilize mood over time.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Surmontil. However, the following is a synopsis of the general guidelines for the use of Surmontil:

• It is usually taken one to three times a day, with or without food.
• If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Skip the missed dose rather than taking two doses close together.
• Because Surmontil can cause drowsiness, taking it at bedtime may be recommended.
• Avoid driving, operating machinery, or drinking alcohol until you know how Surmontil affects you.

Some mild or common side effects of Surmontil seen in clinical trials as compared to placebo include:

• Drowsiness or fatigue.
• Dry mouth.
• Constipation.
• Blurred vision.
• Weight gain.
• Dizziness or low blood pressure, especially when standing up.
• Difficulty urinating (urinary retention).

Some individuals may experience serious side effects while using Surmontil. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Chest pain, irregular heartbeat, increased heart rate, or signs of a heart attack, such as shortness of breath or jaw pain.
• Eye pain or sudden vision changes may be signs of angle-closure glaucoma.
• Fever, sore throat, or unusual bleeding, which may indicate low blood cell counts (agranulocytosis or thrombocytopenia).
• Signs of serotonin syndrome, including agitation, hallucinations, sweating, tremor, fever, or muscle stiffness—especially if you are taking Surmontil with other antidepressants or supplements like tryptophan or St. John’s wort.
• Suicidal thoughts or unusual behavior changes, particularly in children, teens, and young adults.
• Severe allergic reaction, such as rash, hives, swelling, or difficulty breathing.

These are not all of the possible side effects of Surmontil. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Surmontil, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

History of bipolar disorder, schizophrenia, or other psychiatric conditions.

Heart disease, previous heart attack, or irregular heartbeat.

High or low blood pressure.

Glaucoma or increased eye pressure.

Thyroid disorders.

Liver or kidney disease.

Urinary retention or prostate problems.

Seizure disorders.

Do not use Surmontil if you:

Are allergic to trimipramine maleate or any of its ingredients.

Are currently taking or have recently taken monoamine oxidase inhibitors (MAOIs) such as phenelzine, isocarboxazid, selegiline, tranylcypromine, methylene blue, or linezolid. A washout period of at least 14 days is required before starting Surmontil.

Have recently had a heart attack.

Have untreated narrow-angle glaucoma.

Some patients may notice mild improvements in sleep and appetite within the first week, but it usually takes two to four weeks to feel the full antidepressant effects.

When Surmontil is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• MAO inhibitors such as phenelzine, isocarboxazid, selegiline, tranylcypromine, or linezolid.
• SSRIs and SNRIs such as fluoxetine, paroxetine, or sertraline.
• Other tricyclic antidepressants, like amitriptyline or imipramine.
• Buspirone or lithium, which can increase serotonin levels.
• Tramadol or tryptophan supplements, which may trigger serotonin syndrome.
• Barbiturates, sleep aids, or CNS depressants may increase drowsiness.
• Antihistamines and anticholinergic drugs that increase dry mouth, constipation, or blurred vision.
• St. John’s wort and similar herbal products may raise serotonin activity.
• Medications for heart rhythm problems, thyroid disorders, or high blood pressure.
• Supplements containing magnesium or potassium may affect heart rhythm.

Surmontil is available in tablet form for oral use. The typical dosage strengths include:

Surmontil 25 mg tablets.

Surmontil 50 mg tablets.

Surmontil 100 mg tablets.

It should be stored at room temperature away from the reach of children or pets.

Surmontil (trimipramine maleate) was originally developed and marketed by Mallinckrodt Pharmaceuticals and other licensed manufacturers.

Yes, it is available from many manufacturers of generic drugs.

Do not stop taking Surmontil suddenly without your doctor’s guidance. Stopping abruptly can lead to withdrawal symptoms such as nausea, headache, irritability, or sleep disturbance.

There is limited information on the use of trimipramine during pregnancy. It should only be used when the potential benefits outweigh the risks to the baby. Newborns exposed to tricyclic antidepressants late in pregnancy may experience withdrawal symptoms or breathing difficulties.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Trimipramine may pass into breast milk and could cause side effects in a nursing infant, such as drowsiness or feeding difficulties.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.