toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.maprotilinemaprotiline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.maprotiline and trimipramine both increase sedation. Use Caution/Monitor.maravirocmaraviroc, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.marijuanatrimipramine and marijuana both increase sedation. Use Caution/Monitor.meclizinemeclizine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.melatonintrimipramine and melatonin both increase sedation. Use Caution/Monitor.meperidinemeperidine and trimipramine both increase sedation. Use Caution/Monitor.meprobamatetrimipramine and meprobamate both increase sedation. Use Caution/Monitor.metaproterenoltrimipramine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaxalonemetaxalone and trimipramine both increase sedation. Use Caution/Monitor.methadonetrimipramine and methadone both increase QTc interval. Modify Therapy/Monitor Closely.methadone and trimipramine both increase sedation. Use Caution/Monitor.methamphetaminetrimipramine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methocarbamolmethocarbamol and trimipramine both increase sedation. Use Caution/Monitor.methscopolaminemethscopolamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.methylenedioxymethamphetaminetrimipramine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methylphenidatetrimipramine, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidate transdermalmethylphenidate transdermal will increase the level or effect of trimipramine by decreasing elimination. Modify Therapy/Monitor Closely. Consider decreasing the dose of these drugs when given coadministered with methylphenidate. Monitor for drug toxiticities when initiating or discontinuing methylphenidate. midazolammidazolam and trimipramine both increase sedation. Use Caution/Monitor.midazolam intranasalmidazolam intranasal, trimipramine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.midodrinetrimipramine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.mifepristonemifepristone, trimipramine. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.mifepristone will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.mirabegronmirabegron will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.mirtazapinetrimipramine and mirtazapine both increase sedation. Use Caution/Monitor.trimipramine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.mitotanemitotane decreases levels of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.modafiniltrimipramine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphinemorphine and trimipramine both increase sedation. Use Caution/Monitor.trimipramine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.motherworttrimipramine and motherwort both increase sedation. Use Caution/Monitor.moxonidinetrimipramine and moxonidine both increase sedation. Use Caution/Monitor.nabilonetrimipramine and nabilone both increase sedation. Use Caution/Monitor.nalbuphinenalbuphine and trimipramine both increase sedation. Use Caution/Monitor.naratriptannaratriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.nefopamnefopam, trimipramine. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.nelfinavirnelfinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.neostigmineneostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.norepinephrinetrimipramine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramine increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.nortriptylinenortriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.nortriptyline and trimipramine both increase sedation. Use Caution/Monitor.ofloxacintrimipramine and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineolanzapine and trimipramine both increase sedation. Use Caution/Monitor.olanzapine and trimipramine both increase QTc interval. Use Caution/Monitor.oliceridinetrimipramine, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.trimipramine increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olodaterol inhaledtrimipramine and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. TCAs prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmiasonabotulinumtoxinAonabotulinumtoxinA and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.opium tinctureopium tincture and trimipramine both increase sedation. Use Caution/Monitor.orphenadrinetrimipramine and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.orphenadrine and trimipramine both increase sedation. Use Caution/Monitor.osimertinibosimertinib and trimipramine both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxazepamoxazepam and trimipramine both increase sedation. Use Caution/Monitor.oxybutyninoxybutynin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicaloxybutynin topical and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermaloxybutynin transdermal and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxycodoneoxycodone and trimipramine both increase sedation. Use Caution/Monitor.oxymetazoline intranasaltrimipramine increases effects of oxymetazoline intranasal by pharmacodynamic synergism. Use Caution/Monitor. TCAs inhibit norepinephrine uptake in adrenergic neurons, thereby increasing synaptic norepinephrine levels. Coadministration with alpha1 agonists may cause increased adrenergic receptor stimulation. When oxymetazoline is combined with intranasal tetracaine for dental anesthesia, avoid or use alternant anesthetic in patients taking TCAs.oxymorphoneoxymorphone and trimipramine both increase sedation. Use Caution/Monitor.ozanimodozanimod and trimipramine both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidonetrimipramine and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.paliperidone and trimipramine both increase sedation. Use Caution/Monitor.pancuroniumpancuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.papaveretumpapaveretum and trimipramine both increase sedation. Use Caution/Monitor.papaverinetrimipramine and papaverine both increase sedation. Use Caution/Monitor.paroxetinetrimipramine and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.pasireotidetrimipramine and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibtrimipramine and pazopanib both increase QTc interval. Use Caution/Monitor.peginterferon alfa 2bpeginterferon alfa 2b, trimipramine. Other (see comment). Use Caution/Monitor. Comment: When patients are administered peginterferon alpha-2b with CYP2D6 substrates, the therapeutic effect of these drugs may be altered. Peginterferon alpha-2b may increase or decrease levels of CYP2D6 substrate.pentazocinepentazocine and trimipramine both increase sedation. Use Caution/Monitor.trimipramine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.pentobarbitalpentobarbital and trimipramine both increase sedation. Use Caution/Monitor.perphenazineperphenazine and trimipramine both increase sedation. Use Caution/Monitor.phendimetrazinetrimipramine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenobarbitalphenobarbital and trimipramine both increase sedation. Use Caution/Monitor.phenobarbital will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.phenterminetrimipramine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrinetrimipramine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phenylephrine ophthalmictrimipramine, phenylephrine ophthalmic. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.phenylephrine POtrimipramine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodinetrimipramine and pholcodine both increase sedation. Use Caution/Monitor.physostigminephysostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpinepilocarpine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozidepimozide and trimipramine both increase sedation. Use Caution/Monitor.pirbuteroltrimipramine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.posaconazoletrimipramine and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.posaconazole will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.pralidoximepralidoxime and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.pregabalinpregabalin, trimipramine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.primidoneprimidone and trimipramine both increase sedation. Use Caution/Monitor.prochlorperazineprochlorperazine and trimipramine both increase QTc interval. Use Caution/Monitor.prochlorperazine and trimipramine both increase sedation. Use Caution/Monitor.promethazinepromethazine and trimipramine both increase sedation. Use Caution/Monitor.propanthelinepropantheline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.propofolpropofol and trimipramine both increase sedation. Use Caution/Monitor.propylhexedrinetrimipramine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineprotriptyline and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptyline and trimipramine both increase sedation. Use Caution/Monitor.pyridostigminepyridostigmine increases and trimipramine decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quazepamquazepam and trimipramine both increase sedation. Use Caution/Monitor.quetiapinequetiapine and trimipramine both increase sedation. Use Caution/Monitor.quetiapine, trimipramine. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.quininetrimipramine and quinine both increase QTc interval. Use Caution/Monitor.ramelteontrimipramine and ramelteon both increase sedation. Use Caution/Monitor.ranolazinetrimipramine and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.rapacuroniumrapacuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.remifentaniltrimipramine, remifentanil. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. May also increase risk of serotonin syndrome.remimazolamremimazolam, trimipramine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.rifabutinrifabutin decreases levels of trimipramine by increasing metabolism. Use Caution/Monitor.rifampinrifampin will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rilpivirinerilpivirine increases toxicity of trimipramine by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsade de Pointes.risperidonetrimipramine and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.risperidone and trimipramine both increase sedation. Use Caution/Monitor.ritonavirritonavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rizatriptanrizatriptan and trimipramine both increase serotonin levels. Modify Therapy/Monitor Closely.rocuroniumrocuronium and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.rolapitantrolapitant will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Rolapitant may increase plasma concentrations of CYP2D6 substrates for at least 28 days following rolapitant administration.romidepsintrimipramine and romidepsin both increase QTc interval. Modify Therapy/Monitor Closely.rucaparibrucaparib will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.salmeteroltrimipramine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.SAMetrimipramine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.saquinavirsaquinavir will increase the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.scopolaminescopolamine and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.scullcaptrimipramine and scullcap both increase sedation. Use Caution/Monitor.secobarbitalsecobarbital and trimipramine both increase sedation. Use Caution/Monitor.secobarbital will decrease the level or effect of trimipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May also enhance CNS depressant effect of trimipramineselpercatinibselpercatinib increases toxicity of trimipramine by QTc interval. Use Caution/Monitor.sevofluranesevoflurane and trimipramine both increase sedation. Use Caution/Monitor.sevoflurane and trimipramine both increase QTc interval. Use Caution/Monitor.shepherd's pursetrimipramine and shepherd's purse both increase sedation. Use Caution/Monitor.sodium sulfate/?magnesium sulfate/potassium chloridesodium sulfate/?magnesium sulfate/potassium chloride increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycoltrimipramine, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.sodium sulfate/potassium sulfate/magnesium sulfatesodium sulfate/potassium sulfate/magnesium sulfate increases effects of trimipramine by unknown mechanism. Use Caution/Monitor. Closely monitor for evidence of seizures when using higher dose of magnesium sulfate together with drugs that lower the seizure threshold.solifenacinsolifenacin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.solifenacin and trimipramine both increase QTc interval. Use Caution/Monitor.sorafenibsorafenib and trimipramine both increase QTc interval. Use Caution/Monitor.sparsentansparsentan will decrease the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates. stiripentolstiripentol, trimipramine. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.stiripentol will increase the level or effect of trimipramine by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.stiripentol, trimipramine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.succinylcholinesuccinylcholine increases and trimipramine decreases