What is Tryp?
Tryp is a tricyclic antidepressant. Tryp affects chemicals in the brain that may be unbalanced in people with depression.
Tryp is used to treat symptoms of depression.
Tryp may also be used for purposes not listed in this medication guide.
Tryp indications
Depression (especially with anxiety, agitation and sleep disorders, including childhood, endogenous, involutional, reactive, neurotic, drug, and organic brain damage, alcohol withdrawal), schizophrenic psychoses, mixed emotional disorders, behavioral disorders (activity and attention), nocturnal enuresis (except in patients with hypotonia of the bladder), bulimia nervosa, chronic pain syndrome (chronic pain in cancer patients, migraine, rheumatic pain, atypical facial pain, postherpetic neuralgia, posttraumatic neuropathy, diabetic neuropathy, peripheral neuropathy), prophylaxis of migraine, peptic ulcer and duodenal ulcer.
How should I use Tryp?
Use Tryp as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Tryp comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Tryp refilled.
- Tryp may be taken with food or on an empty stomach.
- Tryp may take up to 30 days to control symptoms of depression. Continue to use Tryp even if you feel well. Do not miss any doses.
- If you miss a dose of Tryp, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Tryp.
Uses of Tryp in details
Use: Labeled Indications
Major depressive disorder (unipolar): Treatment of unipolar major depressive disorder
Off Label Uses
Chronic fatigue syndrome related sleep disturbances and pain
Based on the NICE guidelines for chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy), Tryp is suggested for patients with chronic fatigue syndrome and poor sleep. In addition, based on the Health Canada myalgic encephalomyelitis/chronic fatigue syndrome diagnostic and treatment protocol, Tryp is also suggested for chronic fatigue syndrome related pain.
EFNS guidelines on the clinical management of amyotrophic lateral sclerosis (ALS) recommend Tryp as good clinical practice in the management of sialorrhea, particularly in patients also experiencing emotional lability.
Tryp description
Tryp hydrochloride is a dibenzocycloheptene-derivative tricyclic antidepressant (TCA). TCAs are structurally similar to phenothiazines. They contain a tricyclic ring system with an alkyl amine substituent on the central ring. In non-depressed individuals, Tryp does not affect mood or arousal, but may cause sedation. In depressed individuals, Tryp exerts a positive effect on mood. TCAs are potent inhibitors of serotonin and norepinephrine reuptake. Tertiary amine TCAs, such as Tryp, are more potent inhibitors of serotonin reuptake than secondary amine TCAs, such as nortriptyline. TCAs also down-regulate cerebral cortical β-adrenergic receptors and sensitize post-synaptic serotonergic receptors with chronic use. The antidepressant effects of TCAs are thought to be due to an overall increase in serotonergic neurotransmission. TCAs also block histamine-H1 receptors, α1-adrenergic receptors and muscarinic receptors, which accounts for their sedative, hypotensive and anticholinergic effects (e.g. blurred vision, dry mouth, constipation, urinary retention), respectively. See toxicity section below for a complete listing of side effects. Tryp may be used to treat depression, chronic pain (unlabeled use), irritable bowel syndrome (unlabeled use), diabetic neuropathy (unlabeled use), post-traumatic stress disorder (unlabeled use), and for migraine prophylaxis (unlabeled use).
Tryp dosage
Tryp Dosage
Generic name: Tryp HYDROCHLORIDE 25mg
Dosage form: tablet
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Dosage should be initiated at a low level and increased gradually, noting carefully the clinical response and any evidence of intolerance.
Initial Dosage for Adults:
For outpatients 75 mg of Tryp HCl a day in divided doses is usually satisfactory. If necessary, this may be increased to a total of 150 mg per day. Increases are made preferably in the late afternoon and/or bedtime doses. A sedative effect may be apparent before the antidepressant effect is noted, but an adequate therapeutic effect may take as long as 30 days to develop.
An alternate method of initiating therapy in outpatients is to begin with 50 to 100 mg Tryp HCl at bedtime. This may be increased by 25 or 50 mg as necessary in the bedtime dose to a total of 150 mg per day.
Hospitalized patients may require 100 mg a day initially. This can be increased gradually to 200 mg a day if necessary. A small number of hospitalized patients may need as much as 300 mg a day.
Adolescent and Elderly Patients:
In general, lower dosages are recommended for these patients. Ten mg 3 times a day with 20 mg at bedtime may be satisfactory in adolescent and elderly patients who do not tolerate higher dosages.
Maintenance:
The usual maintenance dosage of Tryp HCl is 50 to 100 mg per day. In some patients 40 mg per day is sufficient. For maintenance therapy the total daily dosage may be given in a single dose preferably at bedtime. When satisfactory improvement has been reached, dosage should be reduced to the lowest amount that will maintain relief of symptoms. It is appropriate to continue maintenance therapy 3 months or longer to lessen the possibility of relapse.
Usage in Pediatric Patients
In view of the lack of experience with the use of this drug in pediatric patients, it is not recommended at the present time for patients under 12 years of age.
Plasma Levels
Because of the wide variation in the absorption and distribution of tricyclic antidepressants in body fluids, it is difficult to directly correlate plasma levels and therapeutic effect. However, determination of plasma levels may be useful in identifying patients who appear to have toxic effects and may have excessively high levels, or those in whom lack of absorption or noncompliance is suspected. Because of increased intestinal transit time and decreased hepatic metabolism in elderly patients, plasma levels are generally higher for a given oral dose of Tryp hydrochloride than in younger patients.
Elderly patients should be monitored carefully and quantitative serum levels obtained as clinically appropriate. Adjustment in dosage should be made according to the patient's clinical response and not on the basis of plasma levels.**
More about Tryp (Tryp)
- Side Effects
- During Pregnancy or Breastfeeding
- Dosage Information
- Drug Images
- Drug Interactions
- Support Group
- En Espanol
- 153 Reviews - Add your own review/rating
Consumer resources
- Tryp
- Tryp (Advanced Reading)
- Other brands: Vanatrip
Professional resources
- Tryp (FDA)
- Tryp Hydrochloride (AHFS Monograph)
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Tryp interactions
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What other drugs will affect Tryp?
When this drug applied simultaneously with:
- drugs have a depressing effect on the central nervous system, it is possibly a significant increase in inhibitory action on the central nervous system, hypotensive effect, respiratory depression.
- drugs with anticholinergic activity may increase anticholinergic effects.
- it may be enhance the action of sympathomimetic funds for the cardiovascular system and increase the risk of cardiac arrhythmia, tachycardia, severe hypertension.
- antipsychotic drugs (neuroleptics) are relatively suppressed metabolism, with a reduction in the threshold of convulsive readiness.
- antihypertensive drugs (except clonidine, guanethidine and their derivatives) may increase the antihypertensive action and the risk of orthostatic hypotension.
- with MAO inhibitors may been developed a hypertensive crisis; with clonidine, guanethidine it may be decreased the hypotensive effect of clonidine or guanethidine; with barbiturates, carbamazepine it may be decreased the action of Tryp by increasing its metabolism.
- with sucralfate decreases absorption of Tryp; with fluvoxamine - increases the concentration of Tryp in blood plasma and the risk of toxic effects; with fluoxetine - increased concentration of Tryp in plasma and develop toxic reactions due to inhibition of isoenzyme CYP2D6 under the influence of fluoxetine; with quinidine - may slow metabolism of Tryp; with cimetidine - may slow metabolism of Tryp, increasing its concentration in blood plasma and the development of toxic effects.
While taking alcohol the action of ethanol increases, especially during the first few days of therapy.
There was described a case of serotonin syndrome with simultaneously use with sertraline.
Tryp side effects
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What are the possible side effects of Tryp?
Within each category the following adverse reactions are listed in order of decreasing severity. Included in the listing are a few adverse reactions which have not been reported with this specific drug. However, pharmacological similarities among the tricyclic antidepressant drugs require that each of the reactions be considered when Tryp is administered.
Cardiovascular: Myocardial infarction; stroke; nonspecific ECG changes and changes in AV conduction; heart block; arrhythmias; hypotension, particularly orthostatic hypotension; syncope; hypertension; tachycardia; palpitation.
CNS and Neuromuscular: Coma; seizures; hallucinations; delusion; confusional states; disorientation; incoordination; ataxia; tremors; peripheral neuropathy; numbness, tingling and paresthesias of the extremities; extrapyramidal symptoms including abnormal involuntary movements and tardive dyskinesia; dysarthria; disturbed concentration; excitement; anxiety; insomnia; restlessness; nightmares; drowsiness; dizziness; weakness; fatigue; headache; syndrome of inappropriate ADH (antidiuretic hormone) secretion; tinnitus; alteration in EEG patterns.
Anticholinergic: Paralytic ileus; hyperpyrexia; urinary retention; dilatation of the urinary tract; constipation; blurred vision, disturbance of accommodation, increased ocular pressure, mydriasis; dry mouth.
Allergic: Skin rash; urticaria; photosensitization; edema of face and tongue.
Hematologic: Bone marrow depression including agranulocytosis, leukopenia, thrombocytopenia; purpura; eosinophilia.
Gastrointestinal: Rarely hepatitis (including altered liver function and jaundice); nausea; epigastric distress; vomiting; anorexia; stomatitis; peculiar taste; diarrhea; parotid swelling; black tongue.
Endocrine: Testicular swelling and gynecomastia in the male; breast enlargement and galactorrhea in the female; increased or decreased libido; impotence; elevation and lowering of blood sugar levels.
Other: Alopecia; edema; weight gain or loss; urinary frequency; increased perspiration.
Withdrawal Symptoms: After prolonged administration, abrupt cessation of treatment may produce nausea, headache, and malaise. Gradual dosage reductions have been reported to produce, within two weeks, transient symptoms including irritability, restlessness, and dream and sleep disturbance.
These symptoms are not indicative of addiction. Rare instances have been reported of mania or hypomania occurring within 2 to 7 days following cessation of chronic therapy with tricyclic antidepressants.
Causal Relationship Unknown: Other reactions, reported under circumstances where a causal relationship could not be established, are listed to serve as alerting information to physicians.
Body as a Whole: Lupus-like syndrome (migratory arthritis, positive ANA and rheumatoid factor).
Digestive: Hepatic failure, ageusia.
Postmarketing Adverse Events: A syndrome resembling neuroleptic malignant syndrome (NMS) has been very rarely reported after starting or increasing the dose of Tryp hydrochloride, with and without concomitant medications known to cause NMS. Symptoms have included muscle rigidity, fever, mental status changes, diaphoresis, tachycardia, and tremor.
Very rare cases of serotonin syndrome (SS) have been reported with Tryp hydrochloride in combination with other drugs that have a recognized association with SS.
Very rare cases of cardiomyopathy have been reported with Tryp.
Tryp contraindications
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What is the most important information I should know about Tryp?
Tryp hydrochloride is contraindicated in patients who have shown prior hypersensitivity to it.
It should not be given concomitantly with monoamine oxidase inhibitors. Hyperpyretic crises, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressant and monoamine oxidase inhibiting drugs simultaneously. When it is desired to replace a monoamine oxidase inhibitor with Tryp hydrochloride, a minimum of 14 days should be allowed to elapse after the former is discontinued. Tryp hydrochloride should then be initiated cautiously with a gradual increase in dosage until optimum response is achieved.
Tryp hydrochloride should not be given with Cisapride due to the potential for increased QT interval and increased risk for arrhythmia.
This drug is not recommended for use during the acute recovery phase following myocardial infarction.
Active ingredient matches for Tryp:
| Unit description / dosage (Manufacturer) | Price, USD |
| TRYP 10MG TABLET 1 strip / 10 tablets each (Theo Pharma Pvt Ltd) | $ 0.27 |
| TRYP 25MG TABLET 1 strip / 10 tablets each (Theo Pharma Pvt Ltd) | $ 0.27 |
| TRYP 50MG TABLET 1 strip / 10 tablets each (Theo Pharma Pvt Ltd) | $ 0.31 |
| TRYP 75MG TABLET 1 strip / 10 tablets each (Theo Pharma Pvt Ltd) | $ 0.41 |
| TRYP tab 10 mg x 10's (Theo Pharma) | $ 0.18 |
| TRYP tab 25 mg x 10's (Theo Pharma) | $ 0.20 |
| TRYP tab 50 mg x 10's (Theo Pharma) | $ 0.23 |
| TRYP tab 75 mg x 10's (Theo Pharma) | $ 0.30 |
| Tryp 25mg Tablet (Theo Pharma Pvt Ltd) | $ 0.03 |
| Tryp 50mg Tablet (Theo Pharma Pvt Ltd) | $ 0.03 |
| Tryp 75mg Tablet (Theo Pharma Pvt Ltd) | $ 0.04 |
List of Tryp substitutes (brand and generic names): | |
| Trynol (Taiwan) | |
| Trynol 25 mg x 100's, 500's, 1000's | |
| Tryptacap | |
| Tryptacare (India) | |
| Tryptacare 50mg TAB / 100 (Symbiosis (Polaris)) | $ 2.29 |
| TRYPTACARE tab 50 mg x 10's (Symbiosis (Polaris)) | $ 0.23 |
| Tryptacare-H (India) | |
| Tryptacare-H Chlordiazepoxide 5 mg, Amitriptyline hydrochloride12.5 mg. TAB / 100 (Symbiosis (Polaris)) | $ 1.57 |
| TRYPTACARE-H tab 10's (Symbiosis (Polaris)) | $ 0.16 |
| Tryptal (Israel) | |
| Tryptalgin (Argentina) | |
| Tryptanol (Argentina, Brazil, Costa Rica, El Salvador, Guatemala, Honduras, Malaysia, Nicaragua, Panama, Peru, South Africa, Taiwan, Thailand, Venezuela) | |
| Tablet; Oral; Amitriptyline Hydrochloride 25 mg (Merck Sharp & Dohme) | |
| Tryptanol 10 mg x 100's (Merck Sharp & Dohme) | |
| Tryptanol 10 mg x 500's (Merck Sharp & Dohme) | |
| Tryptanol 25 mg x 100's (Merck Sharp & Dohme) | |
| Tryptanol 25 mg x 500's (Merck Sharp & Dohme) | |
| Tablets; Oral; Amitriptyline Hydrochloride 25 mg (Merck Sharp & Dohme) | |
| Tryptanol 25 (Argentina) | |
| Tryptanol 75 (Argentina) | |
| Tryptil (Brazil) | |
| Tryptin (Bangladesh) | |
| Tryptine (Australia) | |
| Tryptizol (Ethiopia, Ireland, Luxembourg, Netherlands, Oman, Portugal, Spain, Sweden, Switzerland) | |
| Tablet; Oral; Amitriptyline Hydrochloride 10 mg (Algorithm) | |
| Tablet; Oral; Amitriptyline Hydrochloride 25 mg (Algorithm) | |
| Tablet; Oral; Amitriptyline Hydrochloride 75 mg (Algorithm) | |
| Tablets; Oral; Amitriptyline Hydrochloride 10 mg (Algorithm) | |
| Tablets; Oral; Amitriptyline Hydrochloride 25 mg (Algorithm) | |
| Tablets; Oral; Amitriptyline Hydrochloride 75 mg (Algorithm) | |
| Tryptomec | |
| Tryptomec 25 mg Tablet (Lifesavers Remedies) | $ 0.03 |
| Tryptomec 75 mg Tablet (Lifesavers Remedies) | $ 0.06 |
| Tryptomer (India) | |
| TRYPTOMER Capsule/ Tablet / 75mg / 10 units (Merind Ltd (Wockhardt Ltd)) | $ 0.52 |
| TRYPTOMER Capsule/ Tablet / 25mg / 10 units (Merind Ltd (Wockhardt Ltd)) | $ 0.22 |
| TRYPTOMER Capsule/ Tablet / 10mg / 10 units (Merind Ltd (Wockhardt Ltd)) | $ 0.21 |
| Tryptomer 10mg TAB / 10 (Merind Ltd (Wockhardt Ltd)) | $ 0.23 |
| Tryptomer 25mg TAB / 10 (Merind Ltd (Wockhardt Ltd)) | $ 0.33 |
| Tryptomer 75mg TAB / 10 (Merind Ltd (Wockhardt Ltd)) | $ 0.71 |
| Tryptomer 50mg SR-TAB / 15 (Merind Ltd (Wockhardt Ltd)) | $ 1.00 |
| Tablets; Oral; Amitriptyline Hydrochloride 10 mg (Merind Ltd (Wockhardt Ltd)) | |
| Tablets; Oral; Amitriptyline Hydrochloride 25 mg (Merind Ltd (Wockhardt Ltd)) | |
| Tablets; Oral; Amitriptyline Hydrochloride 75 mg (Merind Ltd (Wockhardt Ltd)) | |
| Tablets, Sustained Release; Oral; Amitriptyline Hydrochloride 50 mg (Merind Ltd (Wockhardt Ltd)) | |
| Tryptomer 10 mg Tablet (Merind Ltd (Wockhardt Ltd)) | $ 0.03 |
| Tryptomer 25 mg Tablet (Merind Ltd (Wockhardt Ltd)) | $ 0.04 |
| Tryptomer 75 mg Tablet (Merind Ltd (Wockhardt Ltd)) | $ 0.08 |
| TRYPTOMER 10 MG TABLET 1 strip / 30 tablets each (Merind Ltd (Wockhardt Ltd)) | $ 0.81 |
See 1134 substitutes for Tryp | |
References
- PubChem. "amitriptyline". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "amitriptyline". http://www.drugbank.ca/drugs/DB00321 (accessed September 17, 2018).
- MeSH. "Antidepressive Agents, Tricyclic". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
