trazodone (Rx)

Depression

Initial 150 mg/day PO divided q8-12hr

Increase by 50 mg/day q3-7Days

Outpatient: No more than 400 mg/day

Inpatient: No more than 600 mg/day

Oleptro (extended-release)

• 150 mg PO HS initially; may increase by increments of 75 mg/day q3Days; not to exceed 375 mg/day
• Swallow whole or may break in half along scored line; do not chew or crush

Insomnia (Off-label)

50-100 mg PO qDay

Aggressive Behavior (Off-label)

Initial: 50 mg PO q12hr

Maintenance: 75-400 mg/day divided PO q6-12hr

Cocaine Withdrawal (Off-label)

150-200 mg PO qDay

Alcohol Withdrawal (Off-label)

100-600 mg/day divided PO

Prevention of Migraine (Off-label)

100 mg PO qDay

Dose considerations

MAO inhibitors: Do not administer trazodone within 14 days of administering a MAO inhibitor when treating a psychiatric disorder

Coadministration with MAO inhibitors linezolid or IV methylene blue: Trazodone not recommended in patients actively receiving linezolid or IV methylene blue; consider other interventions if treating psychiatric condition; if coadministration necessary, because benefits outweigh risks, monitor for serotonin syndrome for 2 weeks or until 24 hr after last dose of linezolid or IV methylene blue, whichever comes first; may resume trazodone 24 hr after last dose of linezolid or IV methylene blue

Depression (Off-label)

<6 years: Safety and efficacy not established

6-12 years: 1.5-2 mg/kg/day PO in divided doses initially; not to exceed 6 mg/kg/day divded q8hr  

>12 years: 25-50 mg/day PO; increase by 100-150 mg in divided doses

See Black Box Warnings

Dravet Syndrome (Orphan)

Orphan designation for treatment of Dravet syndrome

Sponsor

• Epygenix Therapeutics, Inc; 140 E. Ridgewood Avenue, Suite 415 South Tower; Paramus, New Jersey 07652

Depression

Immediate release: 25-50 mgPO qHS; increase dose by 25-50 mg every three days if inpatient or every week if oupatient not to exceed 75-150 mg/day

Extended release: Experience limited; use 150 mg PO HS initially; may increase by increments of 75 mg/day q3Days; not to exceed 375 mg/day

Contraindicated (17)

• arsenic trioxide

  trazodone and arsenic trioxide both increase QTc interval. Contraindicated.

• disopyramide

  trazodone and disopyramide both increase QTc interval. Contraindicated.

• eliglustat

  trazodone increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.

• ibutilide

  trazodone and ibutilide both increase QTc interval. Contraindicated.

• indapamide

  trazodone and indapamide both increase QTc interval. Contraindicated.

• isocarboxazid

  isocarboxazid and trazodone both increase serotonin levels. Contraindicated.

• lefamulin

  lefamulin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

• pentamidine

  trazodone and pentamidine both increase QTc interval. Contraindicated.

• phenelzine

  phenelzine and trazodone both increase serotonin levels. Contraindicated.

• pimozide

  trazodone and pimozide both increase QTc interval. Contraindicated.

• procainamide

  trazodone and procainamide both increase QTc interval. Contraindicated.

• procarbazine

  procarbazine and trazodone both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.

• quinidine

  quinidine and trazodone both increase QTc interval. Contraindicated.

• safinamide

  trazodone, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

• saquinavir

  trazodone will decrease the level or effect of saquinavir by P-glycoprotein (MDR1) efflux transporter. Contraindicated.
  
  saquinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• sotalol

  trazodone and sotalol both increase QTc interval. Contraindicated.

• tranylcypromine

  tranylcypromine and trazodone both increase serotonin levels. Contraindicated.

Serious - Use Alternative (181)

• abametapir

  abametapir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• albuterol

  trazodone, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• amiodarone

  trazodone and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

• amisulpride

  trazodone and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline

  amitriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• amoxapine

  amoxapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

• anagrelide

  anagrelide and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• apalutamide

  apalutamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• apomorphine

  apomorphine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• arformoterol

  trazodone, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• aripiprazole

  aripiprazole and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• artemether

  artemether and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• artemether/lumefantrine

  trazodone and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
  
  artemether/lumefantrine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine

  asenapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  asenapine transdermal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• atomoxetine

  atomoxetine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• bedaquiline

  bedaquiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• benzphetamine

  trazodone, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• bosentan

  bosentan will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• buprenorphine

  buprenorphine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  buprenorphine buccal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  buprenorphine subdermal implant and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  buprenorphine transdermal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  buprenorphine, long-acting injection and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• bupropion

  trazodone increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

• buspirone

  trazodone and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

• calcium/magnesium/potassium/sodium oxybates

  trazodone, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• ceritinib

  ceritinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  ceritinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• chloramphenicol

  chloramphenicol will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• chloroquine

  chloroquine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• chlorpromazine

  chlorpromazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• citalopram

  citalopram and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• clarithromycin

  clarithromycin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  trazodone and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.

• clomipramine

  clomipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• clonidine

  trazodone decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

• clozapine

  clozapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• cobicistat

  cobicistat will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• conivaptan

  conivaptan will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• crizotinib

  crizotinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• cyclobenzaprine

  trazodone and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.

• degarelix

  degarelix and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• desflurane

  desflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• desipramine

  desipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• desvenlafaxine

  trazodone and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• dexfenfluramine

  trazodone, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dexmethylphenidate

  trazodone, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dextroamphetamine

  trazodone, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dextromethorphan

  trazodone and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

• diethylpropion

  trazodone, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dobutamine

  trazodone, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dofetilide

  trazodone and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

• donepezil

  donepezil and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• dopamine

  trazodone, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dopexamine

  trazodone, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dosulepin

  trazodone and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxepin

  doxepin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

• dronedarone

  trazodone and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

• droperidol

  trazodone and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

• duloxetine

  duloxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• efavirenz

  efavirenz and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• eliglustat

  eliglustat and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• encorafenib

  encorafenib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  trazodone and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• ephedrine

  trazodone, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• epinephrine

  epinephrine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• epinephrine racemic

  epinephrine racemic and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• eribulin

  eribulin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  trazodone and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin ethylsuccinate

  trazodone and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin lactobionate

  trazodone and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin stearate

  trazodone and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

• escitalopram

  escitalopram and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• etravirine

  etravirine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• fenfluramine

  trazodone, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• fexinidazole

  fexinidazole and trazodone both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
  
  fexinidazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• fingolimod

  fingolimod and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• fluconazole

  trazodone and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

• fluoxetine

  fluoxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• fluphenazine

  fluphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• fluvoxamine

  fluvoxamine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• formoterol

  trazodone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• fosamprenavir

  fosamprenavir increases levels of trazodone by decreasing metabolism. Avoid or Use Alternate Drug.

• gemifloxacin

  gemifloxacin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• gilteritinib

  gilteritinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• glasdegib

  trazodone and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• granisetron

  granisetron and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• guanfacine

  trazodone decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

• haloperidol

  trazodone and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

• hydroxyzine

  hydroxyzine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• idelalisib

  idelalisib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

• imipramine

  imipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• inotuzumab

  inotuzumab and trazodone both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• isoflurane

  isoflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• isoproterenol

  trazodone, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• itraconazole

  itraconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  trazodone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.

• ivosidenib

  ivosidenib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• ketoconazole

  ketoconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  trazodone and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

• levalbuterol

  trazodone, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• levoketoconazole

  levoketoconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  trazodone and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.

• levomilnacipran

  levomilnacipran and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• linezolid

  linezolid and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

• lisdexamfetamine

  trazodone, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• lithium

  lithium and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• lofepramine

  lofepramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.

• lonafarnib

  trazodone will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
  
  lonafarnib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• lopinavir

  lopinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• lorcaserin

  trazodone and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

• lumefantrine

  trazodone and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• maprotiline

  maprotiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

• meperidine

  trazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

• metaproterenol

  trazodone, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• methylene blue

  methylene blue and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

• methylenedioxymethamphetamine

  trazodone, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• midodrine

  trazodone, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• mifepristone

  mifepristone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• milnacipran

  milnacipran and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• mirtazapine

  mirtazapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• moxifloxacin

  trazodone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

• nefazodone

  nefazodone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  nefazodone and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• nevirapine

  nevirapine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• nilotinib

  trazodone and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

• norepinephrine

  trazodone, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• nortriptyline

  nortriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• octreotide

  trazodone and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

• octreotide (Antidote)

  trazodone and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

• olanzapine

  olanzapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• olopatadine intranasal

  trazodone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• oxaliplatin

  oxaliplatin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• ozanimod

  ozanimod increases levels of trazodone by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

• panobinostat

  trazodone and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• paroxetine

  paroxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• perphenazine

  perphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• phendimetrazine

  trazodone, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• phentermine

  trazodone, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  trazodone, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.

• phenylephrine

  trazodone, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. 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 PO

  trazodone, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• pirbuterol

  trazodone, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• pitolisant

  trazodone and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

• pomalidomide

  trazodone decreases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• posaconazole

  posaconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• primaquine

  primaquine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• promazine

  promazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• propylhexedrine

  trazodone, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• protriptyline

  protriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• pseudoephedrine

  trazodone, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• rasagiline

  rasagiline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Trazodone should not be coadministered with a MAOI or within 14 days of discontinuing a MAOI. Similarly, a MAOI should not be given within 14 days of stopping trazodone.

• ribociclib

  ribociclib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifabutin

  rifabutin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifampin

  rifampin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifapentine

  rifapentine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• salmeterol

  trazodone, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• selegiline

  selegiline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• selegiline transdermal

  selegiline transdermal and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• serdexmethylphenidate/dexmethylphenidate

  trazodone, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• sertraline

  sertraline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.
  
  sertraline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  sevoflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• siponimod

  siponimod and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• sodium oxybate

  trazodone, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• solifenacin

  solifenacin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• St John's Wort

  St John's Wort will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.
  
  trazodone and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.

• sunitinib

  sunitinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• tacrolimus

  tacrolimus and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• tedizolid

  tedizolid, trazodone. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

• terbutaline

  trazodone, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• tetrabenazine

  tetrabenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• thioridazine

  thioridazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• tipranavir

  tipranavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• toremifene

  trazodone and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

• trifluoperazine

  trifluoperazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• trimipramine

  trazodone and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• tucatinib

  tucatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• venlafaxine

  trazodone and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• vilazodone

  trazodone, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated.

• voriconazole

  voriconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• vorinostat

  vorinostat and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• vortioxetine

  trazodone increases toxicity of vortioxetine by serotonin levels. Avoid or Use Alternate Drug.

• voxelotor

  voxelotor will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

• xylometazoline

  trazodone, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• yohimbe

  yohimbe, trazodone. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.

• yohimbine

  trazodone, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• ziprasidone

  trazodone and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

Monitor Closely (424)

• 5-HTP

  trazodone and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

• aceclofenac

  trazodone, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• acemetacin

  trazodone, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• aclidinium

  aclidinium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• acrivastine

  acrivastine and trazodone both increase sedation. Use Caution/Monitor.

• albuterol

  trazodone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  albuterol and trazodone both increase QTc interval. Use Caution/Monitor.

• alfentanil

  alfentanil and trazodone both increase sedation. Use Caution/Monitor.

• aliskiren

  trazodone will decrease the level or effect of aliskiren by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• almotriptan

  almotriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• alprazolam

  alprazolam and trazodone both increase sedation. Use Caution/Monitor.

• amikacin

  trazodone will decrease the level or effect of amikacin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• amisulpride

  amisulpride and trazodone both increase sedation. Use Caution/Monitor.

• amitriptyline

  trazodone will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  amitriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amitriptyline and trazodone both increase sedation. Use Caution/Monitor.

• amobarbital

  amobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  amobarbital and trazodone both increase sedation. Use Caution/Monitor.

• amoxapine

  amoxapine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amoxapine and trazodone both increase sedation. Use Caution/Monitor.

• apomorphine

  trazodone and apomorphine both increase sedation. Use Caution/Monitor.

• aprepitant

  aprepitant will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• arformoterol

  trazodone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  arformoterol and trazodone both increase QTc interval. Use Caution/Monitor.

• aripiprazole

  aripiprazole and trazodone both increase sedation. Use Caution/Monitor.

• armodafinil

  armodafinil will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• artemether/lumefantrine

  artemether/lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• asenapine

  asenapine and trazodone both increase sedation. Use Caution/Monitor.

• asenapine transdermal

  asenapine transdermal and trazodone both increase sedation. Use Caution/Monitor.

• aspirin

  trazodone, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• aspirin rectal

  trazodone, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• aspirin/citric acid/sodium bicarbonate

  trazodone, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• atazanavir

  atazanavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  atazanavir increases levels of trazodone by unspecified interaction mechanism. Use Caution/Monitor.

• atogepant

  trazodone will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• atorvastatin

  trazodone will decrease the level or effect of atorvastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• atracurium

  atracurium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine IV/IM

  atropine IV/IM and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• avapritinib

  trazodone will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  avapritinib and trazodone both increase sedation. Use Caution/Monitor.

• axitinib

  trazodone increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• azelastine

  azelastine and trazodone both increase sedation. Use Caution/Monitor.

• azithromycin

  trazodone and azithromycin both increase QTc interval. Use Caution/Monitor.

• baclofen

  baclofen and trazodone both increase sedation. Use Caution/Monitor.

• bazedoxifene/conjugated estrogens

  trazodone will decrease the level or effect of bazedoxifene/conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• belladonna and opium

  belladonna and opium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  belladonna and opium and trazodone both increase sedation. Use Caution/Monitor.

• benperidol

  benperidol and trazodone both increase sedation. Use Caution/Monitor.

• benzhydrocodone/acetaminophen

  benzhydrocodone/acetaminophen, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
  
  benzhydrocodone/acetaminophen and trazodone both increase sedation. Use Caution/Monitor.

• benzphetamine

  trazodone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• brexpiprazole

  trazodone will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.
  
  brexpiprazole and trazodone both increase sedation. Use Caution/Monitor.

• brimonidine

  brimonidine and trazodone both increase sedation. Use Caution/Monitor.

• brivaracetam

  brivaracetam and trazodone both increase sedation. Use Caution/Monitor.

• brompheniramine

  brompheniramine and trazodone both increase sedation. Use Caution/Monitor.

• budesonide

  budesonide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of budesonide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• bupivacaine implant

  trazodone, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

• buprenorphine

  buprenorphine and trazodone both increase sedation. Use Caution/Monitor.

• buprenorphine buccal

  buprenorphine buccal and trazodone both increase sedation. Use Caution/Monitor.

• buprenorphine subdermal implant

  trazodone, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
  
  buprenorphine subdermal implant and trazodone both increase sedation. Use Caution/Monitor.

• buprenorphine transdermal

  buprenorphine transdermal and trazodone both increase sedation. Use Caution/Monitor.

• buprenorphine, long-acting injection

  trazodone, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

• butabarbital

  butabarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  butabarbital and trazodone both increase sedation. Use Caution/Monitor.

• butalbital

  butalbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  butalbital and trazodone both increase sedation. Use Caution/Monitor.

• butorphanol

  butorphanol and trazodone both increase sedation. Use Caution/Monitor.

• caffeine

  trazodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• carbamazepine

  carbamazepine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantly

• carbinoxamine

  carbinoxamine and trazodone both increase sedation. Use Caution/Monitor.

• carisoprodol

  carisoprodol and trazodone both increase sedation. Use Caution/Monitor.

• celecoxib

  trazodone, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• chloral hydrate

  chloral hydrate and trazodone both increase sedation. Use Caution/Monitor.

• chlordiazepoxide

  chlordiazepoxide and trazodone both increase sedation. Use Caution/Monitor.

• chlorpheniramine

  chlorpheniramine and trazodone both increase sedation. Use Caution/Monitor.

• chlorpromazine

  chlorpromazine and trazodone both increase sedation. Use Caution/Monitor.

• chlorzoxazone

  chlorzoxazone and trazodone both increase sedation. Use Caution/Monitor.

• choline magnesium trisalicylate

  trazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• cimetidine

  cimetidine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cinnarizine

  cinnarizine and trazodone both increase sedation. Use Caution/Monitor.

• citalopram

  citalopram and trazodone both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.

• clemastine

  clemastine and trazodone both increase sedation. Use Caution/Monitor.

• clomipramine

  clomipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  clomipramine and trazodone both increase sedation. Use Caution/Monitor.

• clonazepam

  clonazepam and trazodone both increase sedation. Use Caution/Monitor.

• clorazepate

  clorazepate and trazodone both increase sedation. Use Caution/Monitor.

• clozapine

  clozapine and trazodone both increase sedation. Use Caution/Monitor.

• cobicistat

  cobicistat will increase the level or effect of trazodone by Other (see comment). Use Caution/Monitor. Trazodone is a substrate of CYP3A4 and CYP2D6; cobicistat inhibits CYP3A4 and CYP2D6

• cocaine topical

  trazodone and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.

• codeine

  codeine and trazodone both increase sedation. Use Caution/Monitor.

• conjugated estrogens

  trazodone will decrease the level or effect of conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• conjugated estrogens, vaginal

  trazodone will decrease the level or effect of conjugated estrogens, vaginal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• cortisone

  cortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of cortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• crizotinib

  crizotinib increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.

• crofelemer

  crofelemer increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclizine

  cyclizine and trazodone both increase sedation. Use Caution/Monitor.

• cyclobenzaprine

  cyclobenzaprine and trazodone both increase sedation. Use Caution/Monitor.

• cyclosporine

  cyclosporine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cyproheptadine

  cyproheptadine and trazodone both increase sedation. Use Caution/Monitor.

• dabrafenib

  dabrafenib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• dantrolene

  dantrolene and trazodone both increase sedation. Use Caution/Monitor.

• daridorexant

  trazodone and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darifenacin

  darifenacin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• darunavir

  darunavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.

• dasatinib

  dasatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• daunorubicin

  trazodone will decrease the level or effect of daunorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• debrisoquine

  trazodone decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.

• deferasirox

  deferasirox will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• deflazacort

  trazodone will decrease the level or effect of deflazacort by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• desflurane

  desflurane and trazodone both increase sedation. Use Caution/Monitor.

• desipramine

  desipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  desipramine and trazodone both increase sedation. Use Caution/Monitor.

• deutetrabenazine

  deutetrabenazine and trazodone both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexamethasone

  dexamethasone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of dexamethasone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• dexchlorpheniramine

  dexchlorpheniramine and trazodone both increase sedation. Use Caution/Monitor.

• dexfenfluramine

  trazodone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dexmedetomidine

  dexmedetomidine and trazodone both increase sedation. Use Caution/Monitor.

• dexmethylphenidate

  trazodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dextroamphetamine

  trazodone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  trazodone increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

• dextroamphetamine transdermal

  trazodone, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

• dextromoramide

  dextromoramide and trazodone both increase sedation. Use Caution/Monitor.

• diamorphine

  diamorphine and trazodone both increase sedation. Use Caution/Monitor.

• diazepam

  diazepam and trazodone both increase sedation. Use Caution/Monitor.

• diazepam intranasal

  diazepam intranasal, trazodone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

• diclofenac

  trazodone, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• diethylpropion

  trazodone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• difelikefalin

  difelikefalin and trazodone both increase sedation. Use Caution/Monitor.

• difenoxin hcl

  difenoxin hcl and trazodone both increase sedation. Use Caution/Monitor.

• diflunisal

  trazodone, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• digoxin

  trazodone will decrease the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone increases levels of digoxin by unspecified interaction mechanism. Use Caution/Monitor.

• dihydroergotamine

  trazodone and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dihydroergotamine intranasal

  trazodone and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

• diltiazem

  diltiazem will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dimenhydrinate

  dimenhydrinate and trazodone both increase sedation. Use Caution/Monitor.

• diphenhydramine

  diphenhydramine and trazodone both increase sedation. Use Caution/Monitor.

• diphenoxylate hcl

  diphenoxylate hcl and trazodone both increase sedation. Use Caution/Monitor.

• dipipanone

  dipipanone and trazodone both increase sedation. Use Caution/Monitor.

• dobutamine

  trazodone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• docetaxel

  trazodone will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• dolasetron

  trazodone and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

• dopamine

  trazodone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• dopexamine

  trazodone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• doxepin

  doxepin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  doxepin and trazodone both increase sedation. Use Caution/Monitor.

• doxorubicin

  trazodone will decrease the level or effect of doxorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• doxorubicin liposomal

  trazodone will decrease the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• doxylamine

  doxylamine and trazodone both increase sedation. Use Caution/Monitor.

• dronedarone

  dronedarone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• droperidol

  droperidol and trazodone both increase sedation. Use Caution/Monitor.

• duvelisib

  duvelisib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

• efavirenz

  efavirenz will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• elagolix

  elagolix decreases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eletriptan

  eletriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

• encorafenib

  encorafenib, trazodone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

• enzalutamide

  enzalutamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ephedrine

  trazodone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.

• epinephrine

  trazodone increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.

• epinephrine racemic

  trazodone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.

• ergotamine

  trazodone and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• erythromycin base

  erythromycin base will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• erythromycin ethylsuccinate

  erythromycin ethylsuccinate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• erythromycin lactobionate

  erythromycin lactobionate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• erythromycin stearate

  erythromycin stearate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• eslicarbazepine acetate

  eslicarbazepine acetate will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• estazolam

  estazolam and trazodone both increase sedation. Use Caution/Monitor.

• estradiol

  trazodone will decrease the level or effect of estradiol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• estrogens conjugated synthetic

  trazodone will decrease the level or effect of estrogens conjugated synthetic by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• estropipate

  trazodone will decrease the level or effect of estropipate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• ethanol

  trazodone and ethanol both increase sedation. Use Caution/Monitor.

• etodolac

  trazodone, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• etomidate

  etomidate and trazodone both increase sedation. Use Caution/Monitor.

• etoposide

  trazodone will decrease the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• everolimus

  trazodone will decrease the level or effect of everolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• fedratinib

  fedratinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• fenbufen

  trazodone, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fenfluramine

  trazodone increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  fenfluramine, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.

• fenoprofen

  trazodone, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• finerenone

  trazodone will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

• flecainide

  trazodone and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

• flibanserin

  trazodone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

• fluconazole

  fluconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fludrocortisone

  fludrocortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of fludrocortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• fluoxetine

  trazodone and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.

• fluphenazine

  fluphenazine and trazodone both increase sedation. Use Caution/Monitor.

• flurazepam

  flurazepam and trazodone both increase sedation. Use Caution/Monitor.

• flurbiprofen

  trazodone, flurbiprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fluvoxamine

  fluvoxamine and trazodone both increase QTc interval. Modify Therapy/Monitor Closely.

• formoterol

  trazodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• fosamprenavir

  fosamprenavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• fosaprepitant

  fosaprepitant will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• foscarnet

  trazodone and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

• fosphenytoin

  fosphenytoin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• fostemsavir

  trazodone and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• frovatriptan

  frovatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• gabapentin

  gabapentin, trazodone. 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.

• gabapentin enacarbil

  gabapentin enacarbil, trazodone. 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.

• ganaxolone

  trazodone and ganaxolone both increase sedation. Use Caution/Monitor.

• gemtuzumab

  trazodone and gemtuzumab both increase QTc interval. Use Caution/Monitor.

• gentamicin

  trazodone will decrease the level or effect of gentamicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• goserelin

  goserelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• grapefruit

  grapefruit will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• green tea

  green tea, trazodone. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.

• griseofulvin

  griseofulvin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• haloperidol

  haloperidol and trazodone both increase sedation. Use Caution/Monitor.

• henbane

  henbane and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• histrelin

  histrelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• homatropine

  homatropine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• huperzine A

  huperzine A increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydrocodone

  hydrocodone, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

• hydrocortisone

  hydrocortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of hydrocortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• hydromorphone

  hydromorphone and trazodone both increase sedation. Use Caution/Monitor.

• hydroxyzine

  hydroxyzine and trazodone both increase sedation. Use Caution/Monitor.

• hyoscyamine

  hyoscyamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• hyoscyamine spray

  hyoscyamine spray and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ibuprofen

  trazodone, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ibuprofen IV

  trazodone, ibuprofen IV. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• iloperidone

  trazodone and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  iloperidone and trazodone both increase sedation. Use Caution/Monitor.
  
  iloperidone increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

• imatinib

  trazodone will decrease the level or effect of imatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• imipramine

  imipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  imipramine and trazodone both increase sedation. Use Caution/Monitor.

• indinavir

  indinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
  
  trazodone will decrease the level or effect of indinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• indomethacin

  trazodone, indomethacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ipratropium

  ipratropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• irinotecan liposomal

  trazodone will decrease the level or effect of irinotecan liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• isavuconazonium sulfate

  trazodone will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isoniazid

  isoniazid will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

• isoproterenol

  trazodone increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• istradefylline

  istradefylline will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

• itraconazole

  trazodone will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• ivermectin

  trazodone will decrease the level or effect of ivermectin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• ketamine

  ketamine and trazodone both increase sedation. Use Caution/Monitor.

• ketoprofen

  trazodone, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketorolac

  trazodone, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketorolac intranasal

  trazodone, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketotifen, ophthalmic

  trazodone and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

• L-tryptophan

  trazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

• lapatinib

  lapatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of lapatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.

• lasmiditan

  lasmiditan, trazodone. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

• lemborexant

  trazodone will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

• lenacapavir

  lenacapavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.

• lenvatinib

  trazodone and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• leuprolide

  leuprolide increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levalbuterol

  trazodone increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• levofloxacin

  trazodone and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• levorphanol

  levorphanol and trazodone both increase sedation. Use Caution/Monitor.

• linagliptin

  trazodone will decrease the level or effect of linagliptin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Use of alternative treatments is strongly recommended when linagliptin is to be administered with a P-gp inducer.

• lisdexamfetamine

  trazodone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• lithium

  trazodone and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.

• lofepramine

  lofepramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  lofepramine and trazodone both increase sedation. Use Caution/Monitor.

• lofexidine

  trazodone and lofexidine both increase sedation. Use Caution/Monitor.
  
  trazodone decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.

• lomitapide

  trazodone increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

• loperamide

  trazodone will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• loprazolam

  loprazolam and trazodone both increase sedation. Use Caution/Monitor.

• lorazepam

  lorazepam and trazodone both increase sedation. Use Caution/Monitor.

• lorlatinib

  lorlatinib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lormetazepam

  lormetazepam and trazodone both increase sedation. Use Caution/Monitor.

• lornoxicam

  trazodone, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• lovastatin

  trazodone will decrease the level or effect of lovastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• loxapine

  loxapine and trazodone both increase sedation. Use Caution/Monitor.

• loxapine inhaled

  loxapine inhaled and trazodone both increase sedation. Use Caution/Monitor.

• lsd

  trazodone and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

• lumefantrine

  lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lurasidone

  lurasidone, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

• maprotiline

  maprotiline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  maprotiline and trazodone both increase sedation. Use Caution/Monitor.

• maraviroc

  trazodone will decrease the level or effect of maraviroc by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• marijuana

  marijuana will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and marijuana both increase sedation. Use Caution/Monitor.

• meclizine

  meclizine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• meclofenamate

  trazodone, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• mefenamic acid

  trazodone, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• melatonin

  trazodone and melatonin both increase sedation. Use Caution/Monitor.

• meloxicam

  trazodone, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• meperidine

  meperidine and trazodone both increase sedation. Use Caution/Monitor.

• meprobamate

  trazodone and meprobamate both increase sedation. Use Caution/Monitor.

• mestranol

  trazodone will decrease the level or effect of mestranol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• metaproterenol

  trazodone increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• metaxalone

  metaxalone and trazodone both increase sedation. Use Caution/Monitor.

• methadone

  trazodone and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  methadone and trazodone both increase sedation. Use Caution/Monitor.

• methamphetamine

  trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Significant - Monitor Closely..
  
  methamphetamine increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Comment: Amphetamines may increase the toxicity of serotonin modulators, increasing the risk of serotonin syndrome. .

• methocarbamol

  methocarbamol and trazodone both increase sedation. Use Caution/Monitor.

• methscopolamine

  methscopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• methylenedioxymethamphetamine

  trazodone increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• methylphenidate

  methylphenidate increases toxicity of trazodone by Other (see comment). Modify Therapy/Monitor Closely. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity.

• methylprednisolone

  methylprednisolone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of methylprednisolone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• metronidazole

  metronidazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• miconazole vaginal

  miconazole vaginal will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• midazolam

  midazolam and trazodone both increase sedation. Use Caution/Monitor.

• midazolam intranasal

  trazodone will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

• midodrine

  trazodone increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• mipomersen

  mipomersen, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

• mirtazapine

  trazodone and mirtazapine both increase sedation. Use Caution/Monitor.
  
  trazodone and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.

• mitotane

  mitotane decreases levels of trazodone 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.

• modafinil

  trazodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• morphine

  morphine and trazodone both increase sedation. Use Caution/Monitor.
  
  trazodone and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.

• motherwort

  trazodone and motherwort both increase sedation. Use Caution/Monitor.

• moxonidine

  trazodone and moxonidine both increase sedation. Use Caution/Monitor.

• nabilone

  trazodone and nabilone both increase sedation. Use Caution/Monitor.

• nabumetone

  trazodone, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• nafcillin

  nafcillin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nalbuphine

  nalbuphine and trazodone both increase sedation. Use Caution/Monitor.

• naproxen

  trazodone, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• naratriptan

  naratriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• nefopam

  nefopam, trazodone. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.

• nelfinavir

  nelfinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• neomycin PO

  trazodone will decrease the level or effect of neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• nifedipine

  nifedipine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nilotinib

  nilotinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of nilotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• nirmatrelvir

  nirmatrelvir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.

• nirmatrelvir/ritonavir

  nirmatrelvir/ritonavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.

• norepinephrine

  trazodone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  trazodone increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.

• nortriptyline

  nortriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  nortriptyline and trazodone both increase sedation. Use Caution/Monitor.

• ofloxacin

  trazodone and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• olanzapine

  olanzapine and trazodone both increase sedation. Use Caution/Monitor.

• oliceridine

  trazodone will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
  
  trazodone, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

• opium tincture

  opium tincture and trazodone both increase sedation. Use Caution/Monitor.

• orphenadrine

  trazodone and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  orphenadrine and trazodone both increase sedation. Use Caution/Monitor.

• osilodrostat

  osilodrostat and trazodone both increase QTc interval. Use Caution/Monitor.

• oxaliplatin

  oxaliplatin will increase the level or effect of trazodone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.

• oxaprozin

  trazodone, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• oxazepam

  oxazepam and trazodone both increase sedation. Use Caution/Monitor.

• oxcarbazepine

  oxcarbazepine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• oxybutynin

  oxybutynin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin topical

  oxybutynin topical and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin transdermal

  oxybutynin transdermal and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxycodone

  oxycodone and trazodone both increase sedation. Use Caution/Monitor.

• oxymorphone

  oxymorphone and trazodone both increase sedation. Use Caution/Monitor.

• paclitaxel

  trazodone will decrease the level or effect of paclitaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paclitaxel protein bound

  trazodone will decrease the level or effect of paclitaxel protein bound by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paliperidone

  trazodone will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  paliperidone and trazodone both increase sedation. Use Caution/Monitor.

• pancuronium

  pancuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• papaveretum

  papaveretum and trazodone both increase sedation. Use Caution/Monitor.

• papaverine

  trazodone and papaverine both increase sedation. Use Caution/Monitor.

• parecoxib

  trazodone, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• paromomycin

  trazodone will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paroxetine

  trazodone and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.

• pazopanib

  trazodone and pazopanib both increase QTc interval. Use Caution/Monitor.

• peginterferon alfa 2b

  peginterferon alfa 2b, trazodone. 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.

• pentazocine

  pentazocine and trazodone both increase sedation. Use Caution/Monitor.
  
  trazodone and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.

• pentobarbital

  pentobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pentobarbital and trazodone both increase sedation. Use Caution/Monitor.

• perphenazine

  perphenazine and trazodone both increase sedation. Use Caution/Monitor.

• phendimetrazine

  trazodone increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenobarbital

  phenobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  phenobarbital and trazodone both increase sedation. Use Caution/Monitor.

• phentermine

  trazodone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine

  trazodone increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• phenylephrine ophthalmic

  trazodone, 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 PO

  trazodone increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

• pholcodine

  trazodone and pholcodine both increase sedation. Use Caution/Monitor.

• pimozide

  pimozide and trazodone both increase sedation. Use Caution/Monitor.

• pirbuterol

  trazodone increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• piroxicam

  trazodone, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• posaconazole

  trazodone will decrease the level or effect of posaconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• pralidoxime

  pralidoxime and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• prednisolone

  trazodone will decrease the level or effect of prednisolone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• prednisone

  prednisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of prednisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• pregabalin

  pregabalin, trazodone. 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.

• primidone

  primidone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  primidone and trazodone both increase sedation. Use Caution/Monitor.

• prochlorperazine

  prochlorperazine and trazodone both increase QTc interval. Use Caution/Monitor.
  
  prochlorperazine and trazodone both increase sedation. Use Caution/Monitor.

• promethazine

  promethazine and trazodone both increase QTc interval. Use Caution/Monitor.
  
  promethazine and trazodone both increase sedation. Use Caution/Monitor.

• propantheline

  propantheline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• propofol

  propofol and trazodone both increase sedation. Use Caution/Monitor.

• propylhexedrine

  trazodone increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• protriptyline

  protriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  protriptyline and trazodone both increase sedation. Use Caution/Monitor.

• quazepam

  quazepam and trazodone both increase sedation. Use Caution/Monitor.

• quetiapine

  quetiapine and trazodone both increase sedation. Use Caution/Monitor.

• quinupristin/dalfopristin

  quinupristin/dalfopristin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ramelteon

  trazodone and ramelteon both increase sedation. Use Caution/Monitor.

• ranolazine

  trazodone and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

• rapacuronium

  rapacuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• remimazolam

  remimazolam, trazodone. 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.

• rifabutin

  rifabutin decreases levels of trazodone by increasing metabolism. Use Caution/Monitor.

• risperidone

  trazodone will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  risperidone and trazodone both increase sedation. Use Caution/Monitor.

• ritonavir

  ritonavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.
  
  trazodone will decrease the level or effect of ritonavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rizatriptan

  rizatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• rocuronium

  rocuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• romidepsin

  trazodone will decrease the level or effect of romidepsin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rucaparib

  rucaparib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• rufinamide

  rufinamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• salicylates (non-asa)

  trazodone, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• salmeterol

  trazodone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• salsalate

  trazodone, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• SAMe

  trazodone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

• scopolamine

  scopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• scullcap

  trazodone and scullcap both increase sedation. Use Caution/Monitor.

• secobarbital

  secobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  secobarbital and trazodone both increase sedation. Use Caution/Monitor.

• sevoflurane

  sevoflurane and trazodone both increase sedation. Use Caution/Monitor.

• shepherd's purse

  trazodone and shepherd's purse both increase sedation. Use Caution/Monitor.

• silodosin

  trazodone will decrease the level or effect of silodosin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• sirolimus

  trazodone will decrease the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• solifenacin

  solifenacin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• stiripentol

  stiripentol, trazodone. 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.

• streptomycin

  trazodone will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• sufentanil

  sufentanil and trazodone both increase sedation. Use Caution/Monitor.

• sufentanil SL

  sufentanil SL, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

• sulfamethoxazole

  trazodone and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.

• sulfasalazine

  trazodone, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• sulindac

  trazodone, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• sumatriptan

  sumatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• sumatriptan intranasal

  sumatriptan intranasal and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

• tacrolimus

  trazodone will decrease the level or effect of tacrolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• tamsulosin

  trazodone increases levels of tamsulosin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• tapentadol

  tapentadol and trazodone both increase sedation. Use Caution/Monitor.
  
  trazodone and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• tazemetostat

  tazemetostat will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  tecovirimat will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• telavancin

  trazodone and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

• temazepam

  temazepam and trazodone both increase sedation. Use Caution/Monitor.

• terbutaline

  trazodone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• thioridazine

  thioridazine and trazodone both increase sedation. Use Caution/Monitor.

• thiothixene

  thiothixene and trazodone both increase sedation. Use Caution/Monitor.

• tinidazole

  trazodone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tiotropium

  tiotropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tobramycin

  trazodone will decrease the level or effect of tobramycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• tolfenamic acid

  trazodone, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolmetin

  trazodone, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolterodine

  tolterodine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tolvaptan

  trazodone will decrease the level or effect of tolvaptan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• topiramate

  topiramate will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and topiramate both increase sedation. Modify Therapy/Monitor Closely.

• tramadol

  tramadol and trazodone both increase sedation. Use Caution/Monitor.
  
  trazodone and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.

• triazolam

  triazolam and trazodone both increase sedation. Use Caution/Monitor.

• triclabendazole

  triclabendazole and trazodone both increase QTc interval. Use Caution/Monitor.

• triclofos

  triclofos and trazodone both increase sedation. Use Caution/Monitor.

• trifluoperazine

  trifluoperazine and trazodone both increase sedation. Use Caution/Monitor.

• trimethoprim

  trazodone and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

• trimipramine

  trazodone and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  trazodone and trimipramine both increase sedation. Use Caution/Monitor.

• triprolidine

  triprolidine and trazodone both increase sedation. Use Caution/Monitor.

• triptorelin

  triptorelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tropisetron

  trazodone and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

• trospium chloride

  trospium chloride and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• valbenazine

  valbenazine and trazodone both increase QTc interval. Use Caution/Monitor.

• vecuronium

  vecuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• venlafaxine

  trazodone and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.

• verapamil

  verapamil will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• vinblastine

  trazodone will decrease the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• vincristine

  trazodone will decrease the level or effect of vincristine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• vincristine liposomal

  trazodone will decrease the level or effect of vincristine liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• voriconazole

  trazodone and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.

• xylometazoline

  trazodone increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• yohimbine

  trazodone increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• ziconotide

  trazodone and ziconotide both increase sedation. Use Caution/Monitor.

• ziprasidone

  ziprasidone and trazodone both increase sedation. Use Caution/Monitor.

• zolmitriptan

  zolmitriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.

Minor (131)

• acarbose

  trazodone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

• acetazolamide

  acetazolamide will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• almotriptan

  trazodone, almotriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• alvimopan

  trazodone will decrease the level or effect of alvimopan by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• amobarbital

  amobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• anastrozole

  anastrozole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• anticholinergic/sedative combos

  anticholinergic/sedative combos and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• armodafinil

  trazodone will decrease the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• atorvastatin

  trazodone increases levels of atorvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• atropine

  atropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of atropine by unknown mechanism. Minor/Significance Unknown.

• atropine IV/IM

  trazodone increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

• bazedoxifene/conjugated estrogens

  bazedoxifene/conjugated estrogens, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• belladonna alkaloids

  belladonna alkaloids and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• benztropine

  benztropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• bethanechol

  bethanechol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• brimonidine

  trazodone decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

• bumetanide

  bumetanide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• butabarbital

  butabarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• butalbital

  butalbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• carbachol

  carbachol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• carbamazepine

  carbamazepine decreases levels of trazodone by increasing metabolism. Minor/Significance Unknown.

• celandine

  celandine decreases effects of trazodone by pharmacodynamic antagonism. Minor/Significance Unknown. Based on animal studies.

• cevimeline

  cevimeline increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• chlorpromazine

  trazodone, chlorpromazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• chlorpropamide

  trazodone increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

• cisatracurium

  cisatracurium and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• conjugated estrogens

  conjugated estrogens, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• conjugated estrogens, vaginal

  conjugated estrogens, vaginal, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• cyclizine

  cyclizine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• cyclobenzaprine

  cyclobenzaprine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• cyclophosphamide

  cyclophosphamide will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• darifenacin

  darifenacin and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• desflurane

  desflurane, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• dexmethylphenidate

  dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.

• DHEA, herbal

  DHEA, herbal will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• dicyclomine

  dicyclomine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• diphenhydramine

  diphenhydramine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• donepezil

  donepezil increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• echothiophate iodide

  echothiophate iodide increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• eletriptan

  trazodone, eletriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• estradiol

  estradiol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estrogens conjugated synthetic

  estrogens conjugated synthetic, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estrogens esterified

  estrogens esterified, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estropipate

  estropipate, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• ethacrynic acid

  ethacrynic acid, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• ethanol

  ethanol, trazodone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.

• ethinylestradiol

  ethinylestradiol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.

• ethotoin

  trazodone increases levels of ethotoin by unspecified interaction mechanism. Minor/Significance Unknown.

• etomidate

  etomidate, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• eucalyptus

  trazodone and eucalyptus both increase sedation. Minor/Significance Unknown.

• fesoterodine

  fesoterodine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• fexofenadine

  trazodone will decrease the level or effect of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• flavoxate

  flavoxate and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• fluphenazine

  trazodone, fluphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• fosphenytoin

  trazodone increases levels of fosphenytoin by unspecified interaction mechanism. Minor/Significance Unknown.

• frovatriptan

  trazodone, frovatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• furosemide

  furosemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• galantamine

  galantamine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• glimepiride

  trazodone increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

• glipizide

  trazodone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

• glyburide

  trazodone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

• glycopyrrolate

  glycopyrrolate and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• glycopyrrolate inhaled

  glycopyrrolate inhaled and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• hydroxyprogesterone caproate (DSC)

  hydroxyprogesterone caproate (DSC), trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• insulin aspart

  trazodone increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin detemir

  trazodone increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin glargine

  trazodone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin glulisine

  trazodone increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin lispro

  trazodone increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin NPH

  trazodone increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin regular human

  trazodone increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

• isoproterenol

  isoproterenol, trazodone. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

• ketamine

  ketamine, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• larotrectinib

  larotrectinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• lithium

  lithium, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.
  
  trazodone, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.

• loratadine

  trazodone will decrease the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• lovastatin

  trazodone increases levels of lovastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• mestranol

  mestranol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• metformin

  trazodone increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

• miglitol

  trazodone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• naratriptan

  trazodone, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• nateglinide

  trazodone increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

• neostigmine

  neostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• onabotulinumtoxinA

  onabotulinumtoxinA and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• panax ginseng

  panax ginseng increases effects of trazodone by pharmacodynamic synergism. Minor/Significance Unknown.

• pentobarbital

  pentobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• perphenazine

  trazodone, perphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• phenobarbital

  phenobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• phenytoin

  trazodone increases levels of phenytoin by unspecified interaction mechanism. Minor/Significance Unknown.

• physostigmine

  physostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• pilocarpine

  pilocarpine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• pioglitazone

  trazodone increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

• pitavastatin

  trazodone increases levels of pitavastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• pleurisy root

  pleurisy root decreases effects of trazodone by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

• pravastatin

  trazodone increases levels of pravastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• primidone

  primidone, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• prochlorperazine

  trazodone, prochlorperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• progesterone micronized

  progesterone micronized, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• promazine

  trazodone, promazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• promethazine

  trazodone, promethazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• propofol

  propofol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• pyridostigmine

  pyridostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• repaglinide

  trazodone increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

• rivastigmine

  rivastigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• rizatriptan

  trazodone, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• rosiglitazone

  trazodone increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

• rosuvastatin

  trazodone increases levels of rosuvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• ruxolitinib

  trazodone will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ruxolitinib topical

  trazodone will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• sage

  trazodone and sage both increase sedation. Minor/Significance Unknown.

• saxagliptin

  trazodone increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• secobarbital

  secobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• serdexmethylphenidate/dexmethylphenidate

  serdexmethylphenidate/dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.

• sevoflurane

  sevoflurane, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• simvastatin

  trazodone increases levels of simvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• sitagliptin

  trazodone increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• succinylcholine

  succinylcholine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• sulfamethoxazole

  sulfamethoxazole decreases levels of trazodone by unspecified interaction mechanism. Minor/Significance Unknown.

• sumatriptan

  trazodone, sumatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• sumatriptan intranasal

  trazodone, sumatriptan intranasal. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• thioridazine

  trazodone, thioridazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• tolazamide

  trazodone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

• tolbutamide

  trazodone increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

• torsemide

  torsemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• trifluoperazine

  trazodone, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• vasopressin

  trazodone increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

• verapamil

  verapamil increases levels of trazodone by decreasing metabolism. Minor/Significance Unknown.

• vildagliptin

  trazodone increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• zafirlukast

  zafirlukast will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• zolmitriptan

  trazodone, zolmitriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• zolpidem

  zolpidem, trazodone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.

• 5-HTP

  Monitor Closely (1)trazodone and 5-HTP both increase serotonin levels. Modify Therapy/Monitor Closely.

• abametapir

  Serious - Use Alternative (1)abametapir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

• acarbose

  Minor (1)trazodone increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.

• aceclofenac

  Monitor Closely (1)trazodone, aceclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• acemetacin

  Monitor Closely (1)trazodone, acemetacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• acetazolamide

  Minor (1)acetazolamide will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• aclidinium

  Monitor Closely (1)aclidinium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• acrivastine

  Monitor Closely (1)acrivastine and trazodone both increase sedation. Use Caution/Monitor.

• albuterol

  Monitor Closely (2)trazodone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  albuterol and trazodone both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, albuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• alfentanil

  Monitor Closely (1)alfentanil and trazodone both increase sedation. Use Caution/Monitor.

• aliskiren

  Monitor Closely (1)trazodone will decrease the level or effect of aliskiren by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• almotriptan

  Monitor Closely (1)almotriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, almotriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• alprazolam

  Monitor Closely (1)alprazolam and trazodone both increase sedation. Use Caution/Monitor.

• alvimopan

  Minor (1)trazodone will decrease the level or effect of alvimopan by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• amikacin

  Monitor Closely (1)trazodone will decrease the level or effect of amikacin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• amiodarone

  Serious - Use Alternative (1)trazodone and amiodarone both increase QTc interval. Avoid or Use Alternate Drug.

• amisulpride

  Monitor Closely (1)amisulpride and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and amisulpride both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.

• amitriptyline

  Monitor Closely (3)trazodone will decrease the level or effect of amitriptyline by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  amitriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amitriptyline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amitriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and amitriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• amobarbital

  Monitor Closely (2)amobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  amobarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)amobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• amoxapine

  Monitor Closely (2)amoxapine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  amoxapine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)amoxapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and amoxapine both increase serotonin levels. Avoid or Use Alternate Drug.

• anagrelide

  Serious - Use Alternative (1)anagrelide and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• anastrozole

  Minor (1)anastrozole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• anticholinergic/sedative combos

  Minor (1)anticholinergic/sedative combos and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• apalutamide

  Serious - Use Alternative (1)apalutamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

• apomorphine

  Monitor Closely (1)trazodone and apomorphine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)apomorphine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• aprepitant

  Monitor Closely (1)aprepitant will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• arformoterol

  Monitor Closely (2)trazodone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
  
  arformoterol and trazodone both increase QTc interval. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, arformoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• aripiprazole

  Monitor Closely (1)aripiprazole and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)aripiprazole and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• armodafinil

  Monitor Closely (2)armodafinil will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)trazodone will decrease the level or effect of armodafinil by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• arsenic trioxide

  Contraindicated (1)trazodone and arsenic trioxide both increase QTc interval. Contraindicated.

• artemether

  Serious - Use Alternative (1)artemether and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• artemether/lumefantrine

  Monitor Closely (1)artemether/lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and artemether/lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.
  
  artemether/lumefantrine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine

  Monitor Closely (1)asenapine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• asenapine transdermal

  Monitor Closely (1)asenapine transdermal and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)asenapine transdermal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• aspirin

  Monitor Closely (1)trazodone, aspirin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• aspirin rectal

  Monitor Closely (1)trazodone, aspirin rectal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• aspirin/citric acid/sodium bicarbonate

  Monitor Closely (1)trazodone, aspirin/citric acid/sodium bicarbonate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• atazanavir

  Monitor Closely (2)atazanavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  atazanavir increases levels of trazodone by unspecified interaction mechanism. Use Caution/Monitor.

• atogepant

  Monitor Closely (1)trazodone will increase the level or effect of atogepant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• atomoxetine

  Serious - Use Alternative (1)atomoxetine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• atorvastatin

  Monitor Closely (1)trazodone will decrease the level or effect of atorvastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)trazodone increases levels of atorvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• atracurium

  Monitor Closely (1)atracurium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• atropine

  Minor (2)atropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of atropine by unknown mechanism. Minor/Significance Unknown.

• atropine IV/IM

  Monitor Closely (1)atropine IV/IM and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.Minor (1)trazodone increases levels of atropine IV/IM by unknown mechanism. Minor/Significance Unknown.

• avapritinib

  Monitor Closely (2)trazodone will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  avapritinib and trazodone both increase sedation. Use Caution/Monitor.

• axitinib

  Monitor Closely (1)trazodone increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• azelastine

  Monitor Closely (1)azelastine and trazodone both increase sedation. Use Caution/Monitor.

• azithromycin

  Monitor Closely (1)trazodone and azithromycin both increase QTc interval. Use Caution/Monitor.

• baclofen

  Monitor Closely (1)baclofen and trazodone both increase sedation. Use Caution/Monitor.

• bazedoxifene/conjugated estrogens

  Monitor Closely (1)trazodone will decrease the level or effect of bazedoxifene/conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)bazedoxifene/conjugated estrogens, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• bedaquiline

  Serious - Use Alternative (1)bedaquiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• belladonna alkaloids

  Minor (1)belladonna alkaloids and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• belladonna and opium

  Monitor Closely (2)belladonna and opium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  belladonna and opium and trazodone both increase sedation. Use Caution/Monitor.

• benperidol

  Monitor Closely (1)benperidol and trazodone both increase sedation. Use Caution/Monitor.

• benzhydrocodone/acetaminophen

  Monitor Closely (2)benzhydrocodone/acetaminophen, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.
  
  benzhydrocodone/acetaminophen and trazodone both increase sedation. Use Caution/Monitor.

• benzphetamine

  Monitor Closely (1)trazodone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, benzphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• benztropine

  Minor (1)benztropine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• bethanechol

  Minor (1)bethanechol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• bosentan

  Serious - Use Alternative (1)bosentan will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• brexpiprazole

  Monitor Closely (2)trazodone will increase the level or effect of brexpiprazole by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. Administer a quarter of brexpiprazole dose if coadministered with a moderate CYP2D6 inhibitor PLUS a strong/moderate CYP3A4 inhibitor.
  
  brexpiprazole and trazodone both increase sedation. Use Caution/Monitor.

• brimonidine

  Monitor Closely (1)brimonidine and trazodone both increase sedation. Use Caution/Monitor.Minor (1)trazodone decreases effects of brimonidine by pharmacodynamic antagonism. Minor/Significance Unknown.

• brivaracetam

  Monitor Closely (1)brivaracetam and trazodone both increase sedation. Use Caution/Monitor.

• brompheniramine

  Monitor Closely (1)brompheniramine and trazodone both increase sedation. Use Caution/Monitor.

• budesonide

  Monitor Closely (2)budesonide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of budesonide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• bumetanide

  Minor (1)bumetanide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• bupivacaine implant

  Monitor Closely (1)trazodone, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

• buprenorphine

  Monitor Closely (1)buprenorphine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine buccal

  Monitor Closely (1)buprenorphine buccal and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine subdermal implant

  Monitor Closely (2)trazodone, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.
  
  buprenorphine subdermal implant and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine subdermal implant and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine transdermal

  Monitor Closely (1)buprenorphine transdermal and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine transdermal and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• buprenorphine, long-acting injection

  Monitor Closely (1)trazodone, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.Serious - Use Alternative (1)buprenorphine, long-acting injection and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• bupropion

  Serious - Use Alternative (1)trazodone increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

• buspirone

  Serious - Use Alternative (1)trazodone and buspirone both increase serotonin levels. Avoid or Use Alternate Drug.

• butabarbital

  Monitor Closely (2)butabarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  butabarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)butabarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• butalbital

  Monitor Closely (2)butalbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  butalbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)butalbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• butorphanol

  Monitor Closely (1)butorphanol and trazodone both increase sedation. Use Caution/Monitor.

• caffeine

  Monitor Closely (1)trazodone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• calcium/magnesium/potassium/sodium oxybates

  Serious - Use Alternative (1)trazodone, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• carbachol

  Minor (1)carbachol increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• carbamazepine

  Monitor Closely (2)trazodone will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor plasma levels when used concomitantly
  
  carbamazepine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)carbamazepine decreases levels of trazodone by increasing metabolism. Minor/Significance Unknown.

• carbinoxamine

  Monitor Closely (1)carbinoxamine and trazodone both increase sedation. Use Caution/Monitor.

• carisoprodol

  Monitor Closely (1)carisoprodol and trazodone both increase sedation. Use Caution/Monitor.

• celandine

  Minor (1)celandine decreases effects of trazodone by pharmacodynamic antagonism. Minor/Significance Unknown. Based on animal studies.

• celecoxib

  Monitor Closely (1)trazodone, celecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ceritinib

  Serious - Use Alternative (2)ceritinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  ceritinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• cevimeline

  Minor (1)cevimeline increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• chloral hydrate

  Monitor Closely (1)chloral hydrate and trazodone both increase sedation. Use Caution/Monitor.

• chloramphenicol

  Serious - Use Alternative (1)chloramphenicol will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• chlordiazepoxide

  Monitor Closely (1)chlordiazepoxide and trazodone both increase sedation. Use Caution/Monitor.

• chloroquine

  Serious - Use Alternative (1)chloroquine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• chlorpheniramine

  Monitor Closely (1)chlorpheniramine and trazodone both increase sedation. Use Caution/Monitor.

• chlorpromazine

  Monitor Closely (1)chlorpromazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)chlorpromazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, chlorpromazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, chlorpromazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• chlorpropamide

  Minor (1)trazodone increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.

• chlorzoxazone

  Monitor Closely (1)chlorzoxazone and trazodone both increase sedation. Use Caution/Monitor.

• choline magnesium trisalicylate

  Monitor Closely (1)trazodone, choline magnesium trisalicylate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• cimetidine

  Monitor Closely (1)cimetidine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cinnarizine

  Monitor Closely (1)cinnarizine and trazodone both increase sedation. Use Caution/Monitor.

• cisatracurium

  Minor (1)cisatracurium and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• citalopram

  Monitor Closely (1)citalopram and trazodone both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)citalopram and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• clarithromycin

  Serious - Use Alternative (2)trazodone and clarithromycin both increase QTc interval. Avoid or Use Alternate Drug.
  
  clarithromycin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• clemastine

  Monitor Closely (1)clemastine and trazodone both increase sedation. Use Caution/Monitor.

• clomipramine

  Monitor Closely (2)clomipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  clomipramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)clomipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and clomipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• clonazepam

  Monitor Closely (1)clonazepam and trazodone both increase sedation. Use Caution/Monitor.

• clonidine

  Serious - Use Alternative (1)trazodone decreases effects of clonidine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

• clorazepate

  Monitor Closely (1)clorazepate and trazodone both increase sedation. Use Caution/Monitor.

• clozapine

  Monitor Closely (1)clozapine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clozapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• cobicistat

  Monitor Closely (1)cobicistat will increase the level or effect of trazodone by Other (see comment). Use Caution/Monitor. Trazodone is a substrate of CYP3A4 and CYP2D6; cobicistat inhibits CYP3A4 and CYP2D6 Serious - Use Alternative (1)cobicistat will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• cocaine topical

  Monitor Closely (1)trazodone and cocaine topical both increase serotonin levels. Modify Therapy/Monitor Closely.

• codeine

  Monitor Closely (1)codeine and trazodone both increase sedation. Use Caution/Monitor.

• conivaptan

  Serious - Use Alternative (1)conivaptan will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• conjugated estrogens

  Monitor Closely (1)trazodone will decrease the level or effect of conjugated estrogens by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)conjugated estrogens, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• conjugated estrogens, vaginal

  Monitor Closely (1)trazodone will decrease the level or effect of conjugated estrogens, vaginal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)conjugated estrogens, vaginal, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• cortisone

  Monitor Closely (2)cortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of cortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• crizotinib

  Monitor Closely (1)crizotinib increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Dose reduction may be needed for coadministered drugs that are predominantly metabolized by CYP3A.Serious - Use Alternative (1)crizotinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• crofelemer

  Monitor Closely (1)crofelemer increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed.

• cyclizine

  Monitor Closely (1)cyclizine and trazodone both increase sedation. Use Caution/Monitor.Minor (1)cyclizine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• cyclobenzaprine

  Monitor Closely (1)cyclobenzaprine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.Minor (1)cyclobenzaprine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• cyclophosphamide

  Minor (1)cyclophosphamide will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• cyclosporine

  Monitor Closely (1)cyclosporine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• cyproheptadine

  Monitor Closely (1)cyproheptadine and trazodone both increase sedation. Use Caution/Monitor.

• dabrafenib

  Monitor Closely (1)dabrafenib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• dantrolene

  Monitor Closely (1)dantrolene and trazodone both increase sedation. Use Caution/Monitor.

• daridorexant

  Monitor Closely (1)trazodone and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• darifenacin

  Monitor Closely (1)darifenacin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)darifenacin and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• darunavir

  Monitor Closely (1)darunavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with SSRIs, TCAs, or trazodone may require dose titration of antidepressant to desired effect (eg, using the lowest feasible initial or maintenance dose). Monitor for antidepressant response.

• dasatinib

  Monitor Closely (2)trazodone and dasatinib both increase QTc interval. Modify Therapy/Monitor Closely.
  
  dasatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• daunorubicin

  Monitor Closely (1)trazodone will decrease the level or effect of daunorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• debrisoquine

  Monitor Closely (1)trazodone decreases effects of debrisoquine by Other (see comment). Use Caution/Monitor. Comment: Inhibition of uptake by adrenergic neurons.

• deferasirox

  Monitor Closely (1)deferasirox will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• deflazacort

  Monitor Closely (1)trazodone will decrease the level or effect of deflazacort by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• degarelix

  Serious - Use Alternative (1)degarelix and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• desflurane

  Monitor Closely (1)desflurane and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)desflurane, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• desipramine

  Monitor Closely (2)desipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  desipramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)desipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and desipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• desvenlafaxine

  Serious - Use Alternative (1)trazodone and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• deutetrabenazine

  Monitor Closely (1)deutetrabenazine and trazodone both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).

• dexamethasone

  Monitor Closely (2)dexamethasone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of dexamethasone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• dexchlorpheniramine

  Monitor Closely (1)dexchlorpheniramine and trazodone both increase sedation. Use Caution/Monitor.

• dexfenfluramine

  Monitor Closely (2)trazodone and dexfenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  trazodone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dexfenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dexmedetomidine

  Monitor Closely (1)dexmedetomidine and trazodone both increase sedation. Use Caution/Monitor.

• dexmethylphenidate

  Monitor Closely (1)trazodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.

• dextroamphetamine

  Monitor Closely (3)trazodone increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.
  
  trazodone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  trazodone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dextroamphetamine transdermal

  Monitor Closely (1)trazodone, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).

• dextromethorphan

  Serious - Use Alternative (1)trazodone and dextromethorphan both increase serotonin levels. Avoid or Use Alternate Drug.

• dextromoramide

  Monitor Closely (1)dextromoramide and trazodone both increase sedation. Use Caution/Monitor.

• DHEA, herbal

  Minor (1)DHEA, herbal will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• diamorphine

  Monitor Closely (1)diamorphine and trazodone both increase sedation. Use Caution/Monitor.

• diazepam

  Monitor Closely (1)diazepam and trazodone both increase sedation. Use Caution/Monitor.

• diazepam intranasal

  Monitor Closely (1)diazepam intranasal, trazodone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

• diclofenac

  Monitor Closely (1)trazodone, diclofenac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• dicyclomine

  Minor (1)dicyclomine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• diethylpropion

  Monitor Closely (1)trazodone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, diethylpropion. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• difelikefalin

  Monitor Closely (1)difelikefalin and trazodone both increase sedation. Use Caution/Monitor.

• difenoxin hcl

  Monitor Closely (1)difenoxin hcl and trazodone both increase sedation. Use Caution/Monitor.

• diflunisal

  Monitor Closely (1)trazodone, diflunisal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• digoxin

  Monitor Closely (2)trazodone will decrease the level or effect of digoxin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone increases levels of digoxin by unspecified interaction mechanism. Use Caution/Monitor.

• dihydroergotamine

  Monitor Closely (1)trazodone and dihydroergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• dihydroergotamine intranasal

  Monitor Closely (1)trazodone and dihydroergotamine intranasal both increase serotonin levels. Modify Therapy/Monitor Closely.

• diltiazem

  Monitor Closely (1)diltiazem will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• dimenhydrinate

  Monitor Closely (1)dimenhydrinate and trazodone both increase sedation. Use Caution/Monitor.

• diphenhydramine

  Monitor Closely (1)diphenhydramine and trazodone both increase sedation. Use Caution/Monitor.Minor (1)diphenhydramine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• diphenoxylate hcl

  Monitor Closely (1)diphenoxylate hcl and trazodone both increase sedation. Use Caution/Monitor.

• dipipanone

  Monitor Closely (1)dipipanone and trazodone both increase sedation. Use Caution/Monitor.

• disopyramide

  Contraindicated (1)trazodone and disopyramide both increase QTc interval. Contraindicated.

• dobutamine

  Monitor Closely (1)trazodone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dobutamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• docetaxel

  Monitor Closely (1)trazodone will decrease the level or effect of docetaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• dofetilide

  Serious - Use Alternative (1)trazodone and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.

• dolasetron

  Monitor Closely (1)trazodone and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.

• donepezil

  Serious - Use Alternative (1)donepezil and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)donepezil increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• dopamine

  Monitor Closely (1)trazodone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dopamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dopexamine

  Monitor Closely (1)trazodone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dopexamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• dosulepin

  Serious - Use Alternative (1)trazodone and dosulepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxepin

  Monitor Closely (2)doxepin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  doxepin and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)doxepin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxorubicin

  Monitor Closely (1)trazodone will decrease the level or effect of doxorubicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• doxorubicin liposomal

  Monitor Closely (1)trazodone will decrease the level or effect of doxorubicin liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• doxylamine

  Monitor Closely (1)doxylamine and trazodone both increase sedation. Use Caution/Monitor.

• dronedarone

  Monitor Closely (1)dronedarone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and dronedarone both increase QTc interval. Avoid or Use Alternate Drug.

• droperidol

  Monitor Closely (1)droperidol and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and droperidol both increase QTc interval. Avoid or Use Alternate Drug.

• duloxetine

  Serious - Use Alternative (1)duloxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• duvelisib

  Monitor Closely (1)duvelisib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate.

• echothiophate iodide

  Minor (1)echothiophate iodide increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• efavirenz

  Monitor Closely (1)efavirenz will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)efavirenz and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• elagolix

  Monitor Closely (1)elagolix decreases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor CYP3A substrates if coadministered. Consider increasing CYP3A substrate dose if needed.

• eletriptan

  Monitor Closely (1)eletriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, eletriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• eliglustat

  Contraindicated (1)trazodone increases levels of eliglustat by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated. If coadministered with strong or moderate CYP2D6 inhibitors, reduce eliglustat dose from 84 mg BID to 84 mg once daily in extensive and intermediate metabolizers; eliglustat is contraindiated if strong or moderate CYP2D6 inhibitors are given concomitantly with strong or moderate CYP3A inhibitors.Serious - Use Alternative (1)eliglustat and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• elvitegravir/cobicistat/emtricitabine/tenofovir DF

  Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events.

• encorafenib

  Monitor Closely (1)encorafenib, trazodone. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.Serious - Use Alternative (1)encorafenib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• entrectinib

  Serious - Use Alternative (1)trazodone and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.

• enzalutamide

  Monitor Closely (1)enzalutamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ephedrine

  Monitor Closely (2)trazodone increases effects of ephedrine by unknown mechanism. Use Caution/Monitor.
  
  trazodone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, ephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• epinephrine

  Monitor Closely (2)trazodone increases effects of epinephrine by unknown mechanism. Use Caution/Monitor.
  
  trazodone increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)epinephrine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, epinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• epinephrine racemic

  Monitor Closely (2)trazodone increases effects of epinephrine racemic by unknown mechanism. Use Caution/Monitor.
  
  trazodone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)epinephrine racemic and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, epinephrine racemic. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• ergotamine

  Monitor Closely (1)trazodone and ergotamine both increase serotonin levels. Modify Therapy/Monitor Closely.

• eribulin

  Serious - Use Alternative (1)eribulin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin base

  Monitor Closely (1)erythromycin base will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and erythromycin base both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin ethylsuccinate

  Monitor Closely (1)erythromycin ethylsuccinate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and erythromycin ethylsuccinate both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin lactobionate

  Monitor Closely (1)erythromycin lactobionate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and erythromycin lactobionate both increase QTc interval. Avoid or Use Alternate Drug.

• erythromycin stearate

  Monitor Closely (1)erythromycin stearate will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and erythromycin stearate both increase QTc interval. Avoid or Use Alternate Drug.

• escitalopram

  Serious - Use Alternative (1)escitalopram and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• eslicarbazepine acetate

  Monitor Closely (1)eslicarbazepine acetate will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• estazolam

  Monitor Closely (1)estazolam and trazodone both increase sedation. Use Caution/Monitor.

• estradiol

  Monitor Closely (1)trazodone will decrease the level or effect of estradiol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)estradiol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estrogens conjugated synthetic

  Monitor Closely (1)trazodone will decrease the level or effect of estrogens conjugated synthetic by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)estrogens conjugated synthetic, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estrogens esterified

  Minor (1)estrogens esterified, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• estropipate

  Monitor Closely (1)trazodone will decrease the level or effect of estropipate by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)estropipate, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• ethacrynic acid

  Minor (1)ethacrynic acid, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• ethanol

  Monitor Closely (1)trazodone and ethanol both increase sedation. Use Caution/Monitor.Minor (1)ethanol, trazodone. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive impairment of motor skills.

• ethinylestradiol

  Minor (1)ethinylestradiol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Oxidative metabolism of TCAs may be decreased by ethinyl estradiol. Increased antidepressant serum concentrations may occur. Potential for increased TCA adverse effects.

• ethotoin

  Minor (1)trazodone increases levels of ethotoin by unspecified interaction mechanism. Minor/Significance Unknown.

• etodolac

  Monitor Closely (1)trazodone, etodolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• etomidate

  Monitor Closely (1)etomidate and trazodone both increase sedation. Use Caution/Monitor.Minor (1)etomidate, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• etoposide

  Monitor Closely (1)trazodone will decrease the level or effect of etoposide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• etravirine

  Serious - Use Alternative (1)etravirine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• eucalyptus

  Minor (1)trazodone and eucalyptus both increase sedation. Minor/Significance Unknown.

• everolimus

  Monitor Closely (1)trazodone will decrease the level or effect of everolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• fedratinib

  Monitor Closely (1)fedratinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

• fenbufen

  Monitor Closely (1)trazodone, fenbufen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fenfluramine

  Monitor Closely (3)fenfluramine, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration with drugs that increase serotoninergic effects may increase the risk of serotonin syndrome.
  
  trazodone and fenfluramine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  trazodone increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, fenfluramine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• fenoprofen

  Monitor Closely (1)trazodone, fenoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fesoterodine

  Minor (1)fesoterodine and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• fexinidazole

  Serious - Use Alternative (2)fexinidazole and trazodone both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
  
  fexinidazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Fexinidazole inhibits CYP3A4. Coadministration may increase risk for adverse effects of CYP3A4 substrates.

• fexofenadine

  Minor (1)trazodone will decrease the level or effect of fexofenadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• finerenone

  Monitor Closely (1)trazodone will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

• fingolimod

  Serious - Use Alternative (1)fingolimod and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• flavoxate

  Minor (1)flavoxate and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• flecainide

  Monitor Closely (1)trazodone and flecainide both increase QTc interval. Modify Therapy/Monitor Closely.

• flibanserin

  Monitor Closely (1)trazodone will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

• fluconazole

  Monitor Closely (1)fluconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and fluconazole both increase QTc interval. Avoid or Use Alternate Drug.

• fludrocortisone

  Monitor Closely (2)fludrocortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of fludrocortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• fluoxetine

  Monitor Closely (1)trazodone and fluoxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluoxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• fluphenazine

  Monitor Closely (1)fluphenazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)fluphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, fluphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, fluphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• flurazepam

  Monitor Closely (1)flurazepam and trazodone both increase sedation. Use Caution/Monitor.

• flurbiprofen

  Monitor Closely (1)trazodone, flurbiprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• fluvoxamine

  Monitor Closely (1)fluvoxamine and trazodone both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fluvoxamine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• formoterol

  Monitor Closely (1)trazodone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and formoterol both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone, formoterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• fosamprenavir

  Monitor Closely (1)fosamprenavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)fosamprenavir increases levels of trazodone by decreasing metabolism. Avoid or Use Alternate Drug.

• fosaprepitant

  Monitor Closely (1)fosaprepitant will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• foscarnet

  Monitor Closely (1)trazodone and foscarnet both increase QTc interval. Modify Therapy/Monitor Closely.

• fosphenytoin

  Monitor Closely (1)fosphenytoin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)trazodone increases levels of fosphenytoin by unspecified interaction mechanism. Minor/Significance Unknown.

• fostemsavir

  Monitor Closely (1)trazodone and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.

• frovatriptan

  Monitor Closely (1)frovatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, frovatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• furosemide

  Minor (1)furosemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• gabapentin

  Monitor Closely (1)gabapentin, trazodone. 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.

• gabapentin enacarbil

  Monitor Closely (1)gabapentin enacarbil, trazodone. 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.

• galantamine

  Minor (1)galantamine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• ganaxolone

  Monitor Closely (1)trazodone and ganaxolone both increase sedation. Use Caution/Monitor.

• gemifloxacin

  Serious - Use Alternative (1)gemifloxacin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• gemtuzumab

  Monitor Closely (1)trazodone and gemtuzumab both increase QTc interval. Use Caution/Monitor.

• gentamicin

  Monitor Closely (1)trazodone will decrease the level or effect of gentamicin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• gilteritinib

  Serious - Use Alternative (1)gilteritinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• glasdegib

  Serious - Use Alternative (1)trazodone and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.

• glimepiride

  Minor (1)trazodone increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.

• glipizide

  Minor (1)trazodone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

• glyburide

  Minor (1)trazodone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

• glycopyrrolate

  Minor (1)glycopyrrolate and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• glycopyrrolate inhaled

  Minor (2)glycopyrrolate inhaled and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.
  
  trazodone increases levels of glycopyrrolate inhaled by unknown mechanism. Minor/Significance Unknown.

• goserelin

  Monitor Closely (1)goserelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• granisetron

  Serious - Use Alternative (1)granisetron and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• grapefruit

  Monitor Closely (1)grapefruit will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• green tea

  Monitor Closely (1)green tea, trazodone. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.

• griseofulvin

  Monitor Closely (1)griseofulvin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• guanfacine

  Serious - Use Alternative (1)trazodone decreases effects of guanfacine by Other (see comment). Avoid or Use Alternate Drug. Comment: Inhibition of uptake by adrenergic neurons.

• haloperidol

  Monitor Closely (1)haloperidol and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and haloperidol both increase QTc interval. Avoid or Use Alternate Drug.

• henbane

  Monitor Closely (1)henbane and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• histrelin

  Monitor Closely (1)histrelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• homatropine

  Monitor Closely (1)homatropine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• huperzine A

  Monitor Closely (1)huperzine A increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• hydrocodone

  Monitor Closely (1)hydrocodone, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

• hydrocortisone

  Monitor Closely (2)hydrocortisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of hydrocortisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• hydromorphone

  Monitor Closely (1)hydromorphone and trazodone both increase sedation. Use Caution/Monitor.

• hydroxyprogesterone caproate (DSC)

  Minor (1)hydroxyprogesterone caproate (DSC), trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• hydroxyzine

  Monitor Closely (1)hydroxyzine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)hydroxyzine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• hyoscyamine

  Monitor Closely (1)hyoscyamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• hyoscyamine spray

  Monitor Closely (1)hyoscyamine spray and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• ibuprofen

  Monitor Closely (1)trazodone, ibuprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ibuprofen IV

  Monitor Closely (1)trazodone, ibuprofen IV. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ibutilide

  Contraindicated (1)trazodone and ibutilide both increase QTc interval. Contraindicated.

• idelalisib

  Serious - Use Alternative (1)idelalisib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates

• iloperidone

  Monitor Closely (3)trazodone and iloperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  iloperidone and trazodone both increase sedation. Use Caution/Monitor.
  
  iloperidone increases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4.

• imatinib

  Monitor Closely (1)trazodone will decrease the level or effect of imatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• imipramine

  Monitor Closely (2)imipramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  imipramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)imipramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and imipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• indapamide

  Contraindicated (1)trazodone and indapamide both increase QTc interval. Contraindicated.

• indinavir

  Monitor Closely (2)trazodone will decrease the level or effect of indinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  indinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• indomethacin

  Monitor Closely (1)trazodone, indomethacin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• inotuzumab

  Serious - Use Alternative (1)inotuzumab and trazodone both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.

• insulin aspart

  Minor (1)trazodone increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin detemir

  Minor (1)trazodone increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin glargine

  Minor (1)trazodone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin glulisine

  Minor (1)trazodone increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin lispro

  Minor (1)trazodone increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin NPH

  Minor (1)trazodone increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.

• insulin regular human

  Minor (1)trazodone increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.

• ipratropium

  Monitor Closely (1)ipratropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• irinotecan liposomal

  Monitor Closely (1)trazodone will decrease the level or effect of irinotecan liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• isavuconazonium sulfate

  Monitor Closely (1)trazodone will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• isocarboxazid

  Contraindicated (1)isocarboxazid and trazodone both increase serotonin levels. Contraindicated.

• isoflurane

  Serious - Use Alternative (1)isoflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• isoniazid

  Monitor Closely (2)isoniazid will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and isoniazid both increase serotonin levels. Modify Therapy/Monitor Closely.

• isoproterenol

  Monitor Closely (1)trazodone increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, isoproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)isoproterenol, trazodone. Mechanism: unknown. Minor/Significance Unknown. Risk of cardiac arrhythmias.

• istradefylline

  Monitor Closely (1)istradefylline will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

• itraconazole

  Monitor Closely (1)trazodone will decrease the level or effect of itraconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and itraconazole both increase QTc interval. Avoid or Use Alternate Drug.
  
  itraconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• ivermectin

  Monitor Closely (1)trazodone will decrease the level or effect of ivermectin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• ivosidenib

  Serious - Use Alternative (1)ivosidenib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

• ketamine

  Monitor Closely (1)ketamine and trazodone both increase sedation. Use Caution/Monitor.Minor (1)ketamine, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• ketoconazole

  Serious - Use Alternative (2)trazodone and ketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
  
  ketoconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• ketoprofen

  Monitor Closely (1)trazodone, ketoprofen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketorolac

  Monitor Closely (1)trazodone, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketorolac intranasal

  Monitor Closely (1)trazodone, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• ketotifen, ophthalmic

  Monitor Closely (1)trazodone and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

• L-tryptophan

  Monitor Closely (1)trazodone and L-tryptophan both increase serotonin levels. Modify Therapy/Monitor Closely.

• lapatinib

  Monitor Closely (3)trazodone will decrease the level or effect of lapatinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and lapatinib both increase QTc interval. Modify Therapy/Monitor Closely.
  
  lapatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• larotrectinib

  Minor (1)larotrectinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• lasmiditan

  Monitor Closely (1)lasmiditan, trazodone. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

• lefamulin

  Contraindicated (1)lefamulin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.

• lemborexant

  Monitor Closely (1)trazodone will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

• lenacapavir

  Monitor Closely (1)lenacapavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.

• lenvatinib

  Monitor Closely (1)trazodone and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.

• leuprolide

  Monitor Closely (1)leuprolide increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• levalbuterol

  Monitor Closely (1)trazodone increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, levalbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• levofloxacin

  Monitor Closely (1)trazodone and levofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• levoketoconazole

  Serious - Use Alternative (2)trazodone and levoketoconazole both increase QTc interval. Avoid or Use Alternate Drug.
  
  levoketoconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• levomilnacipran

  Serious - Use Alternative (1)levomilnacipran and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• levorphanol

  Monitor Closely (1)levorphanol and trazodone both increase sedation. Use Caution/Monitor.

• linagliptin

  Monitor Closely (1)trazodone will decrease the level or effect of linagliptin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Use of alternative treatments is strongly recommended when linagliptin is to be administered with a P-gp inducer.

• linezolid

  Serious - Use Alternative (1)linezolid and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

• lisdexamfetamine

  Monitor Closely (1)trazodone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, lisdexamfetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• lithium

  Monitor Closely (1)trazodone and lithium both increase serotonin levels. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)lithium and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)lithium, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Risk of neurotoxicity in geriatric pts. Multiple mechanisms involved.
  
  trazodone, lithium. Mechanism: unknown. Minor/Significance Unknown. Risk of neurotoxicity.

• lofepramine

  Monitor Closely (2)lofepramine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  lofepramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)lofepramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.

• lofexidine

  Monitor Closely (2)trazodone decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor.
  
  trazodone and lofexidine both increase sedation. Use Caution/Monitor.

• lomitapide

  Monitor Closely (1)trazodone increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

• lonafarnib

  Serious - Use Alternative (2)trazodone will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.
  
  lonafarnib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.

• loperamide

  Monitor Closely (1)trazodone will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• lopinavir

  Serious - Use Alternative (1)lopinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• loprazolam

  Monitor Closely (1)loprazolam and trazodone both increase sedation. Use Caution/Monitor.

• loratadine

  Minor (1)trazodone will decrease the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.

• lorazepam

  Monitor Closely (1)lorazepam and trazodone both increase sedation. Use Caution/Monitor.

• lorcaserin

  Serious - Use Alternative (1)trazodone and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.

• lorlatinib

  Monitor Closely (1)lorlatinib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• lormetazepam

  Monitor Closely (1)lormetazepam and trazodone both increase sedation. Use Caution/Monitor.

• lornoxicam

  Monitor Closely (1)trazodone, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• lovastatin

  Monitor Closely (1)trazodone will decrease the level or effect of lovastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)trazodone increases levels of lovastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• loxapine

  Monitor Closely (1)loxapine and trazodone both increase sedation. Use Caution/Monitor.

• loxapine inhaled

  Monitor Closely (1)loxapine inhaled and trazodone both increase sedation. Use Caution/Monitor.

• lsd

  Monitor Closely (1)trazodone and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.

• lumefantrine

  Monitor Closely (1)lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.

• lurasidone

  Monitor Closely (1)lurasidone, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

• maprotiline

  Monitor Closely (2)maprotiline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  maprotiline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)maprotiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.

• maraviroc

  Monitor Closely (1)trazodone will decrease the level or effect of maraviroc by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• marijuana

  Monitor Closely (2)marijuana will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and marijuana both increase sedation. Use Caution/Monitor.

• meclizine

  Monitor Closely (1)meclizine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• meclofenamate

  Monitor Closely (1)trazodone, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• mefenamic acid

  Monitor Closely (1)trazodone, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• melatonin

  Monitor Closely (1)trazodone and melatonin both increase sedation. Use Caution/Monitor.

• meloxicam

  Monitor Closely (1)trazodone, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• meperidine

  Monitor Closely (1)meperidine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.

• meprobamate

  Monitor Closely (1)trazodone and meprobamate both increase sedation. Use Caution/Monitor.

• mestranol

  Monitor Closely (1)trazodone will decrease the level or effect of mestranol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)mestranol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• metaproterenol

  Monitor Closely (1)trazodone increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• metaxalone

  Monitor Closely (1)metaxalone and trazodone both increase sedation. Use Caution/Monitor.

• metformin

  Minor (1)trazodone increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.

• methadone

  Monitor Closely (2)trazodone and methadone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  methadone and trazodone both increase sedation. Use Caution/Monitor.

• methamphetamine

  Monitor Closely (2)trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Significant - Monitor Closely..
  
  methamphetamine increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Comment: Amphetamines may increase the toxicity of serotonin modulators, increasing the risk of serotonin syndrome. .

• methocarbamol

  Monitor Closely (1)methocarbamol and trazodone both increase sedation. Use Caution/Monitor.

• methscopolamine

  Monitor Closely (1)methscopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• methylene blue

  Serious - Use Alternative (1)methylene blue and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

• methylenedioxymethamphetamine

  Monitor Closely (1)trazodone increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. 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

  Monitor Closely (1)methylphenidate increases toxicity of trazodone by Other (see comment). Modify Therapy/Monitor Closely. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity.

• methylprednisolone

  Monitor Closely (2)methylprednisolone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of methylprednisolone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• metronidazole

  Monitor Closely (1)metronidazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• miconazole vaginal

  Monitor Closely (1)miconazole vaginal will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• midazolam

  Monitor Closely (1)midazolam and trazodone both increase sedation. Use Caution/Monitor.

• midazolam intranasal

  Monitor Closely (1)trazodone will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

• midodrine

  Monitor Closely (1)trazodone increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• mifepristone

  Serious - Use Alternative (1)mifepristone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• miglitol

  Minor (1)trazodone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.

• milnacipran

  Serious - Use Alternative (1)milnacipran and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• mipomersen

  Monitor Closely (1)mipomersen, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

• mirtazapine

  Monitor Closely (2)trazodone and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  trazodone and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• mitotane

  Monitor Closely (1)mitotane decreases levels of trazodone 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.

• modafinil

  Monitor Closely (1)trazodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

• morphine

  Monitor Closely (2)trazodone and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  morphine and trazodone both increase sedation. Use Caution/Monitor.

• motherwort

  Monitor Closely (1)trazodone and motherwort both increase sedation. Use Caution/Monitor.

• moxifloxacin

  Serious - Use Alternative (1)trazodone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.

• moxonidine

  Monitor Closely (1)trazodone and moxonidine both increase sedation. Use Caution/Monitor.

• nabilone

  Monitor Closely (1)trazodone and nabilone both increase sedation. Use Caution/Monitor.

• nabumetone

  Monitor Closely (1)trazodone, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• nafcillin

  Monitor Closely (1)nafcillin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nalbuphine

  Monitor Closely (1)nalbuphine and trazodone both increase sedation. Use Caution/Monitor.

• naproxen

  Monitor Closely (1)trazodone, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• naratriptan

  Monitor Closely (1)naratriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• nateglinide

  Minor (1)trazodone increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.

• nefazodone

  Serious - Use Alternative (2)nefazodone and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.
  
  nefazodone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• nefopam

  Monitor Closely (1)nefopam, trazodone. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.

• nelfinavir

  Monitor Closely (2)nelfinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• neomycin PO

  Monitor Closely (1)trazodone will decrease the level or effect of neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• neostigmine

  Minor (1)neostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• nevirapine

  Serious - Use Alternative (1)nevirapine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• nifedipine

  Monitor Closely (1)nifedipine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• nilotinib

  Monitor Closely (2)nilotinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of nilotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.

• nirmatrelvir

  Monitor Closely (1)nirmatrelvir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.

• nirmatrelvir/ritonavir

  Monitor Closely (1)nirmatrelvir/ritonavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.

• norepinephrine

  Monitor Closely (2)trazodone increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor.
  
  trazodone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• nortriptyline

  Monitor Closely (2)nortriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  nortriptyline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)nortriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• octreotide

  Serious - Use Alternative (1)trazodone and octreotide both increase QTc interval. Avoid or Use Alternate Drug.

• octreotide (Antidote)

  Serious - Use Alternative (1)trazodone and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.

• ofloxacin

  Monitor Closely (1)trazodone and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.

• olanzapine

  Monitor Closely (1)olanzapine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• oliceridine

  Monitor Closely (2)trazodone will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is discontinued, consider increase oliceridine dosage until stable drug effects are achieved. Monitor for signs of opioid withdrawal.
  
  trazodone, oliceridine. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely.

• olopatadine intranasal

  Serious - Use Alternative (1)trazodone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

• onabotulinumtoxinA

  Minor (1)onabotulinumtoxinA and trazodone both decrease cholinergic effects/transmission. Minor/Significance Unknown.

• opium tincture

  Monitor Closely (1)opium tincture and trazodone both increase sedation. Use Caution/Monitor.

• orphenadrine

  Monitor Closely (2)trazodone and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  orphenadrine and trazodone both increase sedation. Use Caution/Monitor.

• osilodrostat

  Monitor Closely (1)osilodrostat and trazodone both increase QTc interval. Use Caution/Monitor.

• oxaliplatin

  Monitor Closely (1)oxaliplatin will increase the level or effect of trazodone by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.Serious - Use Alternative (1)oxaliplatin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• oxaprozin

  Monitor Closely (1)trazodone, oxaprozin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• oxazepam

  Monitor Closely (1)oxazepam and trazodone both increase sedation. Use Caution/Monitor.

• oxcarbazepine

  Monitor Closely (1)oxcarbazepine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• oxybutynin

  Monitor Closely (1)oxybutynin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin topical

  Monitor Closely (1)oxybutynin topical and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxybutynin transdermal

  Monitor Closely (1)oxybutynin transdermal and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• oxycodone

  Monitor Closely (1)oxycodone and trazodone both increase sedation. Use Caution/Monitor.

• oxymorphone

  Monitor Closely (1)oxymorphone and trazodone both increase sedation. Use Caution/Monitor.

• ozanimod

  Serious - Use Alternative (1)ozanimod increases levels of trazodone by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

• paclitaxel

  Monitor Closely (1)trazodone will decrease the level or effect of paclitaxel by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paclitaxel protein bound

  Monitor Closely (1)trazodone will decrease the level or effect of paclitaxel protein bound by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paliperidone

  Monitor Closely (3)trazodone will decrease the level or effect of paliperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and paliperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  paliperidone and trazodone both increase sedation. Use Caution/Monitor.

• panax ginseng

  Minor (1)panax ginseng increases effects of trazodone by pharmacodynamic synergism. Minor/Significance Unknown.

• pancuronium

  Monitor Closely (1)pancuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• panobinostat

  Serious - Use Alternative (1)trazodone and panobinostat both increase QTc interval. Avoid or Use Alternate Drug. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended.

• papaveretum

  Monitor Closely (1)papaveretum and trazodone both increase sedation. Use Caution/Monitor.

• papaverine

  Monitor Closely (1)trazodone and papaverine both increase sedation. Use Caution/Monitor.

• parecoxib

  Monitor Closely (1)trazodone, parecoxib. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• paromomycin

  Monitor Closely (1)trazodone will decrease the level or effect of paromomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• paroxetine

  Monitor Closely (1)trazodone and paroxetine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)paroxetine and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• pazopanib

  Monitor Closely (1)trazodone and pazopanib both increase QTc interval. Use Caution/Monitor.

• peginterferon alfa 2b

  Monitor Closely (1)peginterferon alfa 2b, trazodone. 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.

• pentamidine

  Contraindicated (1)trazodone and pentamidine both increase QTc interval. Contraindicated.

• pentazocine

  Monitor Closely (2)trazodone and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  pentazocine and trazodone both increase sedation. Use Caution/Monitor.

• pentobarbital

  Monitor Closely (2)pentobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  pentobarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)pentobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• perphenazine

  Monitor Closely (1)perphenazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)perphenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, perphenazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, perphenazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• phendimetrazine

  Monitor Closely (1)trazodone increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, phendimetrazine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• phenelzine

  Contraindicated (1)phenelzine and trazodone both increase serotonin levels. Contraindicated.

• phenobarbital

  Monitor Closely (2)phenobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  phenobarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)phenobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• phentermine

  Monitor Closely (1)trazodone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (2)trazodone, phentermine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.
  
  trazodone, phentermine. Either increases toxicity of the other by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of serotonin syndrome.

• phenylephrine

  Monitor Closely (1)trazodone increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, phenylephrine. Other (see comment). Avoid or Use Alternate Drug. 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 ophthalmic

  Monitor Closely (1)trazodone, 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 PO

  Monitor Closely (1)trazodone increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .Serious - Use Alternative (1)trazodone, phenylephrine PO. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• phenytoin

  Minor (1)trazodone increases levels of phenytoin by unspecified interaction mechanism. Minor/Significance Unknown.

• pholcodine

  Monitor Closely (1)trazodone and pholcodine both increase sedation. Use Caution/Monitor.

• physostigmine

  Minor (1)physostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• pilocarpine

  Minor (1)pilocarpine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• pimozide

  Contraindicated (1)trazodone and pimozide both increase QTc interval. Contraindicated.Monitor Closely (1)pimozide and trazodone both increase sedation. Use Caution/Monitor.

• pioglitazone

  Minor (1)trazodone increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

• pirbuterol

  Monitor Closely (1)trazodone increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, pirbuterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• piroxicam

  Monitor Closely (1)trazodone, piroxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• pitavastatin

  Minor (1)trazodone increases levels of pitavastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• pitolisant

  Serious - Use Alternative (1)trazodone and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.

• pleurisy root

  Minor (1)pleurisy root decreases effects of trazodone by unspecified interaction mechanism. Minor/Significance Unknown. Theoretical interaction.

• pomalidomide

  Serious - Use Alternative (1)trazodone decreases levels of pomalidomide by P-glycoprotein (MDR1) efflux transporter. Avoid or Use Alternate Drug.

• posaconazole

  Monitor Closely (2)trazodone will decrease the level or effect of posaconazole by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and posaconazole both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)posaconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• pralidoxime

  Monitor Closely (1)pralidoxime and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• pravastatin

  Minor (1)trazodone increases levels of pravastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• prednisolone

  Monitor Closely (1)trazodone will decrease the level or effect of prednisolone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• prednisone

  Monitor Closely (2)prednisone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will decrease the level or effect of prednisone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• pregabalin

  Monitor Closely (1)pregabalin, trazodone. 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.

• primaquine

  Serious - Use Alternative (1)primaquine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• primidone

  Monitor Closely (2)primidone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  primidone and trazodone both increase sedation. Use Caution/Monitor.Minor (1)primidone, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• procainamide

  Contraindicated (1)trazodone and procainamide both increase QTc interval. Contraindicated.

• procarbazine

  Contraindicated (1)procarbazine and trazodone both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.

• prochlorperazine

  Monitor Closely (2)prochlorperazine and trazodone both increase QTc interval. Use Caution/Monitor.
  
  prochlorperazine and trazodone both increase sedation. Use Caution/Monitor.Minor (2)trazodone, prochlorperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, prochlorperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• progesterone micronized

  Minor (1)progesterone micronized, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.

• promazine

  Serious - Use Alternative (1)promazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, promazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, promazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• promethazine

  Monitor Closely (2)promethazine and trazodone both increase QTc interval. Use Caution/Monitor.
  
  promethazine and trazodone both increase sedation. Use Caution/Monitor.Minor (2)trazodone, promethazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, promethazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• propantheline

  Monitor Closely (1)propantheline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• propofol

  Monitor Closely (1)propofol and trazodone both increase sedation. Use Caution/Monitor.Minor (1)propofol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• propylhexedrine

  Monitor Closely (1)trazodone increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, propylhexedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• protriptyline

  Monitor Closely (2)protriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  protriptyline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)protriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and protriptyline both increase serotonin levels. Avoid or Use Alternate Drug.

• pseudoephedrine

  Serious - Use Alternative (1)trazodone, pseudoephedrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• pyridostigmine

  Minor (1)pyridostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• quazepam

  Monitor Closely (1)quazepam and trazodone both increase sedation. Use Caution/Monitor.

• quetiapine

  Monitor Closely (1)quetiapine and trazodone both increase sedation. Use Caution/Monitor.

• quinidine

  Contraindicated (1)quinidine and trazodone both increase QTc interval. Contraindicated.

• quinupristin/dalfopristin

  Monitor Closely (1)quinupristin/dalfopristin will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ramelteon

  Monitor Closely (1)trazodone and ramelteon both increase sedation. Use Caution/Monitor.

• ranolazine

  Monitor Closely (1)trazodone and ranolazine both increase QTc interval. Modify Therapy/Monitor Closely.

• rapacuronium

  Monitor Closely (1)rapacuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• rasagiline

  Serious - Use Alternative (1)rasagiline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Trazodone should not be coadministered with a MAOI or within 14 days of discontinuing a MAOI. Similarly, a MAOI should not be given within 14 days of stopping trazodone.

• remimazolam

  Monitor Closely (1)remimazolam, trazodone. 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.

• repaglinide

  Minor (1)trazodone increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.

• ribociclib

  Serious - Use Alternative (1)ribociclib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifabutin

  Monitor Closely (1)rifabutin decreases levels of trazodone by increasing metabolism. Use Caution/Monitor.Serious - Use Alternative (1)rifabutin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifampin

  Serious - Use Alternative (1)rifampin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• rifapentine

  Serious - Use Alternative (1)rifapentine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• risperidone

  Monitor Closely (3)trazodone will decrease the level or effect of risperidone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  trazodone and risperidone both increase QTc interval. Modify Therapy/Monitor Closely.
  
  risperidone and trazodone both increase sedation. Use Caution/Monitor.

• ritonavir

  Monitor Closely (2)trazodone will decrease the level or effect of ritonavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.
  
  ritonavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely.

• rivastigmine

  Minor (1)rivastigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• rizatriptan

  Monitor Closely (1)rizatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, rizatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• rocuronium

  Monitor Closely (1)rocuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• romidepsin

  Monitor Closely (1)trazodone will decrease the level or effect of romidepsin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• rosiglitazone

  Minor (1)trazodone increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.

• rosuvastatin

  Minor (1)trazodone increases levels of rosuvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• rucaparib

  Monitor Closely (1)rucaparib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

• rufinamide

  Monitor Closely (1)rufinamide will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• ruxolitinib

  Minor (1)trazodone will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ruxolitinib topical

  Minor (1)trazodone will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• safinamide

  Contraindicated (1)trazodone, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

• sage

  Minor (1)trazodone and sage both increase sedation. Minor/Significance Unknown.

• salicylates (non-asa)

  Monitor Closely (1)trazodone, salicylates (non-asa). Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• salmeterol

  Monitor Closely (1)trazodone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, salmeterol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• salsalate

  Monitor Closely (1)trazodone, salsalate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• SAMe

  Monitor Closely (1)trazodone and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.

• saquinavir

  Contraindicated (2)trazodone will decrease the level or effect of saquinavir by P-glycoprotein (MDR1) efflux transporter. Contraindicated.
  
  saquinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

• saxagliptin

  Minor (1)trazodone increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• scopolamine

  Monitor Closely (1)scopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• scullcap

  Monitor Closely (1)trazodone and scullcap both increase sedation. Use Caution/Monitor.

• secobarbital

  Monitor Closely (2)secobarbital will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  secobarbital and trazodone both increase sedation. Use Caution/Monitor.Minor (1)secobarbital, trazodone. Other (see comment). Minor/Significance Unknown. Comment: Barbiturates may increase adverse effects, including respiratory depression, produced by toxic doses of TCAs. With therapeutic doses of TCAs, barbiturates increase metabolism and decrease blood concentrations of TCAs.

• selegiline

  Serious - Use Alternative (1)selegiline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• selegiline transdermal

  Serious - Use Alternative (1)selegiline transdermal and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.

• serdexmethylphenidate/dexmethylphenidate

  Serious - Use Alternative (1)trazodone, serdexmethylphenidate/dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.Minor (1)serdexmethylphenidate/dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.

• sertraline

  Serious - Use Alternative (2)sertraline and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.
  
  sertraline and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• sevoflurane

  Monitor Closely (1)sevoflurane and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)sevoflurane and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (1)sevoflurane, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Risk of arrhythmias or hypotension.

• shepherd's purse

  Monitor Closely (1)trazodone and shepherd's purse both increase sedation. Use Caution/Monitor.

• silodosin

  Monitor Closely (1)trazodone will decrease the level or effect of silodosin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• simvastatin

  Minor (1)trazodone increases levels of simvastatin by unspecified interaction mechanism. Minor/Significance Unknown.

• siponimod

  Serious - Use Alternative (1)siponimod and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• sirolimus

  Monitor Closely (1)trazodone will decrease the level or effect of sirolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• sitagliptin

  Minor (1)trazodone increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• sodium oxybate

  Serious - Use Alternative (1)trazodone, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

• solifenacin

  Monitor Closely (1)solifenacin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.Serious - Use Alternative (1)solifenacin and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• sotalol

  Contraindicated (1)trazodone and sotalol both increase QTc interval. Contraindicated.

• St John's Wort

  Serious - Use Alternative (2)trazodone and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.
  
  St John's Wort will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• stiripentol

  Monitor Closely (1)stiripentol, trazodone. 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.

• streptomycin

  Monitor Closely (1)trazodone will decrease the level or effect of streptomycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• succinylcholine

  Minor (1)succinylcholine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

• sufentanil

  Monitor Closely (1)sufentanil and trazodone both increase sedation. Use Caution/Monitor.

• sufentanil SL

  Monitor Closely (1)sufentanil SL, trazodone. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

• sulfamethoxazole

  Monitor Closely (1)trazodone and sulfamethoxazole both increase QTc interval. Modify Therapy/Monitor Closely.Minor (1)sulfamethoxazole decreases levels of trazodone by unspecified interaction mechanism. Minor/Significance Unknown.

• sulfasalazine

  Monitor Closely (1)trazodone, sulfasalazine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• sulindac

  Monitor Closely (1)trazodone, sulindac. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• sumatriptan

  Monitor Closely (1)sumatriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, sumatriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• sumatriptan intranasal

  Monitor Closely (1)sumatriptan intranasal and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, sumatriptan intranasal. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• sunitinib

  Serious - Use Alternative (1)sunitinib and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• tacrolimus

  Monitor Closely (1)trazodone will decrease the level or effect of tacrolimus by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)tacrolimus and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• tamsulosin

  Monitor Closely (1)trazodone increases levels of tamsulosin by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

• tapentadol

  Monitor Closely (2)trazodone and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  tapentadol and trazodone both increase sedation. Use Caution/Monitor.

• tazemetostat

  Monitor Closely (2)tazemetostat will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tecovirimat

  Monitor Closely (1)tecovirimat will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

• tedizolid

  Serious - Use Alternative (1)tedizolid, trazodone. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

• telavancin

  Monitor Closely (1)trazodone and telavancin both increase QTc interval. Modify Therapy/Monitor Closely.

• temazepam

  Monitor Closely (1)temazepam and trazodone both increase sedation. Use Caution/Monitor.

• terbutaline

  Monitor Closely (1)trazodone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• tetrabenazine

  Serious - Use Alternative (1)tetrabenazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• thioridazine

  Monitor Closely (1)thioridazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)thioridazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, thioridazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, thioridazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• thiothixene

  Monitor Closely (1)thiothixene and trazodone both increase sedation. Use Caution/Monitor.

• tinidazole

  Monitor Closely (1)trazodone will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

• tiotropium

  Monitor Closely (1)tiotropium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tipranavir

  Serious - Use Alternative (1)tipranavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• tobramycin

  Monitor Closely (1)trazodone will decrease the level or effect of tobramycin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• tolazamide

  Minor (1)trazodone increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.

• tolbutamide

  Minor (1)trazodone increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.

• tolfenamic acid

  Monitor Closely (1)trazodone, tolfenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolmetin

  Monitor Closely (1)trazodone, tolmetin. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.

• tolterodine

  Monitor Closely (1)tolterodine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tolvaptan

  Monitor Closely (1)trazodone will decrease the level or effect of tolvaptan by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• topiramate

  Monitor Closely (2)topiramate will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
  
  trazodone and topiramate both increase sedation. Modify Therapy/Monitor Closely.

• toremifene

  Serious - Use Alternative (1)trazodone and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.

• torsemide

  Minor (1)torsemide, trazodone. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Possible additive hyponatremia.

• tramadol

  Monitor Closely (2)trazodone and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.
  
  tramadol and trazodone both increase sedation. Use Caution/Monitor.

• tranylcypromine

  Contraindicated (1)tranylcypromine and trazodone both increase serotonin levels. Contraindicated.

• triazolam

  Monitor Closely (1)triazolam and trazodone both increase sedation. Use Caution/Monitor.

• triclabendazole

  Monitor Closely (1)triclabendazole and trazodone both increase QTc interval. Use Caution/Monitor.

• triclofos

  Monitor Closely (1)triclofos and trazodone both increase sedation. Use Caution/Monitor.

• trifluoperazine

  Monitor Closely (1)trifluoperazine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trifluoperazine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.Minor (2)trazodone, trifluoperazine. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
  
  trazodone, trifluoperazine. Either increases levels of the other by decreasing metabolism. Minor/Significance Unknown. Additive anticholinergic effects.

• trimethoprim

  Monitor Closely (1)trazodone and trimethoprim both increase QTc interval. Modify Therapy/Monitor Closely.

• trimipramine

  Monitor Closely (2)trazodone and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
  
  trazodone and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)trazodone and trimipramine both increase QTc interval. Avoid or Use Alternate Drug.
  
  trazodone and trimipramine both increase serotonin levels. Avoid or Use Alternate Drug.

• triprolidine

  Monitor Closely (1)triprolidine and trazodone both increase sedation. Use Caution/Monitor.

• triptorelin

  Monitor Closely (1)triptorelin increases toxicity of trazodone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.

• tropisetron

  Monitor Closely (1)trazodone and tropisetron both increase QTc interval. Modify Therapy/Monitor Closely.

• trospium chloride

  Monitor Closely (1)trospium chloride and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• tucatinib

  Serious - Use Alternative (1)tucatinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

• valbenazine

  Monitor Closely (1)valbenazine and trazodone both increase QTc interval. Use Caution/Monitor.

• vasopressin

  Minor (1)trazodone increases effects of vasopressin by pharmacodynamic synergism. Minor/Significance Unknown.

• vecuronium

  Monitor Closely (1)vecuronium and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

• venlafaxine

  Monitor Closely (1)trazodone and venlafaxine both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)trazodone and venlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

• verapamil

  Monitor Closely (1)verapamil will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Minor (1)verapamil increases levels of trazodone by decreasing metabolism. Minor/Significance Unknown.

• vilazodone

  Serious - Use Alternative (1)trazodone, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated.

• vildagliptin

  Minor (1)trazodone increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.

• vinblastine

  Monitor Closely (1)trazodone will decrease the level or effect of vinblastine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• vincristine

  Monitor Closely (1)trazodone will decrease the level or effect of vincristine by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• vincristine liposomal

  Monitor Closely (1)trazodone will decrease the level or effect of vincristine liposomal by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

• voriconazole

  Monitor Closely (1)trazodone and voriconazole both increase QTc interval. Modify Therapy/Monitor Closely.Serious - Use Alternative (1)voriconazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

• vorinostat

  Serious - Use Alternative (1)vorinostat and trazodone both increase QTc interval. Avoid or Use Alternate Drug.

• vortioxetine

  Serious - Use Alternative (1)trazodone increases toxicity of vortioxetine by serotonin levels. Avoid or Use Alternate Drug.

• voxelotor

  Serious - Use Alternative (1)voxelotor will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid.

• xylometazoline

  Monitor Closely (1)trazodone increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, xylometazoline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• yohimbe

  Serious - Use Alternative (1)yohimbe, trazodone. Mechanism: unspecified interaction mechanism. Contraindicated. May cause increase or decrease in blood pressure.

• yohimbine

  Monitor Closely (1)trazodone increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, yohimbine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

• zafirlukast

  Minor (1)zafirlukast will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

• ziconotide

  Monitor Closely (1)trazodone and ziconotide both increase sedation. Use Caution/Monitor.

• ziprasidone

  Monitor Closely (1)ziprasidone and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and ziprasidone both increase QTc interval. Avoid or Use Alternate Drug.

• zolmitriptan

  Monitor Closely (1)zolmitriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, zolmitriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.

• zolpidem

  Minor (1)zolpidem, trazodone. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive CNS depression.