trazodone (Rx)

Brand and Other Names:Desyrel, Desyrel Dividose, more...Oleptro, Trazodone D
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 50mg
  • 100mg
  • 150mg
  • 300mg

tablet, extended-release

  • 150mg
  • 300mg

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

Insomnia (Off-label)

25-100 mg PO qHS

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

Dosage Forms & Strengths

tablet

  • 50mg
  • 100mg
  • 150mg
  • 300mg

tablet, extended-release

  • 150mg
  • 300mg

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

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Interactions

Interaction Checker

and trazodone

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            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 (147)

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • glasdegib

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

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • sertraline

              sertraline and trazodone both increase serotonin levels. 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • warfarin

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

            • 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 (407)

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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, 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.

            • clobetasone

              trazodone will decrease the level or effect of clobetasone by P-glycoprotein (MDR1) efflux transporter. 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

              trazodone and cocaine 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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.

            • 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

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

              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.

            • 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.

            • 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 (126)

            • acarbose

              trazodone increases effects of acarbose by pharmacodynamic synergism. 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.

            • 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.

            • 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

              hydroxyprogesterone caproate, 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.

            • 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.

            • pilocarpine ophthalmic

              pilocarpine ophthalmic 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.

            • 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.

            • 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.

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            Adverse Effects

            >10%

            Blurred vision (5-15%)

            Dizziness (20-28%)

            Drowsiness (24-40%)

            Dry mouth (15-34%)

            Fatigue (6-15%)

            Headache (10-33%)

            Nausea/vomiting (10-21%)

            1-10%

            Constipation (7-8%)

            Edema (3-7%)

            Confusion (5-6%)

            Disorientation (<2%)

            Incoordination (2-5%)

            Nasal congestion (3-6%)

            Orthostatic hypotension (<7%)

            Syncope (<5%)

            Tremor (1-5%)

            Weight change (5%)

            Ejaculation disorder (2%)

            Decreased libido (1-2%)

            <1%

            Priapism

            Sedation

            Alopecia

            Anxiety

            Acne

            Anemia

            Increased apetite

            Diplopia

            Insomnia

            Urinary retention

            Vertigo

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            Warnings

            Black Box Warnings

            In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (<24 yr of age) taking antidepressants for major depressive disorders and other psychiatric illnesses

            This increase was not seen in patients aged >24 years; a slight decrease in suicidal thinking was seen in adults >65 years

            In children and young adults, risks must be weighed against the benefits of taking antidepressants

            Patients should be monitored closely for changes in behavior, clinical worsening, and suicidal tendencies; this should be done during initial 1-2 months of therapy and dosage adjustments

            The patient’s family should communicate any abrupt changes in behavior to the healthcare provider

            Worsening behavior and suicidal tendencies that are not part of the presenting symptoms may require discontinuation of therapy

            This drug is not FDA approved for use in pediatric patients or for treatment of bipolar depression

            Contraindications

            Hypersensitivity

            Coadministration with serotonergic drugs

            • Risk of serotonin syndrome when coadministered within 14 days of MAOIs, or coadministered with other strong serotonergic drugs (eg, SNRIs, SSRIs)
            • Starting trazodone in a patient who is being treated with linezolid or IV methylene blue is contraindicated because of an increased risk of serotonin syndrome
            • If linezolid or IV methylene blue must be administered, discontinue trazodone immediately and monitor for CNS toxicity; may resume clomipramine 24 hr after last linezolid or methylene blue dose or after 2 weeks of monitoring, whichever comes first

            Cautions

            Administer shortly after meal; if drowsiness occurs, decrease dosage or give most of divided dosage HS

            Discontinue if prolonged or inappropriate erection occurs

            Discontinue if neutropenia, leukopenia

            Use caution in patients with risk of seizures

            Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 years)

            Perform leukocyte and differential with fever, sore throat, or other signs of infection

            Discontinue if leukocytes/ANC decreases below normal range

            Coadministration with MAO inhibitors: risk of serotonin syndrome

            Drugs that interfere with serotonin reuptake have been associated with bleeding; trazodone may also impair platelet aggregation resulting in increased risk of bleeding events

            Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including nonpsychiatric MAOIs, such as linezolid and IV methylene blue) (see Contraindications)

            Coadministration with NSAIDs and aspirin, may increase risk of bleeding

            Bone fractures associated with antidepressant treatments

            Increases risk of hyponatremia

            Use caution in patients with risk of seizures including head trauma, alcoholism, brain damage

            May worsen psychosis in patients or precipitate mania or hypomania; screen, for bipolar disorder, patients presenting with depressive symptoms

            May cause orthostatic hypotension and syncope; use wiht caution

            QT prolongation with or without torsade de pointes and ventricular tachycardia reported

            May increase risk associated with electroconvulsive therapy (ECT); discontinue ECT before initiating trazodone therapy

            Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

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            Pregnancy & Lactation

            Pregnancy

            Published prospective cohort studies, case series, and case reports over several decades with use in pregnant women have not identified drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes

            Drug has been shown to cause increased fetal resorption and other adverse effects on fetus in rat when given at dose levels approximately 7.3 to 11 times the maximum recommended human dose (MRHD) of 400 mg/day in adults on a mg/m² basis; there was also an increase in congenital anomalies in the rabbit at approximately 7.3 to 22 times the MRHD on a mg/m² basis

            Consider the risk of untreated depression when discontinuing or changing treatment with antidepressant medication during pregnancy and postpartum

            Lactation

            Data from published literature report the transfer of trazodone into human milk; there are no data on effect on milk production; limited data from postmarketing reports have not identified an association of adverse effects on breastfed child

            The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child or from underlying maternal condition

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Antidepressant structurally unrelated to SSRIs, tricyclics, tetracyclics or MAOIs, but also inhibits neuronal uptake of serotonin (but not NE); it is a histamine and alpha1-adrenergic receptor antagonist; causes adrenoceptor subsensitivity

            Absorption

            Almost completely absorbed (increased by food)

            Onset: 6 weeks (antidepressant); 1-3 hr sleep aid

            Peak serum time: 30-100 min (up to 2.5 hr if taken with food); 9 hr (extended release)

            Concentration: 480-1620 ng/mL (dose-dependent)

            Distribution

            Protein bound: 85-95%

            Metabolism

            Metabolism: hepatic P450 enzyme CYP3A4 (major) CYP2D6 (minor)

            Metabolites: l-m-chlorophenylpiperazine

            Elimination

            Half-life: 7-10 hr

            Excretion: Urine (75%); feces (25%)

            Dialyzable: No

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            Administration

            Oral Administration

            Take with food

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            trazodone oral
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            300 mg tablet
            trazodone oral
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            Patient Handout

            Patient Education
            trazodone oral

            TRAZODONE - ORAL

            (TRAZ-oh-done)

            COMMON BRAND NAME(S): Desyrel

            WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

            USES: This medication is used to treat depression. It may help to improve your mood, appetite, and energy level as well as decrease anxiety and insomnia related to depression. Trazodone works by helping to restore the balance of a certain natural chemical (serotonin) in the brain.

            HOW TO USE: Read the Medication Guide provided by your pharmacist before you start using trazodone and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth, usually once or twice daily after a meal or snack or as directed by your doctor. If drowsiness is a problem and you are taking 1 dose daily, take it at bedtime. If you are taking 2 doses each day, it may help to take 1 of the doses at bedtime. Follow your doctor's directions carefully.Dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose.Take this medication exactly as prescribed. Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.Keep taking this medication as prescribed even if you feel well. To help you remember, take it at the same time(s) each day. Do not stop taking this medication without consulting your doctor. Anxiety, agitation, and trouble sleeping can occur if the drug is suddenly stopped.It may take 2 to 4 weeks before you notice the full effects of this medication. Tell your doctor if your condition persists or worsens.

            SIDE EFFECTS: See also the Warning section.Nausea, vomiting, diarrhea, drowsiness, dizziness, tiredness, blurred vision, changes in weight, headache, muscle ache/pain, dry mouth, bad taste in the mouth, stuffy nose, constipation, or change in sexual interest/ability may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: shaking (tremors), nightmares, ringing in the ears, problems urinating, blood in urine, signs of infection (e.g., fever, persistent sore throat), shortness of breath, stomach/abdominal pain.Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, fainting, fast/irregular heartbeat, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.For males, in the very unlikely event you have a painful or prolonged erection (priapism) lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking trazodone, tell your doctor or pharmacist if you are allergic to it; or to nefazodone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar disorder, personal or family history of suicide attempts, heart disease (e.g., irregular heartbeat, heart attack), liver disease, kidney disease, blood pressure problems, personal or family history of glaucoma (angle-closure type).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Trazodone may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using trazodone, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using trazodone safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, and QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.Since untreated mental/mood problems (such as depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.This medication passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: digoxin.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.Other medications can affect the removal of trazodone from your body, which may affect how trazodone works. Examples include azole antifungals (such as itraconazole, ketoconazole), HIV protease inhibitors (such as ritonavir, indinavir), macrolide antibiotics (such as erythromycin), rifamycins (such as rifampin), drugs used to treat seizures (such as phenytoin), among others.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: painful/prolonged erection, slow/rapid/irregular heartbeat, unusual drowsiness, unusual dizziness, vomiting, trouble breathing, seizures.

            NOTES: Do not share this medication with others.Psychiatric and/or medical checkups (and laboratory tests) should be done periodically to monitor your progress and check for side effects. Consult your doctor for more details.Have your blood pressure and pulse checked regularly while taking this medication. Discuss with your doctor how to monitor your own blood pressure and pulse.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
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            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.