Skip to Content

Nefazodone Disease Interactions

There are 6 disease interactions with nefazodone:

Major

Nefazodone (Includes Nefazodone) ↔ Hypotension

Severe Potential Hazard, Moderate plausibility

Applies to: Cerebrovascular Insufficiency, Dehydration, Hypotension, Ischemic Heart Disease, Diarrhea, Vomiting, History - Myocardial Infarction, History - Cerebrovascular Disease

Nefazodone has alpha-1 adrenergic blocking activity and may cause significant decreases in blood pressure, including orthostatic hypotension, in approximately 5% of patients. Therapy with nefazodone should be administered cautiously in patients with preexisting hypotension or conditions that could be exacerbated by hypotension, such as a history of myocardial infarction, angina, or ischemic stroke. Patients with dehydration (e.g., due to severe diarrhea or vomiting) may be predisposed to hypotension and should also be managed carefully during therapy with nefazodone. Blood pressure should be monitored at regular intervals, particularly during dosage escalation or whenever dosage has been altered, and patients should be advised not to rise abruptly from a sitting or recumbent position.

References

  1. "Product Information. Serzone (nefazodone)." Bristol-Myers Squibb, Princeton, NJ.
  2. Fontaine R "Novel serotonergic mechanisms and clinical experience with nefazodone." Clin Neuropharmacol 16 Suppl 3 (1993): s45-50
Major

Nefazodone (Includes Nefazodone) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, treatment with nefazodone should not be initiated in patients with active liver disease or elevated baseline serum transaminase levels. Cases of hepatic failure resulting in death or liver transplant, at an estimated rate of 1 per 250,000 to 300,000 patient-years of nefazodone treatment in the U.S. (approximately 3 to 4 times the background rate), have been reported during postmarketing use. The time to liver injury for the reported cases typically ranged from 2 weeks to 6 months of use. Dark urine and nonspecific prodromal symptoms (e.g., nausea, anorexia, malaise, gastrointestinal complaints) were reported in some, but not all, cases prior to the onset of jaundice. There is no evidence that preexisting liver disease increases the likelihood of developing liver failure. However, baseline abnormalities can delay the recognition or confound the diagnosis of a drug-induced hepatotoxic effect, thus use of nefazodone is discouraged in this population. In patients who do receive nefazodone therapy, routine liver function testing should be considered to permit early detection of hepatic injury. Nefazodone therapy should be promptly discontinued if clinical signs or symptoms suggestive of liver injury occur, or if serum transaminase levels exceed 3 times the upper limit of normal. Therapy should be permanently discontinued in patients with presumed or confirmed drug-induced hepatotoxicity. In addition, the use of nefazodone is contraindicated in patients who were withdrawn from nefazodone because of evidence of liver injury.

References

  1. "Product Information. Serzone (nefazodone)." Bristol-Myers Squibb, Princeton, NJ.
  2. ArandaMichel J, Koehler A, Bejarano PA, Poulos JE, Luxon BA, Khan CM, Ee LC, Balistreri WF, Weber FL "Nefazodone-induced liver failure: Report of three cases." Ann Intern Med 130 (1999): 285-8
Moderate

Antidepressants (Includes Nefazodone) ↔ Angle Closure Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma (Narrow Angle)

Some antidepressants exert mydriatic activity that can induce increased intraocular pressure and result in angle-closure (narrow angle) glaucoma in a patient with anatomically narrow angles who does not have a patent iridectomy. Prior to initiating therapy with these agents patients should be examined to determine whether they are susceptible to angle closure, and have a prophylactic procedure (e.g., iridectomy), if they are susceptible. The use of these drugs in patients with untreated anatomically narrow angles should be avoided.

Moderate

Antidepressants (Includes Nefazodone) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Mania, Bipolar Disorder

All antidepressants may occasionally cause mania or hypomania, particularly in patients with bipolar disorder. Therapy with antidepressants should be administered cautiously in patients with a history of mania/hypomania.

References

  1. Kupfer DJ, Carpenter LL, Frank E "Possible role of antidepressants in precipitating mania and hypomania in recurrent depression." Am J Psychiatry 145 (1988): 804-8
  2. Fontaine R "Novel serotonergic mechanisms and clinical experience with nefazodone." Clin Neuropharmacol 16 Suppl 3 (1993): s45-50
  3. Khan A, Fabre LF, Rudolph R "Venlafaxine in depressed outpatients." Psychopharmacol Bull 27 (1991): 141-4
View all 17 references
Moderate

Nefazodone/Trazodone (Includes Nefazodone) ↔ Seizures

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

The use of most antidepressants is associated with a risk of seizures. There have been only rare reports of convulsions, including grand mal seizures, following the administration of nefazodone or trazodone. Although a causal relationship has not been established, therapy with these agents should be administered cautiously in patients with a history of seizures.

References

  1. Lanes T, Ravaris CL "Prolonged ECT seizure duration in a patient taking trazodone." Am J Psychiatry 150 (1993): 525
  2. Hohly EK, Martin RL "Increased seizure duration during ECT with trazodone administration." Am J Psychiatry 143 (1986): 1326
  3. "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb, Princeton, NJ.
View all 8 references
Moderate

Phenylpiperazine Antidepressants (Includes Nefazodone) ↔ Suicidality

Moderate Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Depression

Adults, young adults and children patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. Phenylpiperazine antidepressants are not approved for use in pediatric patients.

nefazodone drug Interactions

There are 1076 drug interactions with nefazodone

nefazodone alcohol/food Interactions

There is 1 alcohol/food interaction with nefazodone

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide