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Desyrel Dividose (trazodone) Disease Interactions

There are 8 disease interactions with Desyrel Dividose (trazodone):

Moderate

Antidepressants (Includes Desyrel Dividose) ↔ 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 Desyrel Dividose) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Mania

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 Desyrel Dividose) ↔ 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 Desyrel Dividose) ↔ 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.

Moderate

Trazodone (Includes Desyrel Dividose) ↔ Cardiovascular Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Cardiovascular Disease, Hyperthyroidism, Arrhythmias

Although less cardiotoxic than the tricyclic antidepressants, trazodone may be arrhythmogenic in some patients with cardiac disease. The use of trazodone has been associated with the occurrence of arrhythmias, including PVCs, ventricular couplets, ventricular tachycardia, atrial fibrillation, and heart block. Myocardial infarction has been reported. Trazodone should not be used during the acute recovery phase following myocardial infarction, and should be administered only with extreme caution in patients with hyperthyroidism and/or cardiovascular disease. Close monitoring of cardiovascular status, including ECG changes, is recommended at all dosages. Many of the newer antidepressants, including bupropion and the selective serotonin reuptake inhibitors (SSRIs), are considerably less or minimally cardiotoxic and may be appropriate alternatives.

References

  1. van de Merwe TJ, Silverstone T, Ankier SI, Warrington SJ, Turner P "A double-blind non-crossover placebo-controlled study between group comparison of trazodone and amitriptyline on cardiovascular function in major depressive disorder." Psychopathology 17 (1984): 64-76
  2. Vlay SC, Friedling S "Trazodone exacerbation of VT." Am Heart J 106 (1983): 604
  3. Glassman AH "The newer antidepressant drugs and their cardiovascular effects." Psychopharmacol Bull 20 (1984): 272-9
View all 15 references
Moderate

Trazodone (Includes Desyrel Dividose) ↔ Hyponatremia

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, SIADH, Hyponatremia

Treatment with trazodone may cause hyponatremia, in many cases secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Caution should be used when treating patients at greater risk of developing hyponatremia such as elderly patients, patients taking diuretics or those who are volume-depleted. Discontinuation of trazodone should be considered in patients with symptomatic hyponatremia and appropriate medical intervention should be instituted.

Moderate

Trazodone (Includes Desyrel Dividose) ↔ Hypotension

Moderate Potential Hazard, Moderate plausibility

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

Trazodone has alpha-1 adrenergic blocking activity and may cause hypotension (including orthostatic hypotension) in approximately 5% of patients. Therapy with trazodone should be administered cautiously in patients with 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 trazodone. 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. Spivak B, Radvan M, Shine M "Postural hypotension with syncope possibly precipitated by trazodone." Am J Psychiatry 144 (1987): 1512-3
  2. "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb, Princeton, NJ.
Moderate

Trazodone (Includes Desyrel Dividose) ↔ Renal/Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease, Renal Dysfunction

Trazodone undergoes metabolism in the liver. The metabolites, at least one of which is pharmacologically active, are excreted by the kidney. There are no data available concerning the pharmacokinetic disposition of trazodone or its metabolites in patients with renal and/or liver disease. Therapy with trazodone should be administered cautiously in patients with significantly impaired renal or hepatic function. Dosage adjustments may be necessary.

References

  1. Greenblatt DJ, Friedman H, Burstein ES, et al. "Trazadone kinetics: effect of age, gender, and obesity." Clin Pharmacol Ther 42 (1987): 193-200
  2. Nilsen OG, Dale O "Single dose pharmacokinetics of trazodone in healthy subjects." Pharmacol Toxicol 71 (1992): 150-3
  3. "Product Information. Desyrel (trazodone)." Bristol-Myers Squibb, Princeton, NJ.

Desyrel Dividose (trazodone) drug Interactions

There are 975 drug interactions with Desyrel Dividose (trazodone)

Desyrel Dividose (trazodone) alcohol/food Interactions

There is 1 alcohol/food interaction with Desyrel Dividose (trazodone)

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.

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