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Trazodone Disease Interactions

There are 8 disease interactions with trazodone:

Moderate

Antidepressants (Includes Trazodone) ↔ 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 Trazodone) ↔ 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. Lennhoff M "Trazodone-induced mania." J Clin Psychiatry 48 (1987): 423-4
View all 17 references
Moderate

Nefazodone/Trazodone (Includes Trazodone) ↔ 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. Tasini M "Complex partial seizures in a patient receiving trazodone." J Clin Psychiatry 47 (1986): 318-9
View all 8 references
Moderate

Phenylpiperazine Antidepressants (Includes Trazodone) ↔ 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 Trazodone) ↔ 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. Vlay SC, Friedling S "Trazodone exacerbation of VT." Am Heart J 106 (1983): 604
  2. 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
  3. McCracken J, Kosanin R "Trazodone administration during ECT associated with cardiac conduction abnormality." Am J Psychiatry 141 (1984): 1488-9
View all 15 references
Moderate

Trazodone (Includes Trazodone) ↔ 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 Trazodone) ↔ 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 Trazodone) ↔ 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.

You should also know about...

trazodone drug Interactions

There are 971 drug interactions with trazodone

trazodone alcohol/food Interactions

There is 1 alcohol/food interaction with 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.

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.

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