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Drug Interactions between Prilosec and trazodone

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

omeprazole traZODone

Applies to: Prilosec (omeprazole) and trazodone

An interaction with omeprazole was suggested as the cause of trazodone toxicity in a patient who experienced lightheadedness and syncope while receiving the combination. In an isolated case report, a 54-year-old patient receiving trazodone (50 mg/day), omeprazole (20 mg/day), and simvastatin (20 mg/day) developed second degree Mobitz type 1 atrioventricular block, which the authors speculated was due to trazodone toxicity stemming from inhibition of its metabolism by omeprazole. However, causality is difficult to establish in this particular case due to potential confounding factors and lack of details. Trazodone is primarily metabolized by CYP450 3A4, yet omeprazole is not known to be a significant in vivo inhibitor of the isoenzyme. In addition, the patient had doubled the dose of trazodone on his own the night before presentation to the emergency room. There were also no rechallenge or dechallenge information provided in the report, nor blood levels of trazodone indicating toxicity. The patient recovered following discontinuation of both omeprazole and trazodone.

References

  1. Tateishi T, Graham SG, Krivoruk Y, Wood AJ (1995) "Omeprazole does not affect measured CYP3A4 activity using the erythromycin breath test" Br J Clin Pharmacol, 40, p. 411-2
  2. (2012) "Product Information. Oleptro (trazodone)." Labopharm Inc
  3. Akinseye OA, Alfishawy M, Radparvar F, Bakshi S (2015) "Trazodone and omeprazole interaction causing frequent second-degree Mobitz type 1 atrioventricular (AV) block (Wenckebach phenomenon) and syncope: a case report and literature review." Am J Case Rep, 16, p. 319-21

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Drug and food interactions

Moderate

traZODone food

Applies to: trazodone

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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