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Drug Interactions between trazodone and Vyvanse

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

  • trazodone
  • Vyvanse (lisdexamfetamine)

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Interactions between your drugs

Moderate

traZODone lisdexamfetamine

Applies to: trazodone and Vyvanse (lisdexamfetamine)

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Trazodone may cause prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. In experimental models, trazodone has been found to inhibit hERG-encoded cardiac potassium channels responsible for the rapid delayed rectifier K+ current (IKr)--an action that is considered a predictor of drug-induced QT prolongation. However, the extent to which trazodone may affect cardiac repolarization in clinical use has not been adequately studied. There have been postmarketing reports of torsade de pointes associated with immediate-release trazodone following overdose and in the presence of multiple confounding factors, even at dosages of 100 mg/day or less. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s).

MANAGEMENT: Coadministration of trazodone with other drugs that can prolong the QT interval should generally be avoided. Caution and clinical monitoring are recommended if concomitant use is required. Trazodone should also not be used in patients with risk factors for QT prolongation. Hypokalemia and hypomagnesemia should be corrected prior to initiation of trazodone treatment and periodically monitored. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. When trazodone is used in combination with other drugs that cause CNS and/or respiratory depression, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their doctor if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. "Product Information. Oleptro (traZODone)." Labopharm Inc, Laval, AL.
  2. Mazur A, Strasberg B, Kusniec J, Sclarovsky S "QT prolongation and polymorphous ventricular tachycardia associated with trasodone-amiodarone combination." Int J Cardiol 52 (1995): 27-9
  3. Antonelli D, Atar S, Freedberg NA, Rosenfeld T "Torsade de pointes in patients on chronic amiodarone treatment: contributing factors and drug interactions." Isr Med Assoc J 7 (2005): 163-5
  4. EMA. European Medicines Agency. European Union "EMA - List of medicines under additional monitoring. Available from: URL: http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000366.jsp&mid=WC0b01ac058067c852" ([2013 - ]):
  5. Levenson JL "Prolonged QT interval after trazodone overdose." Am J Psychiatry 156 (1999): 969-70
  6. Dattilo PB, Nordin C "Prolonged QT associated with an overdose of trazodone." J Clin Psychiatry 68 (2007): 1309-10
  7. Goodnick PJ, Jerry J, Parra F "Psychotropic drugs and the ECG: focus on the QTc interval." Expert Opin Pharmacother 3 (2002): 479-98
View all 7 references

Drug and food interactions

Moderate

traZODone food

Applies to: trazodone

Alcohol can increase the nervous system side effects of traZODone such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with traZODone. Do not use more than the recommended dose of traZODone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

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Moderate

lisdexamfetamine food

Applies to: Vyvanse (lisdexamfetamine)

Using lisdexamfetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with lisdexamfetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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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.

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.