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Trazodone Generic Name & Formulations
Legal Class
Rx
General Description
Trazodone HCl 50mg, 100mg, 150mg+, 300mg+; scored (+bi/trisected) tabs.
Pharmacological Class
Triazolopyridine.
How Supplied
Contact supplier
Manufacturer
Mechanism of Action
The mechanism of action as an antidepressant is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS. Trazodone is both a selective serotonin reuptake inhibitor (SSRI) and a 5HT2 receptor antagonist and the net result of this action on serotonergic transmission and its role in trazodone’s antidepressant effect is unknown.
Trazodone Indications
Indications
Depression.
Trazodone Dosage and Administration
Adult
≥18yrs: initially 150mg/day in divided doses with food. May increase by 50mg/day at 3–4 day intervals; max 400mg/day (outpatients) or 600mg/day (inpatients) in divided doses; give most of dose at bedtime.
Children
Not established.
Trazodone Contraindications
Not Applicable
Trazodone Boxed Warnings
Not Applicable
Trazodone Warnings/Precautions
Warnings/Precautions
Increased risk of suicidal thinking and behavior in children, adolescents and young adults; monitor for clinical worsening and unusual changes. Monitor for serotonin syndrome or NMS-like reactions; discontinue if occurs. Screen for bipolar disorder. Pre-existing cardiovascular disease (monitor). Acute post MI: not recommended. Risk of QT prolongation esp. in hypokalemia, hypomagnesemia, or genetic disposition. Angle-closure glaucoma. Predisposition to priapism; discontinue if occurs. Renal and hepatic impairment. Volume-depleted. Mania/hypomania. Psychosis. Epilepsy. Avoid ECT. Write ℞ for smallest practical amount. Reevaluate periodically. Elderly. Pregnancy. Nursing mothers.
Trazodone Pharmacokinetics
Elimination
Renal. Half-life: 3–6 hours (Phase 1); 5–9 hours (Phase 2).
Trazodone Interactions
Interactions
Avoid concomitant during or within 14 days of MAOIs. Increased risk of serotonin syndrome with other serotonergics (eg, SSRIs, SNRIs, triptans) and drugs that impair serotonin metabolism (eg, MAOIs, antipsychotics, dopamine antagonists). Concomitant tryptophan: not recommended. Concomitant QT-prolonging drugs or CYP3A4 inhibitors may increase risk of cardiac arrhythmias. Increased risk of bleeding with concomitant NSAIDs, aspirin, or others that affect coagulation; monitor. Potentiates alcohol, other CNS depressants, barbiturates, digoxin, phenytoin, antihypertensives. Potentiated by potent CYP3A4 inhibitors (eg, nefazodone, ritonavir, indinavir, ketoconazole, itraconazole); consider reducing trazodone dose. Antagonized by potent CYP3A4 inducers (eg, carbamazepine); may need dose adjustments. Discontinue before general anesthetics, if possible.
Trazodone Adverse Reactions
Adverse Reactions
Somnolence/sedation, dizziness, constipation, blurred vision, dry mouth, syncope, arrhythmias, hypotension, nausea, fatigue, headache, hyponatremia (esp. in elderly).
Trazodone Clinical Trials
See Literature
Trazodone Note
Notes
Formerly known under the brand name Desyrel.
Trazodone Patient Counseling
See Literature
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