Generic Name and Formulations:
Trazodone HCl 50mg, 100mg, 150mg+, 300mg+; scored (+bi/trisected) tabs.
Various generic manufacturers
Indications for Trazodone:
≥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.
<18yrs: not recommended.
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 (Cat.C). Nursing mothers.
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.
Somnolence/sedation, dizziness, constipation, blurred vision, dry mouth, syncope, arrhythmias, hypotension, nausea, fatigue, headache, hyponatremia (esp. in elderly).
Formerly known under the brand name Desyrel.
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