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Trazodone Drug Interactions

by on May 26, 2012

There are some drugs that can interfere with the way trazodone works and can increase the risk of side effects. Usually, these drugs affect the metabolism and excretion of trazodone in the body. Concomitant use of trazodone with these drugs can either increase or decrease the trazodone levels in blood. It is important to know what drugs to avoid while taking trazodone to prevent any unwanted effects.

Significant Drug Interactions

Here are some of the drugs that can lead to significant drug interaction.

Blood Thinner or Anticoagulant – When taken together with trazodone, warfarin can result in either an increase or decrease in the prothrombin time.

  • warfarin (Coumadin)

Digoxin – Trazodone increases the amount of digoxin in the blood which increases the risk of abnormal heart beat or rhythm. Frequent monitoring of digoxin levels is necessary to avoid side effects.

  • digoxin (Lanoxin, Lanoxicaps)

MAOI and Other Antidepressant Drugs – It is not clear how these drugs will interact with trazodone. However, since many other antidepressants are likely to interact with it, caution should be taken when taking these drugs.

  • nefazodone (Serzone)
  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • rasagiline (Azilect)
  • selegiline (Eldepryl, Emsam, Zelapar)
  • tranylcypromine (Parnate®)
  • Amitriptyline
  • Citalopram (Celexa)
  • Cymbalta (duloxetine)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • Paxil (paroxetine)
  • Zoloft (sertraline)
  • venlafaxine (Effexor)
  • desvenlafaxine (Pristiq)

Antibiotic and Antifungal Drugs – These medications can increase the level of trazodone in the blood which can increase the risk of adverse effects. Dose adjustments may be necessary when combining these medications.

  • clarithromycin (Biaxin)
  • erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin)
  • levofloxacin (Levaquin)
  • pentamidine (NebuPent, Pentam)
  • ketoconazole (Extina, Ketozole, Nizoral, Xolegal)
  • itraconazole (Sporanox)
  • voriconazole (Vfend)

Heart or Blood Pressure Medications – These drugs may increase the level of trazodone in the blood increasing the risk of adverse effects. Dose adjustments may be necessary when combining these medications.

  • diltiazem (Cartia, Cardizem)
  • nicardipine (Cardene)
  • nifedipine (Nifedical, Procardia)
  • verapamil (Calan, Covera, Isoptin, Verelan)

Antiarrhythmic drugs – These medications can result in increased trazodone levels in the blood which increase the risk of adverse effects. Dose adjustments may be necessary when combining these medications.

  • amiodarone (Cordarone, Pacerone)
  • disopyramide (Norpace)
  • procainamide (Pronestyl)
  • quinidine (Quin-G)

Drugs for HIV/AIDS – These medications tend to increase the amount of trazodone in the blood, which may increase the risk of adverse effects. Dose adjustments may be necessary when taking these drugs with trazodone. Patients combining ritonavir with trazodone may experience side effects such as nausea, low blood pressure, and syncope.

  • amprenavir (Agenerase)
  • atazanavir (Reyataz)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • nelfinavir (Viracept)
  • ritonavir (Norvir)
  • delavirdine (Rescriptor)

Seizure Drugs – Carbamezepine tends to decrease the amount o trazodone in blood, possibly reducing its intended pharmacologic effect. Contrastingly, trazodone may increase the amount of phenytoin in the blood. Concurrent use of these drugs with trazodone may require dose adjustments.

  • carbamazepine (Carbatrol, Tegretol)
  • phenytoin (Dilantin)

Non-Steroidal Anti-Inflammatory Drug (NSAID) – Diclofenac can increase the amount of trazodone in the blood, which may increase the risk of adverse effects. Dose adjustments may be necessary when taking these diclofenac with trazodone.

  • diclofenac (Voltaren, Cataflam, Voltaren-XR)

Other drugs that can potentially interact with trazodone include drugs for relief of nausea and vomiting, such as dolasetron (Anzemet) and ondansetron (Zofran); anti-malaria drugs such as chloroquine (Arelan); drugs for migraine such as sumatriptan (Imitrex); and narcotic medication such as methadone (Dolophine, Methadose).

This medication guide does not list all drugs that can interact with trazodone. It is best to inform your healthcare provider of all the drugs that you take (prescription and over-the-counter drugs). And do not take any medications without consulting your healthcare provider.

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