Trazodone/Selected CYP3A4 Inhibitors
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Serious. These medicines may interact and cause very harmful effects. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Your medicine may slow down how quickly your liver processes trazodone.
What might happen:
The amount of trazodone in your blood may increase and cause side effects such as nausea, dizziness, confusion, low blood pressure, fainting, or an irregular heartbeat, which may be life-threatening.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together and if you have an increase in nausea, confusion, or low blood pressure, or if you have any dizziness, fainting, or an irregular heartbeat. Your doctor may want to change the dose of your trazodone.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
References:
1.Oleptro (trazodone hydrochloride) US prescribing information. Angelini Labopharm Inc. November, 2012.
2.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. February, 2011.
3.Greenblatt DJ, von Moltke LL, Harmatz JS, Fogelman SM, Chen G, Graf JA, Mertzanis P, Byron S, Culm KE, Granda BW, Daily JP, Shader RI. Short-term exposure to low-dose ritonavir impairs clearance and enhances adverse effects of trazodone. J Clin Pharmacol 2003 Apr;43(4):414-22.
4.Norvir (ritonavir) US prescribing information. Abbott Laboratories November, 2012.
5.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories January, 2013.
6.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline February, 2013.
7.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company January, 2013.
8.Zalma A, von Moltke LL, Granda BW, Harmatz JS, Shader RI, Greenblatt DJ. In vitro metabolism of trazodone by CYP3A: inhibition by ketoconazole and human immunodeficiency viral protease inhibitors. Biol Psychiatry 2000 Apr 1;47(7):655-61.
9.Margolese HC, Chouinard G. Serotonin syndrome from addition of low-dose trazodone to nefazodone. Am J Psychiatry 2000 Jun;157(6):1022.
10.Farkas D, Volak LP, Harmatz JS, von Moltke LL, Court MH, Greenblatt DJ. Short-term clarithromycin administration impairs clearance and enhances pharmacodynamic effects of trazodone but not of zolpidem. Clin Pharmacol Ther 2009 Jun;85(6):644-50.
11.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/ DrugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
