Trazodone/Selected CYP3A4 Inhibitors Interactions
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.
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.
- 1.Oleptro (trazodone hydrochloride) US prescribing information. Angelini Labopharm Inc. November, 2012.
- 2.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. September, 2016.
- 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 August, 2019.
- 5.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories August, 2019.
- 6.Diflucan (fluconazole) US prescribing information. Pfizer Inc. February, 2019.
- 7.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline March, 2019.
- 8.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company March, 2018.
- 9.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.
- 10.Margolese HC, Chouinard G. Serotonin syndrome from addition of low-dose trazodone to nefazodone. Am J Psychiatry 2000 Jun;157(6):1022.
- 11.Drew BJ, Ackerman MJ, Funk M, Gibler WB, Kligfield P, Menon V, Philippides GJ, Roden DM, Zareba W. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol 2010 Mar 2;55(9):934-47.
- 12.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.
- 13.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and -drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
- 14.Kharasch ED, Walker A, Hoffer C, Sheffels P. Sensitivity of intravenous and oral alfentanil and pupillary miosis as minimally invasive and noninvasive probes for hepatic and first-pass CYP3A activity. J Clin Pharmacol 2005 Oct;45(10):1187-97.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.