Trazodone

DEA Class;  Rx

Common Brand Names; Desyrel, Desyrel Dividose, Oleptro, Trazodone D

Hypersensitivity

• Blurred vision (5-15%)
• Dizziness (20-28%)
• Drowsiness (24-40%)
• Dry mouth (15-34%)
• Fatigue (6-15%)
• Headache (10-33%)
• Nausea/vomiting (10-21%)
• Constipation (7-8%)
• Edema (3-7%)
• Confusion (5-6%)
• Disorientation (<2%)
• Incoordination (2-5%)
• Nasal congestion (3-6%)
• Orthostatic hypotension (<7%)
• Syncope (<5%)
• Tremor (1-5%)
• Weight change (5%)
• Ejaculation disorder (2%)
• Decreased libido (1-2%)
• Priapism
• Sedation
• Alopecia
• Anxiety
• Acne
• Anemia
• Increased apetite
• Diplopia
• Insomnia
• Urinary retention
• Vertigo

Administer shortly after meal; if drowsiness occurs, decrease dosage or give most of divided dosage HS

Discontinue if prolonged or inappropriate erection occurs

Discontinue if neutropenia, leukopenia

Use caution in patients with risk of seizures

Clinical worsening and suicide ideation may occur despite medication in adolescents and young adults (18-24 years)

Perform leukocyte and differential with fever, sore throat, or other signs of infection

Discontinue if leukocytes/ANC decreases below normal range

Coadministration with MAO inhibitors: risk of serotonin syndrome

Drugs that interfere with serotonin reuptake have been associated with bleeding; trazodone may also impair platelet aggregation resulting in increased risk of bleeding events

Potentially life-threatening serotonin syndrome reported when coadministered with drugs that impair serotonin metabolism (in particular, MAOIs, including nonpsychiatric MAOIs, such as linezolid and IV methylene blue) (see Contraindications)

Coadministration with NSAIDs and aspirin, may increase risk of bleeding

Bone fractures associated with antidepressant treatments

Increases risk of hyponatremia

Use caution in patients with risk of seizures including head trauma, alcoholism, brain damage

May worsen psychosis in patients or precipitate mania or hypomania; screen, for bipolar disorder, patients presenting with depressive symptoms

May cause orthostatic hypotension and syncope; use wiht caution

QT prolongation with or without torsade de pointes and ventricular tachycardia reported

May increase risk associated with electroconvulsive therapy (ECT); discontinue ECT before initiating trazodone therapy

Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

Published prospective cohort studies, case series, and case reports over several decades with use in pregnant women have not identified drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes

Data from published literature report the transfer of trazodone into human milk; there are no data on effect on milk production; limited data from postmarketing reports have not identified an association of adverse effects on breastfed child