- What is trazodone, and how does it work (mechanism of action)?
- Is trazodone available as a generic drug?
- Do I need a prescription for trazodone?
- What are the side effects of trazodone?
- What is the dosage for trazodone?
- Which drugs or supplements interact with trazodone?
- Is trazodone safe to take if I'm pregnant or breastfeeding?
- What else should I know about trazodone?
What is the dosage for trazodone?
For the treatment of depression, the dose for adults is 150-600 mg per day of regular tablets.
- The initial starting dose usually is 150 mg per day which is increased by 50 mg/day every 3-7 days.
- Trazodone regular tablets are given in one or more daily doses, sometimes with the largest dose at night.
- The dose of extended release tablets are 150 mg at bedtime initially which is increased by 75 mg/day every 3 days. Extended release tablets should be swallowed whole and not crushed or chewed. The maximum dose is 375 mg daily.
- As with all antidepressants, it may take several weeks for the full effects of treatment to be seen. Doses often are adjusted slowly upwards to find the optimal dose.
- Elderly patients and debilitated persons may need lower doses.
- Trazodone should be taken after a meal or light snack to reduce the risk of dizziness. Food also increases the amount of drug absorbed into the body.
Doses of 25-75 mg are prescribed for insomnia.
Which drugs or supplements interact with trazodone?
All antidepressants that increase concentrations of serotonin in the brain, including trazodone, should not be taken with MAO-inhibitors. Drugs in the MAO-inhibitor class include isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure and tremor. This same type of interaction may occur when trazodone is used with selegiline (Eldepryl). If a patient is switched from trazodone to an MAO inhibitor, at least one week should be allowed after stopping trazodone before the MAO inhibitor is begun. After stopping an MAO inhibitor, two weeks should elapse before starting trazodone.
Increased blood concentrations of digoxin (Lanoxin) and phenytoin (Dilantin) have been reported in persons taking trazodone due to a decrease in the metabolism (break-down and elimination) of these drugs by trazodone.
Carbamazepine (Tegretol) may decrease blood levels of trazodone by increasing its elimination from the body. Ketoconazole (Nizoral), ritonavir (Norvir), and indinavir (Crixivan) inhibit the breakdown of trazodone leading to increased blood levels of trazodone and potential side effects.
Drugs that increase serotonin may cause bleeding. Therefore, combining trazodone with aspirin, nonsteroidal anti-inflammatory drugs, warfarin (Coumadin) or other drugs that affect bleeding may increase the likelihood of upper gastrointestinal bleeding.
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