Trazodone oral tablet interactions: A detailed guide

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Overview

This article describes possible interactions with trazodone oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.

To find coupon options for trazodone and to learn more about the drug, including its uses, see this article.

Boxed warning: Risk of suicidal thoughts and behaviors

Trazodone has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Trazodone, like other antidepressant drugs, can raise the risk of suicidal thoughts and behaviors in certain people. This includes children and adults ages 24 years and younger. Note trazodone is not approved for use in children under 18 years old.

See the end of this article for more information about this warning.

Other drugs and trazodone

Drugs that may interact with trazodone oral tablet are listed below. This article doesn’t include all drugs that may interact with trazodone.

Drugs that may interact with trazodone oral tablet include:

• hydroxyzine (Vistaril):
  • what might happen: can increase the risk of side effects from trazodone and hydroxyzine, including long QT syndrome (a type of irregular heart rhythm)
• anticoagulants:
  • drug examples: rivaroxaban (Xarelto), warfarin (Jantoven)
  • what might happen: can increase the risk of bleeding as a side effect from trazodone or anticoagulants
• other antidepressants:
  • drug examples: duloxetine (Cymbalta), sertraline (Zoloft)
  • what might happen: can increase the risk of side effects from trazodone and other antidepressants
• antiplatelets:
  • drug examples: clopidogrel (Plavix)
  • what might happen: can increase the risk of bleeding as a side effect from trazodone or antiplatelets
• nonsteroidal anti-inflammatory drugs (NSAIDs):
  • drug examples: ibuprofen (Advil), aspirin
  • what might happen: can increase the risk of bleeding as a side effect from trazodone or NSAIDs
• certain antifungals:
  • drug examples: ketoconazole, itraconazole (Sporanox, Tolsura)
  • what might happen: can increase the risk of side effects of trazodone
• certain antiepileptic drugs:
  • drug examples: carbamazepine (Tegretol), phenytoin (Dilantin)
  • what might happen: can make trazodone less effective
• certain antiarrhythmic drugs:
  • drug examples: disopyramide (Norpace), amiodarone (Pacerone)
  • what might happen: can increase the risk of irregular heart rhythm as a side effect from trazodone and certain antiarrhythmic drugs
• certain antipsychotics:
  • drug examples: chlorpromazine, ziprasidone (Geodon)
  • what might happen: can increase the risk of irregular heart rhythm as a side effect from trazodone and antipsychotics
• monoamine oxidase inhibitors (MAOIs):*
  • drug examples: selegiline (Emsam, Zelepar), linezolid (Zyvox)
  • what might happen: can increase the risk of side effects from trazodone and MAOIs

* For more information on this interaction, see the “When to avoid trazodone” section.

When to avoid trazodone

Certain health conditions or other factors could increase some risks with trazodone oral tablet. Because of this, doctors may not prescribe trazodone in these cases. These health conditions or other factors are called contraindications.

Here’s a contraindication for trazodone oral tablet:

• If you take a monoamine oxidase inhibitor drug (MAOI). If you take an MAOI medication, or have recently taken one, taking trazodone oral tablet may cause serotonin syndrome. With this condition, you have a high amount of the chemical serotonin in your system. You should not take trazodone within 14 days of taking an MAOI medication.

Before starting treatment with trazodone, tell your doctor if the above relates to you. They can recommend whether you should take trazodone.

Questions about trazodone and interactions

Here you’ll find answers to some common questions about trazodone and possible interactions.

What pain reliever can I take with trazodone?

Some pain relievers are safer to take with trazodone than others. For example, acetaminophen (Tylenol) is a pain reliever that doesn’t interact with trazodone. But acetaminophen does have other interactions.

Pain relievers that interact with trazodone include nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, and the opioid drug tramadol. Your doctor can explain the risks and benefits of different pain treatments, including the risks that come with an interaction.

Talk with your doctor or pharmacist to learn more about pain relief options that are safe for you to take with trazodone.

Does trazodone have interactions with caffeine?

No, caffeine isn’t known to interact with trazodone. That said, trazodone can cause certain side effects which may be worsened by caffeine in some people. These side effects include diarrhea, nausea, and upset stomach.

Talk with your doctor if you have questions about caffeine and trazodone. To learn about what foods trazodone interacts with, such as grapefruit and grapefruit juice, see the “Other interactions and trazodone” section below.

Do trazodone and buspirone interact with one another?

Yes, trazodone and buspirone may interact if they’re taken together. Buspirone is used to treat anxiety and other conditions.

Taking trazodone and buspirone together may raise your risk of serotonin syndrome. This is a rare but serious side effect that either drug may cause when taken alone. Serotonin syndrome is caused by a high level of the chemical serotonin in your system.

That said, doctors still sometimes prescribe these drugs together. In some cases, the benefits outweigh the risks of this interaction. Your doctor can discuss this interaction with you, including risks and benefits specific to you and your health history.

Alcohol and trazodone

Trazodone oral tablet is known to interact with alcohol.

Taking trazodone oral tablet and drinking alcohol may cause:

• sleepiness
• problems with balance and coordination
• confusion or disorientation

If you drink alcohol, talk with your doctor about whether it’s safe to consume it during your treatment
with trazodone oral tablet.

Other interactions and trazodone

Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether trazodone oral tablet has these interactions.

The information below doesn’t include all other possible interactions with trazodone.

Trazodone and supplements

Before taking trazodone oral tablet, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. Doing so may help you avoid possible interactions.

Trazodone oral tablet may interact with tryptophan (also called L-tryptophan). This supplement is often used for supporting sleep or mood.

Taking trazodone and tryptophan may lead to serotonin syndrome, a serious condition caused by a high level of the chemical serotonin in your system.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Trazodone interactions with herbs

Trazodone oral tablet may interact with St. John’s wort. This herb is often used for supporting mood. Taking trazodone and St. John’s wort may lead to serotonin syndrome. It can also make trazodone less effective.

Trazodone oral tablet may interact with valerian (also called valerian root). This herb is used to help with sleep. Taking trazodone and using valerian may lead to fatigue (low energy) and sleepiness. It could also cause problems with concentration.

Because of this, you should ask your doctor or pharmacist before taking any of these products during treatment with trazodone oral tablet.

Trazodone interactions with vitamins

Trazodone oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.

Because of this, you should ask your doctor or pharmacist before taking any of these products during treatment with trazodone oral tablet.

Trazodone and food

Trazodone may interact with grapefruit and grapefruit juice. Taking trazodone and consuming grapefruit may increase the amount of trazodone in your system. This raises the risk and severity of side effects from trazodone.

Because of this, talk with your doctor or pharmacist about what foods you should avoid during treatment with trazodone oral tablet.

Trazodone and vaccines

Trazodone oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.

Because of this, you should talk with your doctor or pharmacist before receiving any vaccines during treatment with trazodone oral tablet.

Trazodone and lab tests

Trazodone oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.

Because of this, you should talk with your doctor or pharmacist before having any tests during treatment with trazodone oral tablet.

Trazodone and cannabis or CBD

Reports have shown cannabis (commonly called marijuana) and cannabis products may interact with trazodone. Cannabidiol (CBD) is an example of a cannabis product.

Taking trazodone and cannabis may lead to central nervous system (CNS) depression. Your CNS is made up of your brain and spinal cord. With CNS depression, your CNS functions slow down. Symptoms can include:

• feeling confused or disoriented
• problems with balance and coordination
• sleepiness

Before you take trazodone, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Health factors and trazodone

Certain medical conditions or other health factors may increase the risk of interactions with trazodone oral tablet. Before taking trazodone, tell your doctor about your health history. They’ll determine whether trazodone is right for you.

Here’s a list of health conditions or other factors that might interact with trazodone oral tablet:

• heart conditions, including long QT syndrome
• past heart attack
• bipolar disorder or mania
• bleeding conditions
• kidney conditions
• liver conditions
• low blood pressure
• low blood sodium level
• pregnancy or breastfeeding
• past allergic reaction to trazodone

Preventing trazodone interactions

You may be able to help avoid certain interactions with trazodone oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.

Things to consider include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you’re prescribed a new drug during your trazodone oral tablet treatment.

Taking trazodone exactly as prescribed can also help prevent interactions.

What to ask your doctor

If you have questions about trazodone and possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Does trazodone have similar interactions as other antidepressant medications?
• If I take trazodone and have certain health conditions, will I be monitored more closely during treatment?
• Should I let you know if I make lifestyle changes while I’m taking trazodone, such as to my diet or exercise routine?

Boxed warning for trazodone

Trazodone has a boxed warning for the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Similar to other antidepressants, taking trazodone oral tablet may raise the risk of suicidal thoughts and behaviors in children and adults ages 24 years and younger. Note trazodone is not approved for use in children under 18 years old.

Symptoms of suicidal thoughts and behaviors include:

• making plans to give away your possessions
• avoiding social contact and staying away from others
• expressing that others would be better off without you

It’s important to note that depression itself is also a risk factor for suicidal thoughts and behaviors. Trazodone is prescribed to treat depression.

It’s believed that this risk is highest when you first start taking trazodone, and any time your dosage is changed. This risk may decrease as you continue treatment with trazodone.          

To learn more, talk with your doctor.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.