Trazodone oral tablet interactions: Alcohol, medications, and other factors

Trazodone interactions with other medications

Before you start treatment with trazodone, tell your doctor and pharmacist which prescription, over-the-counter (OTC), and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether trazodone interacts with supplements, herbs, or vitamins, see the “Trazodone and other interactions” section.)

Here’s a table of drugs that can interact with trazodone. Keep in mind that this table doesn’t include all drugs that may interact with trazodone. Some of these interactions are described in detail in “Drug interactions in depth.”

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

When to avoid trazodone

In some cases, factors or conditions could prevent your doctor from prescribing trazodone due to the risk of harm. These are known as contraindications. Trazodone’s contraindications include:

Taking an MAOI

Doctors typically will not prescribe trazodone in combination with a type of antidepressant called an MAOI.

This is because taking trazodone with an MAOI can increase your risk of serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. Symptoms of serotonin syndrome can include:

• blood pressure changes
• excessive sweating
• diarrhea
• nausea or vomiting

Serotonin syndrome can be life threatening for some people.

Below are a few examples of MAOIs that can interact with trazodone:

• methylene blue (Provayblue)
• phenelzine (Nardil)
• selegiline (Emsam)
• isocarboxazid (Marplan)

Before you start treatment with trazodone, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with trazodone. Likewise, after you stop taking trazodone, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Note:Before you start treatment with trazodone, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe trazodone.

Trazodone interaction with alcohol

Your doctor will likely recommend that you not drink alcohol while taking trazodone. They’ll also usually advise you not to take any prescription or OTC drugs (such as certain cough syrups) that contain alcohol during trazodone treatment.

Consuming alcohol and taking trazodone may increase the risk of side effects of trazodone, such as:

• sleepiness
• dizziness
• confusion

The combination of alcohol and trazodone may also, in rare cases, lead to death. If you have questions about alcohol consumption and trazodone, talk with your doctor before starting treatment.

Drug interactions in depth

Here’s a closer look at certain drug interactions of trazodone.

Certain antidepressant medications

Antidepressant medications are typically prescribed to treat depression. They may also be prescribed for anxiety, obsessive-compulsive disorder, and nerve pain.

Interaction result: Taking trazodone with certain other antidepressants may increase the risk of serotonin syndrome, a rare but serious condition. (See “When to avoid trazodone” for details about this condition.)

Interaction explained: Both trazodone and some antidepressants increase serotonin levels in your brain. When trazodone is taken with one of these antidepressants, it could lead to too much serotonin in the body. When this happens, serotonin syndrome may occur.

Examples of antidepressant drugs: Here are some antidepressants that may interact with trazodone:

• sertraline (Zoloft)
• fluoxetine (Prozac)
• venlafaxine (Effexor)
• amitriptyline
• duloxetine (Cymbalta, Drizalma sprinkle)
• nortriptyline (Pamelor)

Steps you or your doctor may take: Your doctor will monitor you for symptoms of serotonin syndrome while taking these medications together. If you experience symptoms, talk with your doctor right away. If they think you have serotonin syndrome, they’ll recommend stopping both medications immediately.

Talk with your doctor if you have questions about taking these medications together.

Certain medications for heart rhythm problems

Antiarrhythmic drugs are prescribed to treat heart rhythm problems, such as atrial fibrillation or ventricular tachycardia.

Interaction result: Taking trazodone together with certain heart rhythm medications can increase your risk of serious arrhythmia (irregular heartbeat).

Interaction explained: Trazodone and some antiarrhythmics can both cause QT prolongation as a side effect. This is when your heart muscle takes longer than usual to contract and relax. Taking these medications together can further increase your risk of serious heart rhythm problems.

Symptoms of QT prolongation may include heart palpitations, dizziness, and fainting.

Examples of antiarrhythmic drugs: Here are some antiarrhythmic drugs that may interact with trazodone:

• amiodarone (Pacerone)
• sotalol (Betapace)
• quinidine
• disopyramide (Norpace)

Steps you or your doctor may take: Tell your doctor if you have any heart problems or take heart medications before starting trazodone. This drug may not be the right treatment option for you if you have a heart problem. Or, if your doctor prescribes trazodone for you, they’ll likely monitor you for side effects more closely.

To learn more about taking these medications together, talk with your doctor or pharmacist.

Blood thinners

Blood thinners are prescribed to help prevent and treat blood clots.

Interaction result: Taking trazodone and blood thinners may increase the risk of bleeding.

Interaction explained: Trazodone increases the level of serotonin in your body. Among other functions, serotonin plays a role in blood clotting. Drugs that affect serotonin levels, such as trazodone, may reduce blood clotting and increase the risk of bleeding. Taking trazodone and a blood thinner together may lead to an even higher risk of bleeding.

Symptoms may include:

• nosebleeds
• bruising easier than usual
• cuts that bleed longer than usual
• blood in stool

There have been reports of life threatening bleeding events related to drugs that affect serotonin levels.

Steps you or your doctor may take: Watch for any signs of bleeding when trazodone is used with a blood thinner, and tell your doctor. They may adjust the dose of your medications. In some cases, they may decide to prescribe a different drug that doesn’t increase the risk of bleeding when used with a blood thinner.

If you’d like more information about your risk of bleeding with trazodone, talk with your doctor.

Trazodone and other interactions

Trazodone may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with trazodone.

Trazodone interactions with supplements

Before you start trazodone, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

Trazodone oral tablet may interact with tryptophan (also called L-tryptophan). Some people may use this supplement to support sleep or mood.

Taking trazodone and tryptophan together may lead to serotonin syndrome. This is 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

Doctors will typically recommend you avoid taking St. John’s wort with trazodone. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

St. John’s wort can increaseTrusted Source the levels of serotonin in your brain. When trazodone is taken with St. John’s wort, it could lead to too much serotonin in the brain. This may cause serotonin syndrome.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Trazodone and vitamins

There are no specific reports of vitamins interacting with trazodone. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with trazodone.

Trazodone interactions with food

Grapefruit and grapefruit juice can interact with trazodone. Specifically, grapefruit products can stop your body from breaking down trazodone. This raises the level of trazodone in your body, which increases your risk of side effects from trazodone. Due to this risk, your doctor may recommend not consuming grapefruit and grapefruit juice while taking the drug.

Trazodone and vaccines

There aren’t any known interactions between trazodone and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Trazodone and lab tests

Trazodone isn’t known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

TRAZODONE INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Desyrel (a brand-name version of trazodone).

Taking trazodone and cannabis both can cause central nervous system (CNS) depression. Taking them together may worsen the symptoms of CNS depression. Symptoms may include:

• drowsiness
• confusion
• dizziness
• slowed breathing

Before you start treatment with trazodone, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

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

Trazodone and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with trazodone. Before you take this drug, be sure to talk with your doctor about your health history. Trazodone may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with trazodone include:

• Heart problems: Trazodone can cause irregular heartbeats and QT prolongation. Tell your doctor if you have any heart problems. Examples include irregular heart rhythm, long QT syndrome, or recent heart attack. Your doctor will determine if trazodone is a safe treatment option for you.
• Bipolar disorder: Treatment with trazodone may increase the risk of a manic or mixed episode in people with bipolar disorder. Tell your doctor if you have a history of mania or bipolar disorder. They may prescribe a different medication to treat your condition.
• Narrow-angle glaucoma: Trazodone may make your pupils bigger and cause an angle-closure attack in people with untreated narrow-angle glaucoma.
• Allergic reaction: If you’ve had an allergic reaction to trazodone or any of its ingredients, your doctor will likely not prescribe trazodone. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding: It’s not known whether it’s safe to use trazodone while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects trazodone may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using trazodone. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether trazodone is safe to use while pregnant. If you’re pregnant or planning to become pregnant, tell your doctor before starting trazodone. They can advise you on the right treatment plan for you.
• Risk of suicidal thoughts and behaviors: Trazodone has a boxed warning about the risk of suicidal thoughts and behaviors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous. For details, see the “Boxed warning” at the top of this article.

FAQs about trazodone and interactions

Here are some frequently asked questions about trazodone and possible interactions.

Can trazodone be used for sleep?

Doctors may sometimes prescribe trazodone off-label for sleep. Off-label drug use is when a drug is used for a purpose other than what it’s approved for. Trazodone is FDA approved to treat depression.

The most common side effect of trazodone is drowsiness. This is why trazodone is sometimes used to treat insomnia (trouble sleeping).

If you’re interested in trazodone for sleep, talk with your doctor. They can also suggest other ways to help you sleep.

Is there an interaction between trazodone and caffeine?

There are no specific reports of trazodone interacting with caffeine. However, trazodone is sometimes used off-label to help people sleep. Since caffeine can cause you to stay awake, trazodone may not work as well for sleep if it’s used along with caffeine.

Caffeine can also worsen the side effects of trazodone in some people. These side effects include:

• nausea
• diarrhea
• upset stomach
• dizziness

If you have questions about caffeine consumption while taking trazodone, talk with your doctor or pharmacist.

Preventing interactions

You can take certain steps to help prevent interactions with trazodone. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication listTrusted Source, which your doctor and pharmacist can help you fill out.

It’s also important to read the trazodone label and other paperworkTrusted Source that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If trazodone doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with trazodone by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today 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.