Highlights for trazodone
- Trazodone immediate-release oral tablet is only available as generic drug.
- An extended-release version of trazodone is only available as the brand-name drug Oleptro.
- Trazodone is used to treat depression.
FDA warning: Suicide risk warning
- Trazodone has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
- Drugs used to treat depression, including trazodone, may cause an increase in suicidal thoughts or actions (thoughts or behaviors of harming yourself). This risk is higher in children, teenagers, or young adults. It’s also higher within the first few months of treatment with this drug or during dose changes. You and your family members, caregivers, and doctor should watch for any new or sudden changes in your mood, behaviors, thoughts, or feelings. Call your doctor right away if you have any changes.
- Serotonin syndrome warning: This drug can cause a life-threatening condition called serotonin syndrome. This risk is higher when you first start taking this drug or during dose changes. Your risk may be higher if you also take other drugs that have similar effects as trazodone, such as other drugs used to treat depression. Symptoms include agitation, hallucinations (seeing or hearing something that isn’t there), confusion or trouble thinking, coma (being unconscious for a long time), coordination problems, muscle twitching (overactive reflexes), stiff muscles, racing heart rate, high or low blood pressure, sweating, fever, nausea, vomiting, and diarrhea. Call your doctor right away if you have these symptoms.
- Angle-closure glaucoma warning: This drug can cause your pupils to be slightly bigger and lead to a type of high pressure in your eyes (angle-closure glaucoma). If you’re at high risk for this condition, your doctor may give you a medication to help prevent it.
- Bleeding warning: Taking this drug with other medications that affect your ability to stop bleeding may increase your risk of bleeding. This includes life-threatening, serious bleeding and bleeding-related events, such as nosebleeds, bruising, or skin discoloration due to bleeding below your skin. These drugs include warfarin, dabigatran, rivaroxaban, and pain drugs called non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin.
What is trazodone?
Trazodone oral tablet is a prescription drug. Trazodone immediate-release oral tablet is available only as a generic drug. Generic drugs usually cost less. Trazodone extended-release oral tablet is only available as the brand-name drug Oleptro.
Why it's used
Trazodone is used to treat depression in adults.
How it works
Trazodone belongs to a class of drugs called antidepressants. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
It isn’t fully understood how trazodone works. It may increase serotonin activity in your brain. Serotonin is a chemical that helps maintain mental balance.
Trazodone side effects
Trazodone oral tablet may cause drowsiness or sleepiness. You shouldn’t drive, use machinery, or do other activities that require alertness until you know how this drug affects you. It may cause other side effects.
More common side effects
The more common side effects of trazodone can include:
- blurred vision
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Thoughts of suicide and worsening depression. Symptoms include:
- thoughts about suicide or dying
- attempts to commit suicide
- new or worse depression
- new or worse anxiety
- feeling very agitated or restless
- panic attacks
- insomnia (trouble sleeping)
- new or worse irritability
- acting aggressive, angry, or violent
- acting on dangerous impulses
- mania (an extreme increase in activity and talking)
- other unusual changes in behavior or mood
- Serotonin syndrome. Symptoms include:
- confusion or trouble thinking
- hallucinations (seeing or hearing something that isn’t there)
- problems with coordination
- fast heart rate
- tight muscles
- trouble walking
- Vision problems. Symptoms include:
- eye pain
- changes in your vision, such as blurred vision or visual disturbances
- swelling or redness in or around your eye
- Irregular or fast heartbeat or faint
- Low blood pressure. Symptoms include:
- dizziness or fainting when you change positions, such as standing up from a sitting position
- Unusual bruising or bleeding
- Erection that lasts longer than 6 hours
- Hyponatremia (low sodium in your blood). Symptoms include:
- trouble concentrating
- memory problems
- feeling unsteady when you walk
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
Trazodone may interact with other medications
Trazodone oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Drugs you should not use with trazodone
Do not take these drugs with trazodone. Doing so can cause dangerous effects in the body. Examples of these drugs include:
- Monoamine oxidase inhibitors (MOIs), such as isocarboxazid, phenelzine, tranylcypromine, or selegiline. You shouldn’t take these drugs together or within 14 days of each other. Doing so increases your risk of serotonin syndrome.
Interactions that can cause more side effects
Taking trazodone with certain medications may cause more side effects. These drugs include:
- Central nervous system (CNS) depressants. Trazodone may make your response to barbiturates and other CNS depressants stronger.
- Warfarin. Taking trazodone with warfarin can increase your risk for bleeding. Your doctor will watch you closely.
- Non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin. Trazodone may increase your risk of bleeding when used with these drugs.
- Depression drugs, such as citalopram, fluoxetine, paroxetine, sertraline, venlafaxine, duloxetine, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s wort. Taking these drugs together may increase your risk of serotonin syndrome. This condition can be life-threatening.
- Digoxin. Taking trazodone with digoxin may increase the levels of digoxin in your body. This could increase your risk of side effects from digoxin. These include vomiting, dizziness, vision problems, and irregular heart rate. Your doctor may monitor the level of digoxin in your blood if you take these drugs together.
- Phenytoin. Taking trazodone with digoxin may increase the levels of phenytoin in your body. This could increase your risk of side effects from phenytoin. These include constipation, changes in mood, confusion, and balance problems. Your doctor may monitor the level of phenytoin in your blood if you take these drugs together.
- Ketoconazole or ritonavir. The level of trazodone in your body may increase if you take it with ketoconazole, ritonavir, or other drugs that increase levels of trazodone. This can increase your risk of side effects from trazodone. These include constipation, serotonin syndrome, and vision problems. Your doctor may lower your trazodone dosage if you take drugs that can increase trazodone levels.
Interactions that can make drugs less effective
Certain drugs may decrease the levels of trazodone in your body and make your dosage of trazodone less effective. You doctor may need to increase your dosage of trazodone when you take it with these drugs. These drugs include:
- Phenytoin and carbamazepine
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Trazodone oral tablet comes with several warnings.
Trazodone can cause a severe allergic reaction. Symptoms can include:
- trouble breathing
- swelling of your face, tongue, eyes, or mouth
- rash, hives (itchy welts), or blisters, alone or with a fever or joint pain
If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.
Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).
The use of drinks that contain alcohol can increase your risk of sleepiness or dizziness from trazodone. If you drink alcohol, talk to your doctor.
Warnings for people with certain health conditions
For people with heart disease: If you have heart disease, ask your doctor whether this drug is safe for you. Taking trazodone may cause irregular heartbeat and a prolonged QT interval (a heart rhythm issue that may cause chaotic or abnormal heart beats). Your doctor may watch you closely if you take this drug.
For people with angle-closure glaucoma: This drug may make your pupils bigger and may cause an angle closure attack.
For people with a history of mania or bipolar disorder: People with a history of bipolar disorder who are treated with trazodone for depression may have a higher chance of manic episodes. If you have a history of mania or bipolar disorder, your doctor may need to use a different medication.
Warnings for other groups
For pregnant women: Trazodone is a category C pregnancy drug. That means two things:
- Research in animals has shown adverse effects to the fetus when the mother takes the drug.
- There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.
Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus. Call your doctor right away if you become pregnant while taking this drug.
Women who are breastfeeding: Trazodone may pass into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.
For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.
If you’re over the age of 65 years, you may be at higher risk of developing side effects while taking this drug. This includes hyponatremia (low salt levels in your blood).
For children: The safety and effectiveness of this drug haven’t been established in children. This drug shouldn’t be used in people younger than 18 years.
How to take trazodone
This dosage information is for trazodone oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:
- your age
- the condition being treated
- how severe your condition is
- other medical conditions you have
- how you react to the first dose
Forms and strengths
- Form: Oral immediate-release tablet
- Strengths: 50 mg, 100 mg, 150 mg, 300 mg
- Form: Oral extended-release tablet
- Strengths: 150 mg, 300 mg
Dosage for major depressive disorder
Adult dosage (ages 18 years and older)
- Typical starting dosage: 150 mg per day in divided doses
- Dosage increases: Your doctor may increase your dose by 50 mg per day every 3 or 4 days.
- Maximum dose: 400 mg per day in divided doses. If you’re staying in a hospital, the maximum dosage is 600 mg per day.
- Typical starting dosage: 150 mg taken once per day
- Dosage increases: Your doctor may increase your dose by 75 mg every three days.
- Maximum dose: 375 mg per day
Child dosage (ages 0–17 years)
This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years of age.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Take as directed
Trazodone oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.
If you stop taking the drug or don’t take it at all: If you stop taking this drug suddenly or don’t take it, your depression may not get better. You may also have withdrawal symptoms. These include anxiety, agitation, and trouble sleeping. If you need to stop taking this drug, your doctor will slowly lower your dose over time.
If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.
If you take too much: You could have dangerous levels of trazodone in your body. Symptoms of an overdose of this drug can include:
- erection that lasts longer than six hours
- stopped breathing
- changes in the way your heart functions, including QT prolongation (a heart rhythm issue that may cause chaotic or abnormal heart beats)
If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.
What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.
How to tell if the drug is working: You should have decreased feelings of depression and your mood should improve.
Important considerations for taking trazodone
Keep these considerations in mind if your doctor prescribes trazodone oral tablet for you.
- Take trazodone shortly after a meal or snack.
- You should swallow this drug whole. You can also break it in half along the score line (indented line down the center of the tablet) and swallow it. Don’t chew or crush trazodone tablets.
- Not every pharmacy stocks all forms or brands of this drug. When filling your prescription, be sure to call ahead.
- Store trazodone at room temperature. Keep it between 68°F and 77°F (20°C and 25°C).
- Keep it away from light.
A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.
- Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
- Don’t worry about airport x-ray machines. They can’t hurt your medication.
- You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
- Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
You and your doctor should monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include:
- Eye exam. You may be at risk of angle closure glaucoma. Your doctor may do an eye exam and treat you if needed.
- Mental health and behavioral problems. You and your doctor should watch for any changes in your behavior and mood. This drug can cause new mental health and behavior problems. It can also make problems you already have worse.
Many insurance companies require a prior authorization for certain forms or brands of this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.
Are there any alternatives?
There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.
Disclaimer: Healthline 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 other 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.