trazodone DESYREL

Class: SARI/​Triazolopyridine
FDA Indications: MDD
Off-Label Use: Fibromyalgia, Insomnia, Anxiety, Bulimia Nervosa, SSRI-induced Sexual Dysfunction, Agitation And Aggression In Dementia, Neuroleptic-induced Acute Akathisia, Sleep Disturbances In Alzheimer's Disease
Prescribing
Forms: 50, 100, 150, 300mg tablet
Dose Range: 150-600 mg/day
Starting: Start 150 mg qd in divided doses for depression, ↑ 50mg q3-4 days, max 600 mg qd; for insomnia 25-150 mg qhs
Stopping: Gradually taper dose

NAMI drug fact sheet

Precautions
Contraindications: Concomitant use of MAOIs, not recommended for use s/p MI
Serious Side Effects: priapism (1:8,000-10,000); may be arrhythmogenic in patients with pre-existing CV disease; can prolong QTC
Conditional Risk of TdP, Drugs to Avoid in Congenital Long QT
Side Effects: headache, sedation/somnolence, dizziness, ataxia, lightheadedness, visual changes, constipation, xerostomia, hyperhidrosis, tremor, myalgia, orthostatic hypotension
Pharmacodynamics
1° MOA: Serotonin antagonist/reuptake inhibitor
Target: Antagonism at:
Pharmacokinetics
t½: 7 (5-9)° TMAX:
Substrate of: 3A4; 2D6
Inhibits: ∅ ; Induces:
Active Metabolites: mCPP
DDIs
Misc
  • - biphasic t½: 1st phase is 3-6°, 2nd is 5-9°
  • - attractive option for patients with h/o drug/etoh abuse
  • - despite being second most commonly rx'd 'sleeper' (after Ambien), evidence for efficacy is very limited
Special Populations

Category C—The animal and limited human data suggest that the risk for major malformations in the embryo is low. Studies for other aspects of developmental toxicity in the embryo-fetus, however, have not been conducted.

Although the amount of trazodone in milk is very small (RID 2.8%), in 2001 the American Academy of Pediatrics classified trazodone as a drug for which the effect on nursing infants is unknown but may be of concern.

May require lower doses. Start low.


No dosage adjustment necessary.


Use with caution. Dosage adjustment required based on severity of impairment.

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Last updated August 27 2018 18:45:06. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.