Buy Trazodone Online

What is trazodone?

Trazodone is an antidepressant medicine. It affects chemicals in the brain that may become unbalanced and cause depression.

Trazodone is used to treat major depressive disorder.

Trazodone may also be used for purposes not listed in this medication guide.

Important information about trazodone

You should not use trazodone if you are allergic to it, or if you are being treated with methylene blue injection.

Do not use trazodone if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trazodone. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Do not give this medication to anyone under 18 years old without medical advice.

Before taking trazodone

You should not use trazodone if you are allergic to it, or if you are being treated with methylene blue injection.

Do not use trazodone if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking trazodone, you must wait at least 14 days before you start taking an MAOI.

To make sure trazodone is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • heart disease;

  • a bleeding or blood clotting disorder;

  • seizures or epilepsy;

  • bipolar disorder (manic depression);

  • a history of Long QT syndrome;

  • a history of drug abuse or suicidal thoughts;

  • if you are being treated with methylene blue injection; or

  • if you have recently had a heart attack.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using trazodone. Your family or other caregivers should also be alert to changes in your mood or symptoms.

FDA pregnancy category C. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant while taking trazodone. Do not start or stop taking this medicine during pregnancy without your doctor's advice.

It is not known whether trazodone passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Do not give this medication to anyone under 18 years old without medical advice.

How should I take trazodone?

Take trazodone exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take the extended-release (Oleptro) tablet on an empty stomach at bedtime, unless your doctor tells you otherwise.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

It may take up to 2 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Do not stop using trazodone suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using trazodone.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of trazodone can be fatal when it is taken with alcohol, barbiturates such as phenobarbital, or sedatives such as diazepam (Valium).

Overdose symptoms may include extreme drowsiness, vomiting, penis erection that is painful or prolonged, fast or pounding heartbeat, seizure (black-out or convulsions), or breathing that slows or stops.

What should I avoid while taking trazodone?

Do not drink alcohol. Trazodone can increase the effects of alcohol, which could be dangerous.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Trazodone may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Trazodone side effects

Stop taking trazodone and call your doctor at once if you have a penis erection that is painful or lasts 6 hours or longer. This is a medical emergency and could lead to a serious condition that must be corrected with surgery.

Get emergency medical help if you have any of these signs of an allergic reaction to trazodone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have:

  • very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out;

  • agitation, hallucinations, overactive reflexes, nausea, diarrhea, loss of coordination;

  • headache with chest pain and severe dizziness, fainting;

  • slurred speech, vomiting, severe weakness, muscle cramps, feeling unsteady, seizure (convulsions), shallow breathing (breathing may stop); or

  • chest pain or pressure, tight feeling in your neck or jaw, sweating, pain spreading to your arm or shoulder.

Common trazodone side effects may include:

  • drowsiness, dizziness, memory problems

  • mild headache, tired feeling;

  • stomach pain, constipation;

  • dry mouth, altered sense of taste;

  • back pain; or

  • blurred vision.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Trazodone Dosing Information

Usual Adult Dose for Depression:

Immediate-release tablets:
Initial dose: 150 mg per day in divided doses.
Maintenance dose: May be increased by 50 mg per day every 3 to 4 days. The maximum dose for outpatients usually should not exceed 400 mg per day in divided doses. Inpatients may be given up to but not in excess of 600 mg per day in divided doses.
Trazodone should be taken shortly after a meal or light snack.

Extended-release tablets:
Recommended starting dose: 150 mg once daily
Maintenance dose: The dose may be increased by 75 mg/day every three days (for example, start 225 mg on day 4 of therapy).
Maximum daily dose: 375 mg
Trazodone extended-release tablets should be taken orally at the same time every day, in the late evening preferably at bedtime, on an empty stomach. Once an adequate response has been achieved, dosage may be gradually reduced, with subsequent adjustment depending on therapeutic response.

Patients should be monitored for withdrawal symptoms when discontinuing treatment with trazodone hydrochloride. The dose should be gradually reduced whenever possible.

The efficacy of trazodone extended-release tablets for the maintenance treatment of MDD has not been evaluated. While there is no body of evidence available to answer the question of how long a patient treated with extended-release tablets should continue the drug, it is generally recommended that treatment be continued for several months after an initial response. Patients should be maintained on the lowest effective dose and be periodically reassessed to determine the continued need for maintenance treatment.

Usual Geriatric Dose for Depression:

Immediate-release tablets:
Initial dose: 150 mg per day in divided doses.
Maintenance dose: May be increased by 50 mg per day every 3 to 4 days. The maximum dose for outpatients usually should not exceed 400 mg per day in divided doses. Inpatients may be given up to but not in excess of 600 mg per day in divided doses.
Trazodone should be taken shortly after a meal or light snack.

Extended-release tablets:
Recommended starting dose: 150 mg once daily
Maintenance dose: The dose may be increased by 75 mg/day every three days (for example, start 225 mg on day 4 of therapy).
Maximum daily dose: 375 mg
Trazodone extended-release tablets should be taken orally at the same time every day, in the late evening preferably at bedtime, on an empty stomach. Once an adequate response has been achieved, dosage may be gradually reduced, with subsequent adjustment depending on therapeutic response.

Patients should be monitored for withdrawal symptoms when discontinuing treatment with trazodone hydrochloride. The dose should be gradually reduced whenever possible.

The efficacy of trazodone extended-release tablets for the maintenance treatment of MDD has not been evaluated. While there is no body of evidence available to answer the question of how long a patient treated with extended-release tablets should continue the drug, it is generally recommended that treatment be continued for several months after an initial response. Patients should be maintained on the lowest effective dose and be periodically reassessed to determine the continued need for maintenance treatment.

In the clinical trial, there were nine patients older than 65. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical literature and experience with trazodone have not identified differences in responses between elderly and younger patients. However, as experience in the elderly with trazodone extended-release tablets is limited, it should be used with caution in geriatric patients.

Antidepressants have been associated with cases of clinically significant hyponatremia in elderly patients who may be at greater risk for this adverse reaction.

Usual Pediatric Dose for Depression:

(Not approved by FDA)
Immediate-release tablets:
6 to 12 years:
Initial dose: 1.5 to 2 mg/kg/day in divided doses.
Maintenance dose: May increase up to 6 mg/kg/day in 3 divided doses.

Greater than 12 years to 18 years:
Initial dose: 25 to 50 mg per day.
Maintenance dose: May increase up to 100 to 150 mg per day in divided doses.

Trazodone should be taken shortly after a meal or light snack.

What other drugs will affect trazodone?

Taking trazodone with other drugs that make you sleepy or slow your breathing can increase these effects. Ask your doctor before taking trazodone with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with trazodone may cause you to bruise or bleed easily.

Many drugs can interact with trazodone. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with trazodone, especially:

  • any other antidepressant medication;

  • bosentan;

  • imatinib;

  • isoniazid;

  • St. John's wort;

  • methadone;

  • tacrolimus;

  • arsenic trioxide, vandetanib, vemurafenib;

  • an antibiotic--azithromycin, clarithromycin, erythromycin, levofloxacin, moxifloxacin, pentamidine, telithromycin;

  • antifungal medication--itraconazole, ketoconazole, posaconazole, voriconazole;

  • anti-malaria medication--artemether and lumefantrine, chloroquine, halofantrine, mefloquine;

  • a blood thinner such as warfarin, Coumadin;

  • heart rhythm medicine--amiodarone, digoxin, disopyramide, dofetilide, dronedarone, flecainide, ibutilide, nicardipine, procainamide, propafenone, quinidine, sotalol;

  • hepatitis C medications--boceprevir, telaprevir;

  • HIV/AIDS medication--atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir;

  • medicine to prevent or treat nausea and vomiting--dolasetron, droperidol, ondansetron;

  • medicine to treat a psychiatric disorder--chlorpromazine, clozapine, haloperidol, mesoridazine, pimozide, thioridazine, ziprasidone;

  • migraine headache medicine--sumatriptan, zolmitriptan;

  • seizure medication--carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or

  • tuberculosis medication--rifabutin, rifampin, rifapentine.

This list is not complete and many other drugs can interact with trazodone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

For the Consumer

Applies to trazodone: oral tablet, oral tablet extended release

Along with its needed effects, trazodone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking trazodone:

More common
  • Blurred vision
  • confusion
  • dizziness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • lightheadedness
  • sweating
  • unusual tiredness or weakness
Less common
  • Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • confusion about identity, place, and time
  • decreased concentration
  • fainting
  • general feeling of discomfort or illness
  • headache
  • lack of coordination
  • muscle tremors
  • nervousness
  • pounding in the ears
  • shortness of breath
  • slow or fast heartbeat
  • swelling
Rare
  • Skin rash
  • unusual excitement

Some side effects of trazodone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Dry mouth (usually mild)
  • muscle or bone pain
  • trouble sleeping
  • trouble with remembering
  • unpleasant taste
Less common
  • Constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • diarrhea
  • hearing loss
  • muscle aches or pains
  • weight loss

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Applies to trazodone: compounding powder, oral tablet, oral tablet extended release

Nervous system

Nervous system side effects are common and include drowsiness and sedation in as many as 50% of treated patients. Dizziness (10% to 30%), sleep abnormalities, headache, fatigue and, more rarely, seizures, dystonia, akathisia, myoclonus, palinopsia (persistence or reappearance of an image of a recently viewed object), and extrapyramidal symptoms have been reported. One case of serotonin syndrome has been reported which is believed to have been precipitated by the combination of venlafaxine and trazodone.

Nearly all selective serotonin reuptake inhibitors, mixed serotonin/norepinephrine reuptake inhibitors, and tricyclic antidepressants cause sleep abnormalities to some extent. These antidepressants have marked dose-dependent effects on rapid eye movement (REM) sleep, causing reductions in the overall amount of REM sleep over the night and delays the first entry into REM sleep (increased REM sleep onset latency (ROL)), both in healthy subjects and depressed patients. The antidepressants that increase serotonin function appear to have the greatest effect on REM sleep. The reduction in REM sleep is greatest early in treatment, but gradually returns towards baseline during long-term therapy; however, ROL remains long. Following discontinuation of therapy the amount of REM sleep tends to rebound. Some of these drugs (i.e., bupropion, mirtazapine, nefazodone, trazodone, trimipramine) appear to have a modest or minimal effect on REM sleep.

Psychiatric

Psychiatric side effects have been reported and include mania, paranoia, hypomania (during and following therapy), increased libido, delirium, agitation, psychosis, hallucinations and self- destructive behavior.

Cardiovascular

Cardiovascular side effects including arrhythmias, hypotension, peripheral edema, postural hypotension, ventricular ectopy, ventricular tachycardia, torsades de pointes, rapid atrial fibrillation, heart block, and other conduction abnormalities have been reported.

Some investigators have suggested that trazodone exerts fewer adverse cardiovascular effects than many other antidepressants.

Genitourinary

Genitourinary side effects including priapism, clitoral priapism, ejaculatory inhibition, and anorgasmia have been reported.

Priapism has been rarely reported (0.01% to 0.1%). Priapism has occurred with doses of 50 to 150 mg daily and typically within the first 28 days of treatment. Approximately one-third of affected individuals have required surgical intervention. It has been suggested that trazodone's alpha-adrenergic blocking properties may contribute to the induction of priapism.

One case of spontaneous orgasms in an elderly postmenopausal woman has also been reported.

Other

Anticholinergic (and possibly alpha-adrenergic blocking) side effects have been reported, although much less frequently than with many other antidepressants. The effects reported include dry mouth, blurred vision, constipation, and urinary retention.

Hepatic

Hepatic side effects including cases of chronic active hepatitis and drug-induced hepatotoxicity have been reported rarely.

One case of severe hepatotoxicity followed a four day course of trazodone therapy.

Dermatologic

Dermatologic side effects including erythema multiforme, leukocytoclastic vasculitis, pustular psoriasis, drug eruptions, and acute peripheral edema have been reported rarely.

Hematologic

Hematologic side effects have included alterations in laboratory studies such as significant decreases in hematocrit, hemoglobin, red blood cell count, serum cholesterol, serum calcium, and serum albumin levels. Pseudoanemia (laboratory findings suggestive of anemia without pathologic significance) has been reported in 36% of treated patients.

Endocrine

Endocrine side effects have included hyperprolactinemia and hyponatremia (in association with the syndrome of inappropriate secretion of antidiuretic hormone).

Gastrointestinal

Gastrointestinal side effects have included dry mouth (up to 34%) and constipation.