pms-Trazodone

Symptomatic relief of depressive illness.

Adult Initially 150-200 mg daily in 2 or 3 divided doses. May be increased by increments of 50 mg, usually up to 300 mg daily in divided doses. Once adequate response has been achieved, dose may be gradually reduced, w/ adjustment depending on therapeutic response.

Should be taken with food: Take shortly after a meal or light snack.

Hypersensitivity.

Potential association w/ behavioural & emotional changes, including self-harm. Rigorous clinical monitoring for suicidal ideation or other indicators of potential for suicidal behaviour is advised, including monitoring for agitation-type emotional & behavioural changes. Gradual dose reduction is recommended due to risk of discontinuation symptoms. Not recommended for use during initial recovery phase of MI. Associated w/ QTc interval prolongation. May be arrhythmogenic. Rare cases of priapism. May cause hypotension including orthostatic hypotension & syncope. Carefully evaluate for history of drug abuse & observe for signs of misuse or abuse. Increased risk of bleeding events. Discontinue if WBC or ANC falls below normal. Risk of serotonin syndrome or NMS-like events. Consider discontinuation in patients w/ symptomatic hyponatremia. Caution in patients w/ cardiac disease; history of bleeding disorder or predisposing conditions (eg, thrombocytopenia); unstable epilepsy or history of seizures; history of mania/hypomania. Avoid concomitant use w/ drugs known to prolong QTc interval. Concomitant use w/ potent CYP3A4 inhibitors is discouraged. Co-administration w/ CYP3A4 inducers. Should not be used in combination w/ MAOIs or serotonin precursors (eg, L-tryptophan, oxitriptan) & should be used w/ caution in patients receiving other serotonergic drugs (eg, triptans, lithium, tramadol, St. John's wort, SSRIs, most TCAs) or neuroleptics/antipsychotics. Caution w/ alcohol, barbiturates & other CNS depressants. May impair mental or physical abilities required for performance of potentially hazardous tasks eg, operating an automobile or machinery. Caution in patients w/ hepatic or renal impairment. Should not be used in women of childbearing potential unless expected benefits justify potential risk to fetus. Carefully consider potential risks & benefits of treatment during later stages of pregnancy. Should not be administered to nursing mothers unless potential benefits justify possible risks to child. Not indicated in ped patients <18 yr. Caution in geriatric patients >65 yr. Elderly patients receiving antidepressants may be at increased risk of clinically significant hyponatremia.

Headache, drowsiness, sedation, dry mouth, dizziness, nausea, fatigue, diarrhea, constipation, back pain, blurred vision.

Increased plasma conc w/ CYP3A4 inhibitors eg, ketoconazole, itraconazole, voriconazole, clarithromycin, erythromycin, atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, amiodarone, grapefruit. Decreased plasma conc w/ CYP3A4 inducers eg, carbamazepine. Concomitant use w/ other QTc-prolonging drugs or drugs that can disrupt electrolyte levels is discouraged. Increased serum levels of digoxin or phenytoin. Increased risk of serotonin syndrome w/ MAOIs or other serotonergic drugs eg, tryptophan, triptans, SSRIs, lithium, fentanyl, tramadol, St. John's wort. Increased risk of bleeding w/ NSAIDs, aspirin, or other drugs that affect coagulation or bleeding. Reports of increased & decreased prothrombin time in warfarinized patients who take trazodone. May enhance response to alcohol & effects of barbiturates & other CNS depressants. Should be discontinued for as long as clinically feasible prior to elective surgery. Efficacy & safety of concurrent use w/ electroconvulsive therapy have not been studied.

Antidepressants

N06AX05 - trazodone ; Belongs to the class of other antidepressants.

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