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trazodone hydrochloride
Desyrel (discontinued) · Oleptro (ER, discontinued) · trazodone generics
Atypical antidepressant⚠ Unverified beta content
At a glance
- Class
- Serotonin antagonist and reuptake inhibitor (SARI); sedating
- Black box
- ⚠ Suicidal thoughts and behaviors
- Key monitoring
- Suicidality / mood / behavior
- Orthostatic BP / HR
- Usual adult dose
- MDD (label): Start 150 mg/day in divided doses; ↑ 50 mg/day every 3–4 days; max 400 mg/day outpatients (600 mg/day inpatients)
- Call provider / escalate if
- Thoughts of suicide or self-harm • Erection lasting more than 4 hours (priapism) • Fainting, palpitations, irregular heartbeat
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- trazodone hydrochloride (Desyrel (discontinued), Oleptro (ER, discontinued), trazodone generics) — serotonin antagonist and reuptake inhibitor (SARI); sedating.
- Used for: Major depressive disorder in adults; Very common off-label: insomnia, anxiety/agitation adjunct.
Usual adult dosing
- MDD (label): Start 150 mg/day in divided doses; ↑ 50 mg/day every 3–4 days; max 400 mg/day outpatients (600 mg/day inpatients) (Take shortly after a meal or light snack; major portion at bedtime if drowsy. Swallow whole or break on score line.)
- Insomnia (off-label, common practice): 25–100 mg at bedtime (Not a labeled dose – verify with prescriber/policy.)
Boxed warning
- Suicidal thoughts and behaviors: antidepressants increased the risk in pediatric and young adult patients in short-term studies; closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors. Not approved for pediatric use.
Monitor
- Suicidality / mood / behavior [Every contact; closely early and after dose changes]
- Orthostatic BP / HR [Initiation and dose changes]
Nursing priorities
- Baseline suicidality, mood, sleep.
- Cardiac history, QTc risk factors, electrolytes; orthostatic BP.
- Give shortly after a meal/light snack; major dose at bedtime if sedating.
- Orthostatic precautions and fall prevention, especially at night and in older adults.
- Monitor for suicidal thoughts, especially early and after dose changes.
Major interactions
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days: Serotonin syndrome – contraindicated.
- Other serotonergic drugs (SSRIs, SNRIs, triptans, tramadol, St John’s wort, buspirone): Serotonin syndrome risk.
- QT-prolonging drugs: Additive QT prolongation – avoid when possible.
Key teaching
- Take it after a meal or snack, and take most of your dose at bedtime if it makes you sleepy.
- Stand up slowly – it can make you dizzy or faint.
- Tell your provider right away about new or worse thoughts of hurting yourself.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Suicidal thoughts and behaviors: antidepressants increased the risk in pediatric and young adult patients in short-term studies; closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors. Not approved for pediatric use.
Other serious warnings
- Serotonin syndrome (alone or with other serotonergic drugs)
- QT prolongation / cardiac arrhythmias – avoid with other QT drugs and with risk factors
- Orthostatic hypotension and syncope
- Increased bleeding risk (with aspirin, NSAIDs, anticoagulants)
- Priapism – prolonged painful erection requires immediate medical attention
- Activation of mania/hypomania
- Cognitive and motor impairment
- Hyponatremia
- Angle-closure glaucoma
- Discontinuation symptoms – taper
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
- Suicidality / mood / behaviorWhen: Every contact; closely early and after dose changes
- Orthostatic BP / HRWhen: Initiation and dose changes
- ECG / QTcWhen: Baseline if riskIf cardiac risk factors or other QT-prolonging drugs
- SodiumWhen: If at risk or symptomatic
- Bleeding signs
- Priapism symptoms
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
Assessment
- Baseline suicidality, mood, sleep.
- Cardiac history, QTc risk factors, electrolytes; orthostatic BP.
- Bleeding risk meds (aspirin, NSAIDs, anticoagulants); serotonergic drugs; MAOIs (contraindicated within 14 days).
- History of bipolar disorder; for male patients, history of priapism.
Interventions
- Give shortly after a meal/light snack; major dose at bedtime if sedating.
- Orthostatic precautions and fall prevention, especially at night and in older adults.
- Monitor for suicidal thoughts, especially early and after dose changes.
- Monitor for serotonin syndrome with serotonergic combinations.
- Instruct patients (esp. male) to seek immediate care for erection >4 hours.
- Taper when discontinuing.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Thoughts of suicide or self-harm
- Erection lasting more than 4 hours (priapism)
- Fainting, palpitations, irregular heartbeat
- Agitation, fever, sweating, tremor, muscle stiffness, diarrhea (serotonin syndrome)
- Unusual bleeding or bruising
- Confusion, weakness (low sodium)
- Manic symptoms
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Somnolence / sedation
- Dizziness / orthostatic hypotension
- Dry mouth
- Headache
- Nausea, constipation
- Blurred vision
- Fatigue, confusion
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days MajorSerotonin syndrome – contraindicated.
- Other serotonergic drugs (SSRIs, SNRIs, triptans, tramadol, St John’s wort, buspirone) MajorSerotonin syndrome risk.
- QT-prolonging drugs MajorAdditive QT prolongation – avoid when possible.
- Aspirin, NSAIDs, antiplatelets, warfarin/anticoagulantsIncreased bleeding risk.
- Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin)↑ trazodone levels – consider lower dose.
- CYP3A4 inducers (carbamazepine)↓ trazodone levels.
- Antihypertensives, alcohol, CNS depressantsAdditive hypotension/sedation.
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
- Take it after a meal or snack, and take most of your dose at bedtime if it makes you sleepy.
- Stand up slowly – it can make you dizzy or faint.
- Tell your provider right away about new or worse thoughts of hurting yourself.
- Seek emergency care right away for an erection that lasts more than 4 hours.
- Do not stop suddenly. Avoid alcohol.
- Tell your provider about all medicines, including aspirin/ibuprofen and herbal products.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- Major depressive disorder in adults (labeled)
- Very common off-label: insomnia (low doses at bedtime), anxiety/agitation adjunct
Dosing
- MDD (label): Start 150 mg/day in divided doses; ↑ 50 mg/day every 3–4 days; max 400 mg/day outpatients (600 mg/day inpatients)Take shortly after a meal or light snack; major portion at bedtime if drowsy. Swallow whole or break on score line.
- Insomnia (off-label, common practice): 25–100 mg at bedtimeNot a labeled dose – verify with prescriber/policy.
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
Prescriber-oriented details; limited in this beta.
cyp Notes
- CYP3A4 substrate (active metabolite mCPP).
discontinuation
- Gradual dose reduction recommended (label).
Sources: FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SO
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): TRAZODONE HYDROCHLORIDE TABLET [APHENA PHARMA SOLUTIONS - TENNESSEE, LLC ]
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified
Reviewer notes – please double-check
- Source label used was a generic label. Note the current labeling lists MDD only; insomnia use is off-label (common practice).