Trazodone hydrochloride (trazodone)

Composition and release form of the drug

Extended-release tablets white or white with a yellowish tinge, oval, biconvex, with two parallel lines on both sides.

Excipients: sucrose - 84 mg, carnauba wax - 24 mg, - 24 mg, magnesium stearate - 6 mg.

10 pieces. - blisters (2) - cardboard packs.
10 pieces. - blisters (6) - cardboard packs.

pharmachologic effect

An antidepressant, a thiazolopyridine derivative. It also has thymoleptic, anxiolytic, sedative and muscle relaxant effects. It has a high affinity for some subtypes of serotonin receptors, suppresses reuptake; the neuronal uptake of norepinephrine and dopamine has little effect.

It has no anticholinergic effect, does not inhibit MAO, and does not change body weight. Eliminates both mental (affective tension, irritability, fear, insomnia) and somatic manifestations of anxiety (palpitations, headache, myalgia, frequent urination, increased sweating). Increases the depth and duration of sleep in depressed patients, restores its physiological structure.

Reduces the pathological craving for ethanol. It is effective for withdrawal symptoms in patients with drug dependence on benzodiazepine derivatives anxiolytic drugs, eliminates anxiety-depressive state and sleep disorders (benzodiazepines can be completely replaced with trazodone during remission). Not addictive. Promotes the restoration of libido and potency.

The therapeutic effect in 50% of patients is observed after 3-7 days, in 25% - after 2-4 weeks.

Pharmacokinetics

After oral administration, absorption from the gastrointestinal tract is high. The time to reach C max in the blood is 1-2 hours. Taking trazodone during or immediately after a meal increases absorption, reduces C max and increases the time to reach it.

Penetrates through histohematogenous barriers, including the BBB. Penetrates into tissues and fluids (bile, saliva, breast milk). Plasma protein binding - 89-95%.

Metabolized in the liver by hydroxylation. Isoenzymes CYP3A4, CYP3A5 and CYP3A7 are involved in the metabolism of the drug.

T 1/2 in the α-phase 3-6 hours, in the β-phase - 5-9 hours. Excreted by the kidneys - 75% in the form of inactive metabolites within 98 hours after administration; 20% - with bile.

Indications

Various forms of depression (endogenous, psychotic, neurotic, somatogenic), incl. with severe anxiety, including at least 4 of the following: disturbances in sleep, appetite, psychomotor agitation or lethargy, decreased interest in the environment, decreased sexual activity, guilt, increased fatigue, slow thinking, decreased ability to concentrate, suicidal attempts / thoughts ; bulimia, kleptomania, anxiety, phobias. Benzodiazepine drug dependence; acute alcohol withdrawal syndrome. Decreased libido, impotence. Prevention of migraine attacks.

Contraindications

Ventricular arrhythmia, tachycardia, myocardial infarction (early recovery period), history of priapism, pregnancy, lactation, hypersensitivity to trazodone.

Dosage

Initial daily dose - 150-200 mg (in 3 divided doses). In mild forms of depression, the average maintenance dose is 150 mg / day; with moderate and severe forms - 300 mg / day. If necessary, the dose can be increased to 600 mg / day. The main part of the daily dose is recommended to be taken before bedtime.

Side effects

From the side of the central nervous system and peripheral nervous system: drowsiness, increased fatigue, dizziness, insomnia, headache, agitation, myalgia, impaired coordination of movements, paresthesia, disorientation, darkening of consciousness, tremor.

On the part of the cardiovascular system:arrhythmia, conduction disturbance, bradycardia, ventricular fibrillation, decreased blood pressure, orthostatic hypotension, fainting.

From the digestive system:nausea, vomiting, diarrhea, dryness and bitterness in the mouth.

On the part of the organ of vision: blurred vision, eye irritation.

From the hematopoietic system: leukopenia, neutropenia (usually minor).

Others: nasal congestion, priapism followed by impotence, allergic reactions.

Drug interactions

A case of "pirouette" -type arrhythmia with the simultaneous use of trazodone with.

A case of a moderately pronounced decrease in the anticoagulant effect of warfarin while being used with trazodone is described.

With simultaneous use, it is possible to increase the concentration of digoxin in the blood plasma and the development of symptoms of intoxication.

With simultaneous use with a case of an increase in the concentration of carbamazepine in the blood plasma is described.

With simultaneous use with lithium salts, tremor, reversible symptoms of neurotoxic action are possible.

When taking pseudoephedrine against the background of trazodone therapy, a case of the development of anxiety, panic, darkening of consciousness, depersonalization was described.

Trazodone belongs to antidepressants used for various depressive disorders. Its main difference from classic forms antidepressants - not belonging to the tricyclic or tetracyclic system. The action of the drug as a serotonin reuptake antagonist and an increase in neural transmission parameters is combined with an effective blocking of receptors belonging to the 5-HT2 subtype. This explains the low risks of side effects in the sexual sphere and consequences such as increased anxiety, aggravation of nervousness and sleep disturbance, although unpleasant manifestations in the form of weakness and drowsiness are not excluded. But the effectiveness of trazodone is inferior to a number of other antidepressants, so its use in severe forms of depression is little justified.

Trazodone instructions for use

pharmachologic effect

The drug belongs to antidepressants, thiazolopyridine derivatives, with the following effects:

• thymoleptic;
• sedative;
• anxiolytic;
• muscle relaxant.

The main effect is manifested in the form of suppression of the reuptake of serotonin, but almost does not affect the neuronal uptake of dopamine and norepinephrine. Does not significantly affect body weight, does not manifest itself in anticholinergic processes and blocking MAO.

Trazodone removes the following mental manifestations of anxiety:

• fear;
• affective tension;
• irritability;
• sleep disorders.

It also eliminates its somatic consequences:

• headache;
• heavy sweating;
• heart palpitations;
• myalgia;
• frequent urination.

In patients, sleep normalizes, and the painful craving for alcohol decreases. The drug is indicated for withdrawal symptoms, effectively blocks the state of anxiety, therefore they are often completely replaced with benzodiazepines in remission. There is no addiction to the drug with prolonged use, it can have a beneficial effect on the restoration of sexual functions.

In half of patients, the therapeutic effect of trazodone becomes noticeable after a few days, in another quarter of patients the effect is observed after 2-4 weeks of use.

Indications for use

Trazodone is used for the following types of disorders:

1. depression:

a) neurotic;

b) psychotic;

c) somatogenic;

d) endogenous;

1. bulimia;
2. panic attacks or phobias;
3. benzodiazepine drug dependence;
4. kleptomania;
5. acute manifestations of a hangover syndrome;
6. pain in diabetic neuropathy;
7. impotence, sexual dysfunction;
8. as a prophylactic agent for migraines.

If a patient is diagnosed with depression, then the following manifestations are indications for the use of the drug:

• anxiety;
• loss of appetite,
• insomnia;
• lethargy or agitation;
• weakness;
• sexual disorders;
• suicidal thoughts.

Mode of application

Trazodone is used as directed by your healthcare professional. The drug is most often used orally, but sometimes intravenous or intramuscular injection options are chosen. At the beginning of treatment, no more than 50 milligrams of the drug is prescribed per day, divided into 2-3 doses. The maximum dosage cannot exceed 500 milligrams per day. For intravenous and intramuscular forms of administration, use one ampoule per injection.

Side effects

When using trazodone, the following unpleasant consequences may occur:

• sleep disorders;
• weakness and fatigue;
• headache and dizziness;
• confusion and hallucinations are possible;
• unpleasant taste in the mouth, increased salivation and nausea;
• arrhythmia, low blood pressure, tachycardia, and heart failure;
• convulsions and tremors, hypomania and muscle twitching;
• jaundice, increased bilirubin levels;
• diarrhea or constipation, cholestasis, vomiting;
• hives, itching, psoriasis, and swelling.

Contraindications

The drug should not be used in the following cases:

• with an allergic reaction to its components;
• with acute drug or alcohol intoxication;
• pregnant women and during lactation;
• children if they are under 6 years old.

You also need to be careful if the patient:

• recovering from a heart attack;
• he has low blood pressure;
• if ventricular arrhythmia is observed;
• suffers from liver and kidney disease;
• if he is under 18;
• when he uses MAO inhibitors.

Overdose

An overdose of the drug is expressed in the following symptoms:

• dizziness;
• nausea and vomiting;
• confused consciousness;
• lethargy and drowsiness;
• difficulty breathing;
• impaired coordination of movements;
• tremor of the limbs;
• lowering blood pressure.

The consequences are eliminated by washing the stomach, taking absorbents, relieving symptoms, supporting vital functions.

Interaction with other drugs

Trazodone should not be used together with pseudoephedrine, their combination causes panic, depersonalization, and mental clouding.

When combined with amiodarone, the likelihood of cardiac arrhythmia is high.

In the case of a combination with trazodone, an increase in plasma concentration is possible with the following drugs:

• digoxin;
• carbamazepine;
• thioridazine.

It is not recommended to use a product with lithium salts, this can provoke tremors, various neurotoxic effects. Joint use with alcohol is dangerous, it leads to a pronounced depression of the central nervous system.

The combination of the drug with tryptophan can manifest itself in the form of hypomania, aversion to food, psychosis. Arterial hypotension increases when combined with trifluoperazine and chlorpromazine.

Composition, release form, analogues

The active substance is trazodone hydrochloride, the medicine may contain, depending on the form of release, the following auxiliary agents:

• carnauba wax;
• sucrose;
• povidone;
• magnesium stearate.

Available in the form of tablets, capsules, ampoules.

Storage conditions and conditions for dispensing from pharmacies

The drug belongs to the drugs of group B. It must be stored in a place protected from light. In the pharmacy, it is dispensed only by prescription.

It's no secret that the state of erection, the degree of libido, the general sexual capabilities of a man directly depend on his psychological state. It is experiences, stress, depression that lead not only to erectile dysfunction, but also to the complete suppression of normal sexuality. Therefore, it is imperative to start treatment with the stabilization of the neuropsychic state of the stronger sex, as well as with the fight against depression. Trazodon is successfully fighting this kind of problems, which we will discuss below.

Instructions for use of Trazodone indicate that the drug belongs to the group of antidepressants that have no effect on MAO, that is, it does not stimulate the central nervous system (central nervous system). The mechanism of therapeutic action is still being studied to the end, however, antidepressant efficacy has been proven. The effect of the drug is due to the fact that it selectively prevents the reuptake of serotonin by special synaptosomes of the brain. Trazodone is able to eliminate two groups of negative manifestations:

1. Somatic, manifested by palpitations, increased sweating, headache, muscle pain (myalgia), frequent urination.
2. Mental, a vivid example of which can be all kinds of fears, insomnia, a sense of tension.

Studies have shown that Trazodone is metabolized in the liver and completely eliminated from the body after 98 hours. The drug is well absorbed from the gastrointestinal tract.

In the pharmacy network, you can find analogues of Trazodon. The most popular are the following:

1. Trittico.
2. Azona.

The active substance and dosage in all drugs are the same, therefore, the indications, contraindications and method of application in the original will not differ from those that have analogues.

Usage details

The indications for the use of Trazodone are not limited to genital disorders in men. The instruction indicates the following diseases for which therapy with this drug is possible:

• Decreased libido against the background of a depressive state.
• Erectile dysfunction due to depression and other psychological problems.
• Various forms of depression (involutional, psychogenic, alcoholic).
• Depressive manifestations in organic diseases of the central nervous system, that is, in Alzheimer's disease, dementia, atherosclerosis of the cerebral vessels.

In any case, the final indications are determined by the doctor, therefore, before using Trazodone, consultation with a specialist is required. In some cases, men tend not to take depression, depression seriously, attributing impotence to anything, but not to the deplorable state of their own nervous system. Therefore, self-medication is strictly prohibited. It is the specialist who will determine the true cause of erectile dysfunction, which means that he will prescribe the right treatment.

Unfortunately, not everyone can prescribe Trazodone and analogues. The instructions contain the following contraindications for use:

1. Pathology of the heart and blood vessels: recent myocardial infarction, rhythm and conduction disturbances (atrioventricular block, ventricular arrhythmias). Patients with arterial hypertension may need to change the selected dosages of antihypertensive drugs.
2. Gastrointestinal diseases: liver failure.
3. Kidney disease accompanied by impaired renal function and renal failure.
4. Priapism. If a man previously had an episode of prolonged, painful erection that required medical intervention, Trazodone is categorically contraindicated.
5. Age limit: under 18 years of age and in childhood, it is impossible to prescribe medication.

Trazodone and its analogs can be prescribed to women to treat depression, but only if the lady is not pregnant or breastfeeding. The full range of contraindications can be found in the instructions for Trazodone. Also, you can not use the drug for people who have hypersensitivity or allergy to any component of the drug. The doctors' comments confirm that the potential harm to health in such cases significantly exceeds the expected benefit.

Clinical trials have identified the adverse effects that trazodone hydrochloride has on the body:

• CNS and sense organs. Patients may complain of general weakness and fatigue, sleep disturbances, and dizziness. More rare side effects were hallucinations, tremors of the limbs (tremors), impaired sensation, seizures, etc.
• Heart and blood vessels. Arterial hypotension and arrhythmias were observed.
• From the side of hematopoiesis. Perhaps a decrease or increase in leukocytes, neutropenia, rarely hemolytic anemia.
• The gastrointestinal tract. Increased appetite, a feeling of an unpleasant taste in the mouth, hypersalivation (increased saliva production), dyspepsia, bloating, bile stagnation. In some cases, an increase in hepatic parameters (bilirubin, amylase), jaundice was observed.
• The genitourinary system. Priapism, urinary disorders.
• The immune system. Like any medicine, Trazodone can cause allergies.

More rare non-systemic manifestations were baldness (alopecia), skin diseases (psoriasis), chest pain without a corresponding diagnosis. Overdose symptoms are similar to side effects, but more clinically expressed. For treatment, symptomatic therapy is used, since there are no specific antidotes.

special instructions

Taking into account the peculiarities of metabolism and the effect of the drug on the body, together with some other drugs, Trazodone should be prescribed with caution.

• Ritonavir. In clinical trials in healthy patients, it was noted that Ritonavir slows down the half-life of Trazodone and increases the risk of side effects: nausea, fainting, hypotension.
• Other inhibitors of CYP3A4 (fluoxetine, ketoconazole). They act like Ritonavir, belonging to the same group.
• Carbomazepine. Reduces the concentration of the drug in the blood, and therefore, Trazodone may not have the desired effect.
• Warfarin. At the moment, research is underway on their joint application. There are already facts that both drugs mutually affect the concentration of active components in the blood serum, which is confirmed by the reviews of scientists published on specialized sites.
• Antihypertensive medicines. You should be careful when using it together, as the risk of hypotension increases.

Reviews of the researchers indicate that during treatment with Trazodone, it is necessary to monitor the general blood counts (leukocytes, blood count), determine the level of liver enzymes, and do an ECG (electrocardiogram). During treatment, it is advisable to refrain from driving vehicles and working with precise mechanisms.

Method of use

The method of application may differ slightly for men of different groups. In some situations, single and daily doses should be slightly adjusted:

The tablet of the original product or analogue is taken before meals or 3-4 hours after, since the simultaneous use with food slows down the absorption of Trazodone. In the event that combined therapy for erectile dysfunction is prescribed, the dose of Trazodone is reduced to 50 mg / day.

Where to go for him

It is better to buy a remedy in a pharmacy, which is confirmed by doctors' reviews. The price of a medicine and its analogues may fluctuate in different regions:

For purchases from online pharmacies, the price may include postage or courier fees. Check this information.

It should be remembered that Trazodone is a serious drug that is undesirable to take without a medical prescription. Therefore, no matter how much you want to quickly get rid of erectile dysfunction against the background of depression, you should not prescribe this medication yourself.

Ivan, 32 years old:

Against the background of depression, sexual desire disappeared. After a month of using Tradozon, a positive effect was outlined. I will definitely continue the treatment prescribed by the doctor.

Valery Sergeevich, 47 years old:

The erection disappeared along with any desire to have sex after a lot of stress, against the background of depression that was reaching for it. I started taking Tradozone after consulting a doctor and I have no regrets. Firstly, after some time, the sex life really improved, and secondly, the depression receded. Now I look at things positively.

Sergey Leonidovich, psychotherapist:

Indeed, Trazodone and its analogues are able to successfully fight erectile dysfunction in men with depression. The drug has long been adopted by the specialists of the clinic where I work. The main thing is the correct approach to therapy, and then the sex life is getting better quickly.

Trazodone is a drug belonging to the group of antidepressants.

What are the composition and form of release of the drug Trazodone?

The pharmaceutical industry produces the drug Trazodone in tablet form, while the tablets have a prolonged effect, they are biconvex, white in color, there are two risks on both sides of the drug. The active substance is trazodone hydrochloride in an amount of 150 milligrams.

Among the auxiliary components there are such compounds: sucrose, magnesium stearate, carnauba wax, in addition, povidone. The tablets are packed in blisters. The expiration date of the medicine is marked on the box with the medicine, after which it is contraindicated to use it.

What is the effect of Trazodone?

The drug Trazodone has an antidepressant effect on the body. The mechanism of action of this drug has not yet been fully elucidated, however, it is known that the active compound of the drug inhibits the reuptake of serotonin, enhances the effects of 5-hydroxytryptophan, which is a precursor of serotonin.

The antidepressant effect of the drug is combined with anxiolytic (anti-anxiety) action, as well as sedation. Medicine relieves (suppresses) anxiety, in addition, tension and fear, as well as somatic manifestations (excessive sweating, palpitations, urinary frequency, headache, and myalgia).

The drug increases the duration and depth of sleep in patients with depression, in addition, restores the structure of sleep. Trazodone reduces the pathological craving for alcohol, in addition, eliminates the depressive-anxiety state with withdrawal symptoms.

The medication is prescribed for concomitant glaucoma, with impaired cognitive function, as well as with prostate hypertrophy and in old age. The drug is not addictive. Well absorbed from digestive tract... The maximum concentration is reached after about an hour. Protein binding - 95%.

Medicinal product passes through the histohematogenous barriers. Trazodone is metabolized in the liver, while m-chlorophenylpiperazine is formed, which is an active metabolite. The half-life is two-phase. It is excreted in the bile and through the kidneys.

What are the indications for the drug Trazodone?

The drug Trazodone is indicated for use in the following situations:

With various depressive conditions, accompanied by severe tension, as well as anxiety;
Prescribe a remedy in the presence of pain syndrome with neuralgia;
With agoraphobia (fear of open space);
Alcohol withdrawal state;
In the presence of drug dependence on benzodiazepines.

In addition, an antidepressant is used for impotence, as well as for decreased libido.

What are the contraindications for use of Trazodone?

I will list in what situations Trazodone is not used, they are as follows:

Do not use the medicine if you are hypersensitive to its components;
With extrasystole;
With myocardial infarction;
Do not prescribe medication until the age of six;
With identified ventricular arrhythmia;
With tachycardia;
With hepatic or renal failure.

With caution, the drug is prescribed for arterial hypertension, in addition, if there is a history of priapism, as well as up to eighteen years of age.

What is the use and dosage of Trazodone?

The drug Trazodone is prescribed orally, with the initial dosage corresponding to 50 or 100 mg, the tablets are taken once a day, preferably before bedtime, if necessary, the doctor can increase the amount of the drug by 50 mg / day every three days until the desired therapeutic effect is achieved.

The maximum daily dosage of Trazodone should not exceed 450 milligrams on an outpatient basis, when treatment is carried out in a hospital, then the dose of the medication can be increased to 600 mg.

What are the side effects of Trazodone?

I will list the main side effects: fatigue, weakness, psychosis, headache, drowsiness, dizziness, insomnia, agitation, hallucinations, tremors are possible, hypotension, muscle twitching, paresthesias, seizures are noted, blurred vision is not excluded, in addition, confusion, as well as double vision.

Other manifestations of a negative nature: orthostatic hypotension, atrial fibrillation, increased appetite, arrhythmia, hemolytic anemia, unpleasant taste in the mouth, methemoglobinemia, in addition, nausea, vomiting, premature menstruation, as well as flatulence and other symptoms.

Overdose from Trazodone

In case of an overdose of an antidepressant agent, the following symptoms are possible: decreased pressure, nausea, vomiting, drowsiness, dizziness, impaired coordination are characteristic, in addition, the so-called epileptiform seizures, and respiratory arrest is also possible.

In a similar situation, the patient is washed with a stomach, forced diuresis is performed, in addition, activated charcoal is prescribed, and symptomatic therapy is indicated.

Special conditions

During treatment with Trazodone, a general blood test should be taken from the patient, in order to detect leukopenia or neutropenia, in addition, it is advisable to conduct an ECG in patients with cardiac pathology.

How to replace Trazodone, what analogues?

Azona belongs to the analogue preparations, in addition, the Trittico remedy.

Conclusion

We have reviewed the drug Trazodone, instructions for use for it. Antidepressants should be taken only as directed by a specialist, adhering to the prescribed dosages of the medication.

The patient must independently study the instructions for using the prescribed drug. Be healthy!

Formula:C19H22ClN5O, chemical name: 2-propyl] -1,2,4-triazolopyridin-3 (2H) -one (as hydrochloride).
Pharmacological group: neurotropics / antidepressants.
Pharmachologic effect: antidepressant.

Pharmacological properties

The mechanism of action of trazodone is not fully understood. Trazodone is characterized by a pronounced affinity for some of the serotonin receptor subtypes. Trazodone selectively inhibits the reuptake of serotonin by synapses of the brain, potentiates the effects of 5-hydroxytryptophan (which is a precursor of serotonin), reduces the sensitivity of beta-adrenergic receptors and slightly affects the neuronal uptake of dopamine and norepinephrine and alpha-adrenergic receptors, MAO does not inhibit. Trazodone has almost no anticholinergic effect, but it can suppress or reduce salivation (especially in elderly and middle-aged patients). The antidepressant effect of trazodone is combined with anxiolytic and sedative effects. Trazodone relieves manifestations of anxiety, both mental (fear, affective tension, insomnia) and somatic (headache, palpitations, myalgia, increased sweating, frequent urination). Trazodone increases the duration and depth of sleep in depressed patients, restores the physiological structure of sleep. Trazodone reduces the pathological craving for alcohol. With withdrawal symptoms in patients with benzodiazepine dependence, trazodone eliminates sleep disturbances and anxiety-depressive state (benzodiazepines can be completely replaced with trazodone during remission). Trazodone helps restore potency and libido. Trazodone can be used for concomitant cognitive impairment, prostatic hypertrophy, glaucoma, as well as in elderly patients, but the latter are more likely to have hypotensive and sedative effects. Trazodone does not cause addiction. Therapeutic effects in some patients (according to clinical trials) were noted by the end of the first week of therapy, in 75% of patients - at the end of the second week, in 25% - after 2–4 weeks.

Trazodone is well absorbed in the gastrointestinal tract. After 1 hour, the maximum concentration in blood plasma is reached. Taking the drug during or immediately after a meal increases its absorption, but reduces the maximum concentration, lengthening the time to reach it up to 2 hours. Trazodone binds to plasma proteins by 89 - 95%. Trazodone passes through tissue barriers (including the blood-brain barrier). Trazodone is metabolized in the liver to form an active metabolite of m-chlorophenylpiperazine. The half-life of trazodone has two phases: the duration of the early phase is 3-6 hours, the late one is 5-9 hours; in some patients, trazodone accumulation is possible. The drug is excreted within 98 hours after its administration in the urine (75%, including 70% in the form of inactive metabolites) and in the bile (20%). There is information about the effectiveness of trazodone in kleptomania, bulimia, panic attacks, phobias (including agoraphobia), acute withdrawal symptoms in alcoholism, pain in diabetic neuropathy and other types chronic pain and for the prevention of migraines.

Indications

Depressive states of various origins (psychotic, endogenous, somatogenic, neurotic and others) with pronounced tension, anxiety; agoraphobia, pain syndrome with neuralgia, benzodiazepine drug dependence, alcohol withdrawal symptoms, impotence, decreased libido.

Dosage and administration of trazodone

Trazodone is taken by mouth. Adults: the initial dose is 50-100 mg once at bedtime, the dose is increased, if necessary, by 50 mg every 3-4 days until the therapeutic effect is achieved. The maximum daily dose on an outpatient basis is 450 mg, in an inpatient setting it is 600 mg. For debilitated and elderly patients, the initial dose is up to 100 mg per day, it can be increased, if necessary, up to 300 mg per day. Children 6 - 18 years old: 1.5 - 2 mg / kg per day, the dose is increased, if necessary, up to 6 mg / kg per day.

Libido disorders: 50 mg per day. Impotence: 200 mg per day with monotherapy, 50 mg per day as part of complex treatment. Benzodiazepine dependence: gradually reducing the dose of benzodiazepines by 0.25 or 0.5 tablets, add 50 mg of trazodone together for 3 weeks, then continue to reduce the dose of benzodiazepines until complete cancellation, then reduce the dose of trazodone by 50 mg per day every 3 weeks.
During trazodone therapy, it is necessary to regularly conduct a general blood test (for the timely detection of blood changes), ECG monitoring is desirable in patients with diseases of the circulatory system. Careful monitoring of patients with suicidal tendencies is necessary, especially in the first weeks of therapy. With the development of severe neutro - and leukopenia, priapism, treatment is immediately canceled; in other cases, trazodone should be withdrawn gradually. Alcohol should be avoided during trazodone therapy. Use trazodone with caution for vehicle drivers during work and people whose activities are associated with increased concentration.

Contraindications for use

Hypersensitivity, ventricular arrhythmia, myocardial infarction (early recovery period), tachycardia, extrasystole, renal and / or hepatic failure, age up to 6 years.

Restrictions on use

History of priapism arterial hypertension (adjustment of doses of antihypertensive drugs may be required), age up to 18 years.
Etc

change during pregnancy and lactation

Do not use trazodone in women during pregnancy. In animal studies, it has been found that trazodone in doses that are 30 to 50 times higher than the MRDC, increases the frequency of fetal resorption and causes congenital defects development. Breastfeeding should be stopped during trazodone therapy. Trazodone with its metabolites is found in the milk of lactating rats. It is not known whether trazodone is excreted with breast milk women.

Side effects of trazodone

Sensory organs and nervous system: fatigue, headache, weakness, dizziness, drowsiness, insomnia, agitation, hypomania, psychosis, hallucinations, muscle twitching, tremor, aphasia, large seizures (grand mal), akathisia, ataxia, dyskinesia, confusion, paresthesias, syncope, diplopia, blurred vision;
blood and circulatory system: arterial hypotension (including orthostatic), arrhythmias (including ectopic ventricular rhythms, tachy - and bradycardia), atrial fibrillation, congestive heart failure, leukopenia or leukocytosis, neutropenia (usually mild), methemoglobinemia, hemolytic anemia;
digestive system: increased appetite, unpleasant taste and dry mouth, caries, hypersalivation, diseases of the periodontal tissues, nausea, oral candidiasis, vomiting, diarrhea, flatulence, constipation, increased levels of amylase and bilirubin in blood plasma, cholestasis, jaundice;
genitourinary system: urinary retention, hematuria, increased urination, premature menstruation, increased libido, hirsutism, priapism, retrograde ejaculation, impotence;
allergic reactions: urticaria, skin rash;
others: chest pain, myalgia, alopecia, edema, psoriasis.

Interaction of trazodone with other substances

Trazodone, in contrast to typical antidepressants, does not reduce the deprimating effects of reserpine, weakens the peripheral effect of norepinephrine and the central effect of amphetamine. Trazodone enhances the effects of drugs that depress the central nervous system (including tricyclic antidepressants, barbiturates, clonidine, antihistamines, alcohol), as well as muscle relaxants and anticholinergics. When using trazodone together with antihypertensive drugs the possibility of developing orthostatic hypotension increases. Trazodone weakens the effects of psychostimulants. Trazodone increases plasma levels of phenytoin and digoxin. Do not use trazodone in conjunction with MAO inhibitors. When ritonavir and trazodone are used together, it may be necessary to reduce the dose of the latter. Patients who take trazodone and carbamazepine together should be closely monitored. When trazodone is combined with potent CYP3A4 inhibitors, its dose should be reduced.

Overdose

In case of an overdose of trazodone, nausea, drowsiness, vomiting, dizziness, impaired coordination, low blood pressure, priapism, epileptiform seizures, respiratory arrest, ECG changes, aggravation of adverse reactions develop. Necessary: \u200b\u200bgastric lavage, intake of activated charcoal, forced diuresis, maintenance of vital functions, symptomatic treatment; there is no specific antidote.

Trade names of drugs with active ingredient trazodone

Azona Trittico