Trazodone Oral Tablet Interactions: Alcohol, Medications, and Others

Does trazodone interact with other drugs?

Before you start taking trazodone, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether trazodone interacts with herbs, vitamins, or supplements, see the “Are there other interactions with trazodone?” section.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The following table lists drugs that may interact with trazodone. Keep in mind that this table does not include all drugs that may interact with trazodone. For more information about some of these interactions, see the “Drug interactions explained” section.

When should I avoid trazodone?

Certain health conditions or other factors could raise your risk of harm if you take trazodone. If these apply to you, your doctor may not prescribe trazodone for you. These are known as contraindications. The list below includes contraindications of trazodone.

If you take an MAOI drug: If you take an MAOI, your doctor likely won’t prescribe trazodone for you. This is because taking the drug could cause serotonin syndrome (a serious condition caused by high levels of serotonin in your body). Examples of MAOIs include:

• isocarboxazid (Marplan)
• linezolid (Zyvox)
• methylene blue (Provayblue)
• phenelzine (Nardil)
• selegiline (Emsam, Zelapar)
• tranylcypromine (Parnate)

If you’re taking an MAOI, your doctor may have you stop taking it before starting trazodone. If this applies to you, they won’t start your trazodone treatment until at least 14 days after your last dose of the MAOI.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to trazodone or any of its ingredients, your doctor likely won’t prescribe trazodone for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking trazodone, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether trazodone is safe for you to take.

Does trazodone interact with alcohol?

You should avoid drinking alcohol while taking trazodone. Trazodone and alcohol can cause some similar side effects, such as sleepiness and dizziness. So you may be more likely to experience these side effects, or they may worsen if you drink alcohol during your trazodone treatment.

If you have questions about consuming alcohol while taking trazodone, talk with your doctor or pharmacist.

Drug interactions explained

Learn more about certain drug interactions that can occur with trazodone.

Interaction with NSAIDs

Trazodone can interact with NSAIDs, which help relieve pain and reduce inflammation (swelling).

Both trazodone and NSAIDs can affect blood clotting and raise your risk of bleeding. So taking these drugs together can increase your risk of this side effect.

If you have an ulcer in your stomach or intestine, you may have a higher risk of experiencing bleeding in your digestive system if you take trazodone with an NSAID.

Examples of NSAID medications include:

• aspirin
• celecoxib (Celebrex)
• ibuprofen (Advil, Motrin)
• naproxen (Naprosyn, Aleve)

What you can do

If you take trazodone with an NSAID, your doctor may prescribe a dosage of trazodone or the NSAID that’s lower than usual. You should not take a higher dose of either medication than your doctor prescribes.

If you take trazodone and an NSAID together, tell your doctor right away if you have symptoms of unusual bleeding, which may include:

• unusual bruising
• red, purple, or dark dots on your skin
• nosebleeds
• symptoms of bleeding in your digestive system, including:
  • black or tar-like stools
  • vomiting blood or a substance that looks like coffee grounds

If you have questions about taking trazodone with NSAIDs, talk with your doctor or pharmacist.

Interaction with certain antibiotics

Trazodone can interact with certain antibiotics, which help treat bacterial infections.

Examples of antibiotics that can interact with trazodone include:

• azithromycin (Zithromax)
• clarithromycin
• rifampin (Rifadin, Rimactane)

Certain antibiotics can affect the action of an enzyme (a type of protein) in your body that helps break down trazodone. For example, rifampin can increase the action of this enzyme. This can lower the level of trazodone in your body, making it less effective at treating depression.

On the other hand, clarithromycin can reduce the action of this enzyme. This can cause trazodone to build up in your body, raising your risk of its side effects. Trazodone’s side effects include sleepiness and QT prolongation (a type of abnormal heart rhythm).

Some antibiotics, such as clarithromycin and azithromycin, can also cause QT prolongation. So taking these drugs with trazodone can raise your risk of this side effect.

If you have electrolyte disturbances such as low potassium or magnesium levels, you may have a higher risk of QT prolongation if you take trazodone with clarithromycin or azithromycin.

What you can do

Your doctor will likely avoid prescribing antibiotics that can cause QT prolongation with trazodone. If you need treatment for a bacterial infection while you’re taking trazodone, your doctor will usually prescribe an antibiotic that doesn’t interact with trazodone.

If you take trazodone with clarithromycin, your doctor may prescribe a dosage of trazodone that’s lower than usual. You should not take a higher dose of either medication than your doctor prescribes.

If you take trazodone with clarithromycin or azithromycin, your doctor may monitor you more closely. For example, they may order blood tests to check your electrolyte levels. Tell your doctor right away if you have symptoms of abnormal heart rhythms. These can include heart palpitations, dizziness, and fainting.

If you take trazodone with rifampin, your doctor will monitor you more closely. Tell your doctor if you think trazodone is not working as well as usual. If needed, your doctor may increase your dosage of trazodone.

If you have questions about taking trazodone with antibiotics, talk with your doctor or pharmacist.

Interaction with opioids

Trazodone can interact with opioid medications, which help relieve moderate to severe pain.

Both trazodone and opioids can cause sleepiness and serotonin syndrome. So taking these drugs together can raise your risk of these side effects.

Examples of opioid medications include:

• fentanyl (Actiq, others)
• oxycodone (Oxycontin)
• tramadol (Ultram, Conzip)

What you can do

If you take trazodone with an opioid, your doctor may prescribe a dosage of trazodone or the opioid that’s lower than usual. You should not take a higher dose of either medication than your doctor prescribes.

If you take trazodone and an opioid together, tell your doctor right away if you feel very sleepy or have symptoms of serotonin syndrome, such as a fast heartbeat, tremor, restlessness, and diarrhea.

If you have questions about taking trazodone with opioids, talk with your doctor or pharmacist.

Are there other interactions with trazodone?

Trazodone may interact with other substances, including supplements, foods, vaccines, or even lab tests. Here are additional interactions that may occur with trazodone. Note that this information does not include all other possible interactions with trazodone.

Does trazodone interact with supplements?

Before you start taking trazodone, talk with your doctor and pharmacist about any herbs, vitamins, or supplements you take. Sharing this information with them may help you avoid possible interactions.

Your doctor will likely not prescribe trazodone with tryptophan or 5-HTP supplements. Both these supplements and trazodone may increase the risk of serotonin syndrome. So taking them together can raise your risk of this side effect.

If you have questions about other supplement interactions that may affect you, talk with your doctor or pharmacist.

Trazodone interactions with herbs

Trazodone can interact with St. John’s wort, which some people use to help treat depression and some other conditions.

St. John’s wort can increase the action of an enzyme in your body that helps break down trazodone. This can lower the level of trazodone in your body, making it less effective at treating depression.

Also, both trazodone and St John’s wort can cause serotonin syndrome. So taking them together can raise your risk of this side effect.

Your doctor will likely not prescribe trazodone with St. John’s wort.

If you have questions about other herb interactions that may affect you, talk with your doctor or pharmacist.

Trazodone interactions with vitamins

There are no current reports of trazodone interacting with vitamins, but this doesn’t mean that vitamin interactions will not be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking trazodone.

Does trazodone interact with food?

There are currently no reports of trazodone interacting with food. If you have questions about eating certain foods during your treatment with trazodone, talk with your doctor.

Does trazodone interact with vaccines?

There are currently no reports of trazodone interacting with vaccines. If you have questions about getting certain vaccines during your trazodone treatment, talk with your doctor.

Does trazodone interact with lab tests?

There are currently no reports of trazodone interacting with lab tests. If you have questions about having certain lab tests done during your treatment with trazodone, talk with the healthcare professional ordering the test.

Does trazodone interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Desyrel, a brand-name version of trazodone that’s no longer available.

Both trazodone and cannabis can cause sleepiness. So using cannabis or cannabis products with trazodone can raise your risk of or worsen this side effect. Your doctor will likely recommend that you avoid using cannabis and cannabis products while taking trazodone.

Before you start treatment with trazodone, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take trazodone?

Certain medical conditions or other health factors may raise the risk of interactions with trazodone. Before taking trazodone, talk with your doctor about your health history. They’ll determine whether trazodone is right for you.

Health conditions or other factors that might interact with trazodone include:

Bipolar disorder or mania: Trazodone can bring about an episode of mania in some people with bipolar disorder. If you or a family member has a history of bipolar disorder or mania, talk with your doctor about whether trazodone is right for you.

Heart problems: Trazodone can cause abnormal heart rhythms in some people. If you have heart disease or other heart problems, such as a slow or irregular heartbeat, you may have a higher risk of this side effect. Talk with your doctor about whether trazodone is safe for you.

Electrolyte disturbances: Trazodone can cause abnormal heart rhythms in some people. If you have electrolyte disturbances, such as low potassium or magnesium levels, you may have a higher risk of this side effect. Your doctor will likely prescribe medication to correct the electrolyte disturbance before prescribing trazodone.

Narrow eye angles: If you have narrow eye angles (a condition in which your iris and cornea are closer together than usual), taking trazodone could cause closed-angle glaucoma. Talk with your doctor about whether trazodone is right for you.

Kidney or liver problems: Trazodone has not been studied in people with kidney or liver problems. If you have a kidney or liver problem, talk with your doctor about whether the medication is right for you.

Pregnancy: It is unknown whether trazodone is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking trazodone.

If you do take trazodone while pregnant, consider enrolling in the National Pregnancy Registry for Antidepressants. This registry collects details about pregnancy issues reported with antidepressants, including trazodone. To learn more, call 866-961-2388 or talk with your doctor.

Breastfeeding: It is unknown whether it’s safe to take trazodone while breastfeeding. The drug passes into breast milk, but it is unknown whether the drug may cause side effects in a child who is breastfed. If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to trazodone or any of its ingredients, your doctor will likely not prescribe trazodone. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Risk of suicidal thoughts and actions: Trazodone has a boxed warning about the risk of suicidal thoughts and actions in people under 25 years old. A boxed warning is the most serious warning from the FDA. For more information about this, see the “Boxed warning” section at the start of this article.

Common questions about trazodone and interactions

Find answers to some frequently asked questions about trazodone and possible interactions.

Does trazodone have interactions with caffeine?

No, trazodone is not known to interact with caffeine. Caffeine is an ingredient in many foods and drinks, including chocolate, tea, coffee, and energy drinks.

Trazodone can cause sleepiness, and caffeine is a stimulant. So some people may use caffeine to counteract sleepiness due to trazodone. This is not known to affect the medication when used to treat depression.

However, doctors may sometimes prescribe trazodone off-label for insomnia (trouble sleeping). If you take trazodone for this use, consuming caffeine will make trazodone less effective for helping you sleep.

If you have other questions about consuming caffeine with trazodone, talk with your doctor or pharmacist.

What pain relievers can I take with trazodone?

Trazodone can interact with several types of pain relievers. These include NSAIDs, such as aspirin and ibuprofen, and opioids, such as tramadol and oxycodone.

Your doctor may prescribe one of these pain relievers with trazodone, but if you take the two medications together, you should watch for certain side effects. For more information about these interactions, see the “Drug interactions explained” section.

It’s generally considered safe to take acetaminophen (Tylenol) with trazodone. This drug has not been reported to interact with trazodone.

If you have questions about taking pain relievers with trazodone, talk with your doctor or pharmacist.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with trazodone. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• whether you drink alcohol or use cannabis
• other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a medication list)
• what to do if you start taking a new drug during your trazodone treatment

It’s also important to understand trazodone’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with trazodone, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking trazodone exactly as prescribed can also help prevent interactions.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.