Clinical Psychiatry News - Desyrel label warns of drug interactions
New labeling for Desyrel (trazodone hydrochloride) alerts health care professionals to potential drug interactions with ketoconazole, ritonavir, and indinavir.
Changes to the clinical pharmacology section of the label note that trazodone–indicated for the treatment of depression–is a substrate of the cytochrome P450 3A4 (CYP3A4) enzyme and that trazodone metabolism can be inhibited by the CYP3A4 inhibitors ketoconazole, ritonavir, and indinavir. The CYP3A4 inhibitors likely lead to substantial increases in trazodone plasma concentrations with the potential for adverse effects. If trazodone is used with a potent CYP3A4 inhibitor, a lower dose of trazodone should be considered. The new precautions reflect the findings of in vitro metabolism studies.
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The changes also note that the anticonvulsant carbamazepine reduced plasma concentrations of trazodone when coadministered. Patients should be closely monitored to see whether there is a need for an increased dose of trazodone when taking both drugs.
Physicians and others are encouraged to report any serious adverse events that occur with the use of Desyrel to the Food and Drug Administration’s MedWatch program by calling 800-332-1088 or via the MedWatch Web site, www.fda.gov/medwatch.
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