Use Caution/Monitor. lofepramine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)lofepramine and trazodone both increase QTc interval. Avoid or Use Alternate Drug. trazodone and lofepramine both increase serotonin levels. Avoid or Use Alternate Drug.lofexidineMonitor Closely (2)trazodone decreases effects of lofexidine by unspecified interaction mechanism. Use Caution/Monitor. trazodone and lofexidine both increase sedation. Use Caution/Monitor.lomitapideMonitor Closely (1)trazodone increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.lonafarnibSerious - Use Alternative (2)trazodone will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown. lonafarnib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.loperamideMonitor Closely (1)trazodone will decrease the level or effect of loperamide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.lopinavirSerious - Use Alternative (1)lopinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.loprazolamMonitor Closely (1)loprazolam and trazodone both increase sedation. Use Caution/Monitor.loratadineMinor (1)trazodone will decrease the level or effect of loratadine by P-glycoprotein (MDR1) efflux transporter. Minor/Significance Unknown.lorazepamMonitor Closely (1)lorazepam and trazodone both increase sedation. Use Caution/Monitor.lorcaserinSerious - Use Alternative (1)trazodone and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lorlatinibMonitor Closely (1)lorlatinib will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.lormetazepamMonitor Closely (1)lormetazepam and trazodone both increase sedation. Use Caution/Monitor.lornoxicamMonitor Closely (1)trazodone, lornoxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.lovastatinMonitor Closely (1)trazodone will decrease the level or effect of lovastatin by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)trazodone increases levels of lovastatin by unspecified interaction mechanism. Minor/Significance Unknown.loxapineMonitor Closely (1)loxapine and trazodone both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled and trazodone both increase sedation. Use Caution/Monitor.lsdMonitor Closely (1)trazodone and lsd both increase serotonin levels. Modify Therapy/Monitor Closely.lumefantrineMonitor Closely (1)lumefantrine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and lumefantrine both increase QTc interval. Avoid or Use Alternate Drug.lurasidoneMonitor Closely (1)lurasidone, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (2)maprotiline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor. maprotiline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)maprotiline and trazodone both increase QTc interval. Avoid or Use Alternate Drug. trazodone and maprotiline both increase serotonin levels. Avoid or Use Alternate Drug.maravirocMonitor Closely (1)trazodone will decrease the level or effect of maraviroc by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.marijuanaMonitor Closely (2)marijuana will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trazodone and marijuana both increase sedation. Use Caution/Monitor.meclizineMonitor Closely (1)meclizine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.meclofenamateMonitor Closely (1)trazodone, meclofenamate. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.mefenamic acidMonitor Closely (1)trazodone, mefenamic acid. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.melatoninMonitor Closely (1)trazodone and melatonin both increase sedation. Use Caution/Monitor.meloxicamMonitor Closely (1)trazodone, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.meperidineMonitor Closely (1)meperidine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meprobamateMonitor Closely (1)trazodone and meprobamate both increase sedation. Use Caution/Monitor.mestranolMonitor Closely (1)trazodone will decrease the level or effect of mestranol by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Minor (1)mestranol, trazodone. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Estrogens and progestins may decr tricyclic antidepressant effects, while increasing TCA plasma concentration and adverse effects.metaproterenolMonitor Closely (1)trazodone increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, metaproterenol. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.metaxaloneMonitor Closely (1)metaxalone and trazodone both increase sedation. Use Caution/Monitor.metforminMinor (1)trazodone increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.methadoneMonitor Closely (2)trazodone and methadone both increase QTc interval. Modify Therapy/Monitor Closely. methadone and trazodone both increase sedation. Use Caution/Monitor.methamphetamineMonitor Closely (2)trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. trazodone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Significant - Monitor Closely.. methamphetamine increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Comment: Amphetamines may increase the toxicity of serotonin modulators, increasing the risk of serotonin syndrome. .methocarbamolMonitor Closely (1)methocarbamol and trazodone both increase sedation. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylenedioxymethamphetamineMonitor Closely (1)trazodone increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, methylenedioxymethamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.methylphenidateMonitor Closely (1)methylphenidate increases toxicity of trazodone by Other (see comment). Modify Therapy/Monitor Closely. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity.methylprednisoloneMonitor Closely (2)methylprednisolone will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trazodone will decrease the level or effect of methylprednisolone by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.metronidazoleMonitor Closely (1)metronidazole will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.miconazole vaginalMonitor Closely (1)miconazole vaginal will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.midazolamMonitor Closely (1)midazolam and trazodone both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)trazodone will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.midodrineMonitor Closely (1)trazodone increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, midodrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.mifepristoneSerious - Use Alternative (1)mifepristone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.miglitolMinor (1)trazodone increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.milnacipranSerious - Use Alternative (1)milnacipran and trazodone both increase serotonin levels. Avoid or Use Alternate Drug.mipomersenMonitor Closely (1)mipomersen, trazodone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.mirtazapineMonitor Closely (2)trazodone and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely. trazodone and mirtazapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)mirtazapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.mitotaneMonitor Closely (1)mitotane decreases levels of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.modafinilMonitor Closely (1)trazodone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.morphineMonitor Closely (2)trazodone and morphine both increase serotonin levels. Modify Therapy/Monitor Closely. morphine and trazodone both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)trazodone and motherwort both increase sedation. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)trazodone and moxifloxacin both increase QTc interval. Avoid or Use Alternate Drug.moxonidineMonitor Closely (1)trazodone and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)trazodone and nabilone both increase sedation. Use Caution/Monitor.nabumetoneMonitor Closely (1)trazodone, nabumetone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.nafcillinMonitor Closely (1)nafcillin will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine and trazodone both increase sedation. Use Caution/Monitor.naproxenMonitor Closely (1)trazodone, naproxen. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.naratriptanMonitor Closely (1)naratriptan and trazodone both increase serotonin levels. Modify Therapy/Monitor Closely.Minor (1)trazodone, naratriptan. Mechanism: unknown. Minor/Significance Unknown. Risk of weakness, dyspnea, chest pain.nateglinideMinor (1)trazodone increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.nefazodoneSerious - Use Alternative (2)nefazodone and trazodone both increase serotonin levels. Avoid or Use Alternate Drug. nefazodone will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nefopamMonitor Closely (1)nefopam, trazodone. Mechanism: unspecified interaction mechanism. Use Caution/Monitor. Use combination with caution.nelfinavirMonitor Closely (2)nelfinavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trazodone will decrease the level or effect of nelfinavir by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.neomycin POMonitor Closely (1)trazodone will decrease the level or effect of neomycin PO by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.neostigmineMinor (1)neostigmine increases and trazodone decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Minor/Significance Unknown.nevirapineSerious - Use Alternative (1)nevirapine will decrease the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nifedipineMonitor Closely (1)nifedipine will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibMonitor Closely (2)nilotinib will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. trazodone will decrease the level or effect of nilotinib by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.nirmatrelvirMonitor Closely (1)nirmatrelvir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.nirmatrelvir/ritonavirMonitor Closely (1)nirmatrelvir/ritonavir will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adverse reactions of nausea, dizziness, hypotension, and syncope observed following coadministration of trazodone and strong CYP3A4 inhibitors. Consider lower trazodone dose.norepinephrineMonitor Closely (2)trazodone increases effects of norepinephrine by unknown mechanism. Use Caution/Monitor. trazodone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, norepinephrine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.nortriptylineMonitor Closely (2)nortriptyline and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor. nortriptyline and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (2)nortriptyline and trazodone both increase QTc interval. Avoid or Use Alternate Drug. trazodone and nortriptyline both increase serotonin levels. Avoid or Use Alternate Drug.octreotideSerious - Use Alternative (1)trazodone and octreotide both increase QTc interval. Avoid or Use Alternate Drug.octreotide (Antidote)Serious - Use Alternative (1)trazodone and octreotide (Antidote) both increase QTc interval. Avoid or Use Alternate Drug.ofloxacinMonitor Closely (1)trazodone and ofloxacin both increase QTc interval. Modify Therapy/Monitor Closely.olanzapineMonitor Closely (1)olanzapine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)olanzapine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.oliceridineMonitor Closely (2)trazodone will increase the level or effect of oliceridine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. If concomitant use is necessary, may require less frequent oliceridine dosing. Closely monitor for respiratory depression and sedation and titrate subsequent doses accordingly. If inhibitor is