Trazodone with Foxglove Interaction Details
Brand Names Associated with Trazodone
- Desyrel®
- Oleptro®
- Trazodone
- Trialodine®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 11, 2023
Interaction Effect
Increased risk of digitalis toxicity
Interaction Summary
A single case report documents digoxin toxicity resulting from traZODone administration. Theoretically, foxglove may be similarly affected by traZODone due to its similarity to digoxin.
Severity
Moderate
Onset
Delayed
Evidence
Probable
How To Manage Interaction
Avoid concomitant use of foxglove and traZODone. It is possible that even intermittent traZODone doses will affect foxglove clearance (i.e., delayed excretion predisposing the patient to digitalis toxicity). Patients who choose to combine foxglove with traZODone should be advised to monitor closely for signs and symptoms of toxicity (e.g., nausea, vomiting, drowsiness, changes in vision, dizziness, muscle weakness, hallucinations).
Mechanism Of Interaction
Not specified
Literature Reports
A) traZODone added to a previously stable dose of digoxin resulted in a toxic digoxin level within 14 days. A 68-year-old woman with a 30-year history of unipolar affective illness was admitted for inpatient psychiatric service. Medical history was significant for congestive heart failure, hypertension, atrial tachyarrhythmias, and impaired renal function presumed secondary to hypertensive nephropathy. She was stabilized on digoxin (125 mcg/day) and quinidine with achievement of therapeutic blood levels for each drug. Digoxin level on admission was 0.8 ng/mL (therapeutic range 1.2 to 1.7 ng/mL) and quinidine level was 4.0 mcg/mL (therapeutic range 1.5 to 5.0 mcg/mL). TraZODone 50 mg at bedtime was begun and increased in 50 mg increments every other day until 300 mg/day was reached on Day 11. On Day 14 she complained of nausea and vomiting. A digoxin level was toxic at 2.8 ng/mL. The quinidine level remained within therapeutic limits at 1.6 mcg/mL. With digoxin discontinuation, the nausea and vomiting resolved within 3 days. She continued traZODone 300 mg daily. Digoxin was resumed at 125 mcg every other day resulting in therapeutic levels .
Trazodone Overview
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Trazodone is used to treat depression. Trazodone is in a class of medications called serotonin modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.