Can You Crush Trazodone Pills?
If the tablets are the immediate-release version, yes, they can be crushed.
Can Trazodone be crushed? Thanks for your help!
Jul 21, 2022- Immediate-release trazodone tablets can be crushed safely with no impact on effectiveness or safety, though the main concern is an unpleasant taste. Extended-release trazodone tablets (Oleptro) cannot be crushed or chewed because it would release the entire dose at once and increase side effects. If you need to crush trazodone, talk to your pharmacist first to make sure you have the immediate-release formulation and not the extended-release version.
Answer
Thank you for reaching out!
Trazodone, an oral antidepressant, is available in various formulations, some of which can be crushed.
Immediate-Release Trazodone Tablets
All immediate-release trazodone products (brand name Desyrel) can safely be cut and split (many generic trazodone tablets are scored to facilitate splitting), but there is some conflicting data on whether they can be crushed.
Several sources, including the FDA-approved prescribing information, state that trazodone immediate-release tablets should not be crushed.
However, this restriction appears only to be due to a reported unpleasant taste of the crushed tablets.
Various sources, including a publication in the Journal of Parenteral and Enteral Nutrition, suggest that crushed trazodone tablets dissolve easily and can be used in a feeding tube if necessary, with no safety or efficacy concerns.
Additionally, a well-respected drug compendium, Merative Micromedex, provides information for pharmacists on how to extemporaneously compound trazodone tablets (which involves crushing them) into a liquid (since trazodone liquid is not commercially available). It suggests:
Extemporaneous Formulation - Oral route (100 mL of trazodone hydrochloride 10 mg/mL)
- Grind ten 100-mg tablets to a fine powder in a mortar and pestle.
- Geometrically add cherry syrup to 100 mL. Mix well.
- When packaged in a tight, light-resistant container, the trazodone suspension is stable for up to 30 days.
This formulation is published in the International Journal of Pharmaceutical Compounding. This formulation is also endorsed by the University of Michigan College of Pharmacy.
The use of crushed trazodone tablets in these compounds has not been reported to cause the medication to be any less effective or safe.
Extended-Release Tablets
Trazodone is also available in an extended-release formulation (brand name Oleptro). Oleptro (extended-release trazodone) cannot be crushed or chewed, as doing so would disrupt the extended-release mechanism, potentially releasing the entire dose at once and increasing the risk of side effects.
It's important to highlight that Oleptro can be split once, with tablets scored for this purpose, allowing for half-tablet dosing. While it's uncommon for extended-release tablets to be cut, Oleptro can be split once if necessary (just not crushed or chewed).
To summarize:
- Immediate-release trazodone tablets can safely be cut, crushed, or split.
- Extended-release trazodone tablets (Oleptro) cannot be crushed but can be split once.
Below is additional information regarding trazodone.
What Is Trazodone?
Trazodone is an oral antidepressant medication, unrelated to other antidepressant classes. It is indicated for the treatment of various conditions, including:
- Major depression
- Generalized anxiety disorder (off-label)
- Panic disorder (off-label)
- Insomnia (off-label)
Aside from its antidepressant properties, trazodone also possesses anti-anxiety effects, making it suitable for anxiety disorders and insomnia.
Administration recommendations vary depending on the trazodone formulation:
Immediate-release tablets:
- Take one dose after a meal or snack to reduce the risk of nausea. Taking on an empty stomach may increase lightheadedness or dizziness.
- If drowsiness occurs, take a larger portion of your daily dose at bedtime.
Extended-release tablets (Oleptro):
- Take one dose at the same time every day in the late evening or at bedtime, on an empty stomach.
- Oleptro tablets should not be crushed or chewed. Tablets may be broken in half one time along the scoreline.
References & sources
Glossary — Terms in This Answer
- Antidepressant
- A medication used to treat depression and certain other mental health conditions by affecting brain chemistry.
- Immediate-Release
- A medication formulation that releases the drug quickly into the bloodstream after you take it.
- Extended-Release
- A medication formulation designed to release the drug slowly over many hours to maintain steady levels in your body.
- Extemporaneous Compounding
- The process of a pharmacist preparing a custom medication mixture by hand, typically when a commercial product is unavailable.
- Suspension
- A liquid medication in which solid particles are mixed throughout but not fully dissolved.
- Off-label
- The use of a medication to treat a condition or patient group that the FDA has not officially approved it for.
- Dosing
- The amount and frequency at which a medication should be taken.
- Efficacy
- The ability of a medication to produce the desired therapeutic effect.