Mental Health Home > Precautions and Warnings With Trazodone ER

You may not be able to use trazodone ER if you have certain medical conditions, such as heart disease, low blood pressure, or bipolar disorder. Being aware of these and other precautions and warnings with trazodone ER can help ensure a safe treatment process, so make sure your healthcare provider has a list of all medications you are taking and any medical conditions you have.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking trazodone ER (Oleptro™) if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Trazodone ER Warnings and Precautions

Some warnings and precautions to be aware of prior to taking this drug include the following:
  • Antidepressants may increase the risk of suicidal thoughts or behavior in children, teenagers, and young adults (see Antidepressants and Suicide for more information). Therefore, if you notice any worsening in depression symptoms or new symptoms, talk to your healthcare provider (or your child's healthcare provider) immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thoughts or behavior.
  • Taking trazodone ER with other medications that affect serotonin can increase your risk of a dangerous group of symptoms called serotonin syndrome. These other medications include other antidepressants, triptans (migraine medications), and several other medications (see Drug Interactions With Trazodone ER for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
    • Confusion or other mental changes
    • A rapid heart rate
    • Nausea
    • Vomiting
    • Diarrhea
    • Hallucinations
    • Blood pressure changes
    • Overactive reflexes
    • Fever
    • Shivering
    • Shakiness
    • Agitation
    • Sweating
    • Seizures
    • Coma.
  • Trazodone ER can cause low blood pressure (hypotension). This may be more common if you are also taking other medications, especially high blood pressure medication. Tell your healthcare provider if you have symptoms of low blood pressure, including lightheadedness, dizziness, or fainting.
  • Trazodone ER can cause priapism, a painful erection of the penis that does not go away. Even though it may seem embarrassing, seek medical attention right away if you experience priapism, as it can cause permanent damage to the penis.
  • Trazodone ER should not be used right after a heart attack. Also, there is some evidence that this medication can cause irregular heart rhythms (arrhythmias) in people with heart disease.
  • Trazodone ER can cause a change in the heart rhythm known as QT prolongation. This could potentially cause serious problems, especially for people who genetically already have a long QT interval (a condition known as long QT syndrome) or for people with electrolyte disturbances, especially low potassium or low magnesium levels in the blood.
  • Trazodone ER can cause low salt levels in the blood (hyponatremia). This is most likely to occur in elderly people or people who are dehydrated. This generally returns to normal when trazodone ER is discontinued, but it can be serious in severe cases. Signs of hyponatremia include:
    • Headaches
    • Difficulty concentrating, memory problems, or confusion
    • Unsteadiness or falling
    • Hallucinations
    • Fainting
    • Seizures
    • Coma.
  • Trazodone ER can increase the risk of bleeding, including dangerous internal bleeding. Check with your healthcare provider before taking this medicine if you have a bleeding disorder or if you take an anticoagulant ("blood-thinning") medication (see Drug Interactions With Trazodone ER for more information).
  • Trazodone ER can increase the risk of mania (often noticed as an extreme increase in activity and talking), especially in people with a history of mood disorders such as bipolar disorder. Make sure your healthcare provider knows your full mental health history before you take this drug.
  • Trazodone ER is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk to your healthcare provider about the risks and benefits of using this medication during pregnancy (see Oleptro and Pregnancy for more information).
  • Trazodone ER passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, make sure to talk with your healthcare provider before taking this drug (see Oleptro and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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