Trazodone's interactions generally fall into a few broad categories. First, serotonergic interactions — combining trazodone with MAOIs, SSRIs, SNRIs, triptans, tramadol, or certain supplements raises serotonin syndrome risk. Second, metabolic interactions — medications that strongly inhibit or induce the CYP3A4 liver enzyme can raise or lower trazodone blood levels. Third, additive sedation — combining trazodone with alcohol, benzodiazepines, opioids, or other sedating substances compounds drowsiness and impairment.
There are also more specific documented interactions, like increased digoxin or phenytoin levels, and cardiac rhythm considerations with other QT-affecting drugs. Explore the full Interaction Library for details on 40+ specific combinations.