Drug interactions
Nelfinavir + Trazodone
Severity: Major
Nelfinavir and Trazodone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Nelfinavir inhibits CYP3A4 and can raise trazodone concentrations, causing excess sedation, hypotension, and QT prolongation or arrhythmia. Trazodone's labelling advises dose reduction with strong CYP3A4 inhibitors.
What this interaction means in plain words
Nelfinavir and Trazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Nelfinavir belongs to Anti Virals; Trazodone belongs to Central Nervous System.
Why it happens
Inhibition of CYP3A4 by nelfinavir reduces trazodone clearance.
What to do
Start with a low trazodone dose and titrate slowly, monitoring for sedation, hypotension and QT prolongation. Consider an ECG, especially with other QT-prolonging drugs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone Contraindicated
Other interactions of Nelfinavir
- Alfuzosin + Nelfinavir Contraindicated
- Avanafil + Nelfinavir Contraindicated
- Dronedarone + Nelfinavir Contraindicated
- Eletriptan + Nelfinavir Contraindicated
- Ergotamine + Nelfinavir Contraindicated
- Flibanserin + Nelfinavir Contraindicated
Frequently asked questions
Can I take Nelfinavir with Trazodone?
MediHelp rates the interaction as major. Nelfinavir and Trazodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Nelfinavir inhibits CYP3A4 and can raise trazodone concentrations, causing excess sedation, hypotension, and QT prolongation or arrhythmia. Trazodone's labelling advises dose reduction with strong CYP3A4 inhibitors.
How serious is the interaction between Nelfinavir and Trazodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with a low trazodone dose and titrate slowly, monitoring for sedation, hypotension and QT prolongation. Consider an ECG, especially with other QT-prolonging drugs.
What other medicines interact with Trazodone?
MediHelp also lists interactions of Trazodone with, for example, Arsenic trioxide, Ibutilide, Isocarboxazid. The full list is on the Trazodone page.
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