Drug interactions
Nirmatrelvir + Trazodone
Severity: Major
Nirmatrelvir 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
Nirmatrelvir inhibits CYP3A4 strongly (as a booster-containing regimen) and can markedly raise trazodone levels. This may cause sedation, hypotension, syncope, nausea and QT prolongation.
What this interaction means in plain words
Nirmatrelvir 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.
Nirmatrelvir belongs to Anti Virals; Trazodone belongs to Central Nervous System.
Why it happens
Strong inhibition of CYP3A4-mediated trazodone metabolism.
What to do
Consider reducing the trazodone dose during the short antiviral course and monitor for sedation and hypotension. Return to the usual dose after treatment ends.
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 Nirmatrelvir
- Alfuzosin + Nirmatrelvir Contraindicated
- Amiodarone + Nirmatrelvir Contraindicated
- Apalutamide + Nirmatrelvir Contraindicated
- Carbamazepine + Nirmatrelvir Contraindicated
- Colchicine + Nirmatrelvir Contraindicated
- Dronedarone + Nirmatrelvir Contraindicated
Frequently asked questions
Can I take Nirmatrelvir with Trazodone?
MediHelp rates the interaction as major. Nirmatrelvir 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. Nirmatrelvir inhibits CYP3A4 strongly (as a booster-containing regimen) and can markedly raise trazodone levels. This may cause sedation, hypotension, syncope, nausea and QT prolongation.
How serious is the interaction between Nirmatrelvir 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: Consider reducing the trazodone dose during the short antiviral course and monitor for sedation and hypotension. Return to the usual dose after treatment ends.
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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