Does trazodone interact with Plavix? (7+ tips)

In this article, we will discuss whether trazodone can interact with Plavix, what the potential risk of taking trazodone and Plavix together is, what research suggests, what to do if you have taken trazodone and Plavix together, and what the alternative is to taking trazodone with Plavix.

Does trazodone interact with Plavix?

Yes, trazodone can interact with Plavix when used together. Trazodone is generally considered safe and belongs to the class of drugs known as serotonin-antagonist and reuptake inhibitors (SARI), which affect the balance of serotonin in the brain. It is an FDA-approved drug for the treatment of major depressive disorders. (1)

Plavix is an antiplatelet drug and is used in the treatment of recent myocardial infarction, stroke, acute coronary syndrome, etc. The combination of trazodone and Plavix should not be used together. However, individual responses to trazodone and Plavix can differ; not everyone will experience bleeding. (2)

What is the potential interaction between trazodone and Plavix?

Trazodone and Plavix, when taken together, can cause unusual bleeding. Trazodone-induced bleeding is believed to be related to increased serotonin. Trazodone increases serotonin levels by inhibiting the serotonin transporter and serotonin type-2 receptors, interfering with normal blood clotting.

The risk of bleeding increases severalfold with the concomitant use of Plavix, which is an antiplatelet drug that inhibits platelet aggregation. (2)

What does research suggest?

Research on the bleeding risk with the combined use of trazodone and Plavix suggests that trazodone is among those antidepressants that have the highest risk of gastrointestinal bleeding, and with the concomitant use of antiplatelet drugs, e.g., Plavix, this risk increases by many folds. (3)

A meta-analysis on the use of serotonergic antidepressants in patients who are on anticoagulant or antiplatelet therapy concluded that patients using serotonergic antidepressants, e.g., trazodone and antiplatelet drugs, e.g., Plavix, together, are at a higher risk of gastrointestinal bleeding. (4)

A combination of trazodone and Plavix can be life-threatening and should be used with extreme caution.

What to do if you have taken trazodone with Plavix?

If you have taken trazodone with Plavix and are concerned about the potential risk of bleeding, it is crucial to contact your healthcare provider or emergency services to discuss your situation. Be prepared to provide information about the doses of each medication, the timing of ingestion, and any symptoms you may be experiencing.

Your doctor will closely monitor your situation and will be prepared for any emergency. You should never self-diagnose or change your medication regimen without consulting a healthcare professional.

What is the alternative to taking trazodone and Plavix together?

Your doctor will switch you to other antidepressants to avoid the interaction between trazodone and Plavix. Antidepressants that have a different side effect profile than trazodone and do not cause unusual bleeding are agomelatine, bupropion, mirtazapine, etc. (5)

Your doctor will closely monitor you for signs of bleeding if you are in a high-risk group. Your doctor will guide you according to your needs to make treatment more comfortable for you.

How to ensure safe and effective use of trazodone and Plavix?

To ensure the safe and effective use of trazodone and Plavix, follow these guidelines:

  • Open communication: Inform your healthcare provider about all the medications, including prescription drugs, OTC drugs, and supplements, that you are taking. Discuss your allergies and previous adverse reactions to medications to avoid any emergencies.

 

  • Careful monitoring: Regularly visit your healthcare provider to monitor your overall health and assess the safety of the prescribed medications. Be vigilant for any unwanted symptoms and report them to your healthcare provider.

 

  • Follow the medication instructions: Follow the prescribed dosage for both trazodone and Plavix. Do not change your dose or stop taking either medication without consulting your healthcare provider.

 

  • Awareness of potential interactions: Be aware of potential drug interactions, especially if you are taking multiple medications. Inform your healthcare provider about any changes in your medication, including adding new medications.

 

  • Dietary considerations: Ask about any foods that you may need to avoid, especially if you are taking Plavix, as certain foods may interact with antiplatelet medications. For example, grapefruit juice. (6)

 

  • Avoid alcohol: Avoid alcohol consumption, as it may interact with trazodone and can increase the risk of side effects. Avoid recreational drugs, as they can have unpredictable interactions with prescribed medications. (7)

 

  • Monitoring for side effects: Be vigilant for potential side effects of both medications. For example, Plavix may increase the risk of bleeding, and trazodone may increase bleeding too. Report any unusual or severe side effects to your healthcare provider immediately.

 

  • Emergency preparedness: Be aware of signs of serious side effects or medical emergencies related to either medication, such as severe bleeding, difficulty breathing, or chest pain. Seek immediate medical attention if any such symptoms occur.

 

According to my knowledge and research on the topic, the concomitant use of trazodone and Plavix can increase bleeding risk in patients and can be fatal. It is crucial for individuals to communicate openly with their healthcare providers about all the medications, supplements, and OTC drugs they are taking to avoid any emergency situation.

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References

1.-

Shin JJ, Saadabadi A. Trazodone. [Updated 2022 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470560/

2.-

PLAVIX (Clopidogrel bisulfate), a prescribing guide by The U.S. Food and Drug Administration, Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020839s044lbl.pdf

3.-

DESYREL (Trazodone hydrochloride), a prescribing guide by The U.S. Food and Drug Administration, Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018207s032lbl.pdf

4.-

Nochaiwong S, Ruengorn C, Awiphan R, Chai-Adisaksopha C, Tantraworasin A, Phosuya C, Kanjanarat P, Chongruksut W, Sood MM, Thavorn K. Use of serotonin reuptake inhibitor antidepressants and the risk of bleeding complications in patients on anticoagulant or antiplatelet agents: a systematic review and meta-analysis. Ann Med. 2022 Dec;54(1):80-97. doi: 10.1080/07853890.2021.2017474. PMID: 34955074; PMCID: PMC8725830. https://pubmed.ncbi.nlm.nih.gov/34955074/

5.-

Aguiar, J Drug Metab Toxicol 2016, Treatment of Depression in Patients on Anticoagulation Therapy: Antidepressant-Rivaroxaban Drug Interactions, Available from: https://www.longdom.org/open-access/treatment-of-depression-in-patients-on-anticoagulation-therapyantidepressantrivaroxaban-drug-interactions-2157-7609-1000215.pdf

6.-

Bailey, D. G. (2013). Grapefruit juice and clopidogrel. CMAJ : Canadian Medical Association Journal, 185(12), 1066. https://doi.org/10.1503/cmaj.113-2127

7.-

Ge PX, Jiang LP, Tai T, Zhu T, Ji JZ, Li YF, Mi QY, Xie HG. Short-term standard alcohol consumption enhances platelet response to clopidogrel through inhibition of Nrf2/Ces1 pathway and induction of Cyp2c in mice. Life Sci. 2021 Aug 15;279:119268. doi: 10.1016/j.lfs.2021.119268. Epub 2021 Feb 21. PMID: 33626394. https://pubmed.ncbi.nlm.nih.gov/33626394/

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