Generic Name: Nefazodone Brand Name(s): Generics only. No brands available.

Uses

What is Nefazodone used for?

Nefazodone is used to treat depression. Because of the risk of liver disease, this medication is usually used after trying other drugs. Nefazodone works by helping to restore the balance of certain natural chemicals (neurotransmitters such as serotonin, norepinephrine) in the brain.

How should I take Nefazodone?

Take this medication by mouth with or without food, usually twice daily or as directed by your doctor.

Dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may start you at a low dose and gradually increase your dose.

Take this medication exactly as prescribed. Do not increase your dose or take this medication more often than prescribed. Your condition will not improve any faster, and the risk of serious side effects may be increased.

Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day.

It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without consulting your doctor.

It may take several weeks before this drug takes effect. Tell your doctor if your condition persists or worsens.

How do I store Nefazodone?

Nefazodone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Nefazodone in the bathroom or the freezer. There may be different brands of Nefazodone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Nefazodone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Nefazodone?

Before taking nefazodone, tell your doctor or pharmacist if you are allergic to it; or to trazodone; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, personal or family history of psychiatric disorder (e.g., bipolar/manic-depressive disorder), personal or family history of suicide attempts, heart/blood vessel disease (e.g., history of stroke/heart attack), loss of too much body water (dehydration), seizures, intestinal ulcers/bleeding (peptic ulcer disease), personal or family history of glaucoma (angle-closure type).

Before having surgery, tell your doctor or dentist that you are using this medication.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana. Alcohol may also cause liver disease.

Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially dizziness/drowsiness or bleeding.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Since untreated mental/mood problems (such as depression) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Nefazodone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Nefazodone. Nefazodone is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Nefazodone?

Dizziness, drowsiness, lightheadedness, nausea, dry mouth, or constipation may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: confusion, weakness, fainting, seizures, easy bleeding/bruising.

Get medical help right away if you have any very serious side effects, including: black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).

For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Nefazodone?

Some products that may interact with this drug include: carbamazepine, eplerenone, ergot alkaloids (such as dihydroergotamine, ergonovine, ergotamine, methylergonovine), ivabradine, lurasidone, pimozide, triazolam, alpha blockers (e.g., terazosin), digoxin, fluoxetine, medications for high blood pressure, other antidepressants (e.g., trazodone, SSRIs such as fluoxetine), other drugs that can cause bleeding/bruising (e.g., anticoagulants such as heparin or warfarin, antiplatelet drugs including NSAIDs such as ibuprofen).

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and 1 week after treatment with this medication. Ask your doctor when to start or stop taking this medication.

Avoid taking eletriptan within 72 hours of taking this medication.

This medication can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include buspirone, dasatinib, domperidone, fentanyl, regorafenib, sunitinib, tacrolimus, “statin” cholesterol drugs (such as simvastatin, lovastatin, atorvastatin), certain benzodiazepines (such as alprazolam) among others.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana, drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as aspirin, ibuprofen, naproxen) that may increase your risk for bleeding if taken together with this drug. Low-dose aspirin should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention (usually at dosages of 81-325 milligrams per day). Consult your doctor or pharmacist for more details.

Nefazodone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Nefazodone?

Nefazodone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Nefazodone?

Nefazodone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Nefazodone.

What is the dose of Nefazodone for an adult?

Usual Adult Dose for Depression

Initial dose: 200 mg orally per day in two divided doses

Maintenance dose: 300 to 600 mg orally per day

Comments:

-Dose increases should occur in increments of 100 mg per day to 200 mg per day, on a 2 times a day schedule, and at intervals of no less than 1 week.

-Several weeks may be required for full effect.

-Patients in long-term studies were followed for up to 52 weeks; patients receiving prolonged treatment should be periodically assessed for usefulness.

Use: Treatment of depression, including major depressive disorder

Usual Geriatric Dose for Depression

Elderly or debilitated patients:

-Initial dose: 100 mg orally per day administered in two divided doses

-Maintenance dose: Up to 300 to 600 mg orally per day

Comments:

-Since these patients often have reduced drug clearance and/or increased sensitivity to the side effects, it may be appropriate to modify the rate of subsequent dose titration.

-Several weeks may be required for full effect.

-Patients in long-term studies were followed for up to 52 weeks; patients receiving prolonged treatment should be periodically assessed for usefulness.

Use: Treatment of depression, including major depressive disorder

Liver Dose Adjustments

Patients with evidence of liver injury: Contraindicated

This drug should be discontinued and not restarted if patients develop signs of liver dysfunction (AST or ALT greater than or equal to 3 times the upper limit of normal [3x ULN]).

Dose Adjustments

Use with an MAOI:

-Starting this drug: Allow at least 14 days after stopping an MAOI to start this drug.

-Stopping this drug: Allow at least 7 days after stopping this drug to start an MAOI.

Dose adjustments may be required on the basis of clinical response when this drug is coadministered with buspirone, propanolol, and desipramine.

Use with Triazolam:

-Coadministration should be avoided for most patients.

-If use is deemed necessary AND if the dosage form of triazolam permits sufficient dosage reduction, providers should consider reducing the initial triazolam dose by 75%.

Dialysis

Dialysis is not expected to remove this drug.

Other Comments

Storage requirements:

-Protect from light.

General:

-Prescribers should consider the risk of hepatic failure associated with this drug prior to starting treatment.

-Major depressive disorder includes a prominent and relatively persistent depressed/dysphoric mood that typically interferes with daily functioning nearly every day for at least 2 weeks AND at least 5 of the following: depressed mood, loss of interest in usual activities, significant weight/appetite changes, insomnia/hypersomnia, psychomotor agitation/retardation, increased fatigue, feelings of guilt/worthlessness, slowed thinking/impaired concentration, a suicide attempt, or suicidal ideation.

Monitoring:

-Hepatic: Serum transaminases, signs/symptoms of liver dysfunction

-Psychiatric: Suicidal thoughts and behaviors

Patient advice:

-Patients should be cautioned accordingly since this drug may impair the mental and/or physical abilities required for the performance of operating an automobile or machinery.

-Patients should be instructed to avoid abrupt discontinuation of treatment.

-Patients should be advised to immediately report any signs/symptoms of liver dysfunction, allergic reactions, visual disturbances, or new/worsening depression or suicidality.

-Patients and caregivers should be told to avoid alcohol during treatment. A healthcare provider should be consulted prior to talking or planning on taking additional medications concomitantly.

-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

What is the dose of Nefazodone for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Nefazodone available?

Nefazodone is available in the following dosage forms and strengths:

  • Oral tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Nefazodone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 5, 2018 | Last Modified: April 5, 2018

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