What are the common side effects of trazodone? How does trazodone interact with other medications? What are the dosing guidelines for trazodone oral? Get the answers to these and other key questions about this antidepressant medication.

Understanding Trazodone Oral

Trazodone is an antidepressant medication that belongs to the class of drugs known as serotonin modulators. It is primarily used to treat depression, but may also be prescribed off-label for other conditions, such as insomnia, anxiety, and certain types of chronic pain.

Common Side Effects of Trazodone

Like any medication, trazodone can cause a variety of side effects. Some of the most commonly reported side effects include:

• Nausea, vomiting, or diarrhea
• Drowsiness, dizziness, or tiredness
• Blurred vision
• Changes in weight
• Headache or muscle aches
• Dry mouth or a bad taste in the mouth
• Stuffy nose or constipation
• Changes in sexual interest or ability

If any of these side effects persist or worsen, it’s important to inform your doctor or pharmacist.

Managing Dry Mouth and Dizziness

Dry mouth, a common side effect of trazodone, can be managed by sucking on sugar-free hard candy, chewing sugar-free gum, drinking water, or using a saliva substitute. To reduce the risk of dizziness and lightheadedness, it’s recommended to get up slowly when rising from a sitting or lying position.

Serious Side Effects to Report

While most side effects of trazodone are mild, there are some more serious side effects that require immediate medical attention, such as:

• Shaking or tremors
• Nightmares or ringing in the ears
• Problems urinating or blood in the urine
• Signs of infection, such as fever or persistent sore throat
• Shortness of breath or abdominal pain
• Chest pain, irregular heartbeat, or fainting
• Seizures or changes in vision

If you experience any of these serious side effects, seek medical attention immediately.

Serotonin Syndrome

Trazodone can potentially increase serotonin levels, which in rare cases can lead to a condition called serotonin syndrome. Symptoms of serotonin syndrome include:

• Rapid heartbeat
• Hallucinations
• Loss of coordination
• Severe dizziness, nausea, vomiting, or diarrhea
• Muscle twitching
• Unexplained fever or agitation

If you develop any of these symptoms, seek medical help right away, as serotonin syndrome can be a life-threatening condition.

Priapism

In very rare cases, trazodone can cause a painful and prolonged erection known as priapism. If this occurs, you should stop taking the medication and seek immediate medical attention, as priapism can lead to permanent damage if left untreated.

Interactions and Warnings

Trazodone can interact with a variety of other medications, including other antidepressants, blood thinners, and certain antibiotics. It’s important to inform your doctor about all the medications you are currently taking, including over-the-counter drugs and supplements.

Trazodone is generally not recommended for use in children and adolescents under the age of 18, as the risks may outweigh the benefits in this population. However, in some cases, a healthcare provider may determine that trazodone is the best medication to treat a child’s specific condition.

It’s also important to be aware that your mental health may change in unexpected ways when taking trazodone, even if you are an adult. You, your family, or your caregiver should contact your doctor immediately if you experience any new or worsening symptoms of depression, suicidal thoughts or behavior, or other significant changes in mood or behavior.

Dosing and Administration

Trazodone is typically taken once or twice daily, with or without food. The recommended starting dose is usually 150 mg per day, which may be gradually increased as needed and tolerated, up to a maximum dose of 400 mg per day.

It’s important to follow your healthcare provider’s instructions carefully and not to suddenly stop taking trazodone, as this can lead to withdrawal symptoms. If you need to discontinue the medication, your doctor will likely recommend tapering the dose gradually to minimize any potential side effects.

Trazodone Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

See also the Warning section.

Nausea, vomiting, diarrhea, drowsiness, dizziness, tiredness, blurred vision, changes in weight, headache, muscle ache/pain, dry mouth, bad taste in the mouth, stuffy nose, constipation, or change in sexual interest/ability may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

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

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

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 you have any serious side effects, including: shaking (tremors), nightmares, ringing in the ears, problems urinating, blood in urine, signs of infection (e.g., fever, persistent sore throat), shortness of breath, stomach/abdominal pain.

Get medical help right away if you have any very serious side effects, including: chest/jaw/left arm pain, fainting, fast/irregular heartbeat, seizures, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

For males, in the very unlikely event you have a painful or prolonged erection (priapism) 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.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Trazodone: MedlinePlus Drug Information

A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as trazodone during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take trazodone, but in some cases, a doctor may decide that trazodone is the best medication to treat a child’s condition.

You should know that your mental health may change in unexpected ways when you take trazodone or other antidepressants even if you are an adult over age 24. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor when you are unable to seek treatment on your own.

Your healthcare provider will want to see you often while you are taking trazodone, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.

The doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with trazodone. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm.

No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.

Trazodone (Oral Route) Side Effects

Side Effects

Drug information provided by: IBM Micromedex

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

1. 
   Blurred vision
2. 
   confusion
3. 
   dizziness
4. 
   dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
5. 
   lightheadedness
6. 
   sweating
7. 
   unusual tiredness or weakness

Less common

1. 
   Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
2. 
   confusion about identity, place, and time
3. 
   decreased concentration
4. 
   fainting
5. 
   general feeling of discomfort or illness
6. 
   headache
7. 
   lack of coordination
8. 
   muscle tremors
9. 
   nervousness
10. 
    pounding in the ears
11. 
    shortness of breath
12. 
    slow or fast heartbeat
13. 
    swelling

Rare

1. 
   Skin rash
2. 
   unusual excitement

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

1. 
   Dry mouth (usually mild)
2. 
   muscle or bone pain
3. 
   trouble sleeping
4. 
   trouble with remembering
5. 
   unpleasant taste

Less common

1. 
   Constipation
2. 
   continuing ringing or buzzing or other unexplained noise in the ears
3. 
   diarrhea
4. 
   hearing loss
5. 
   muscle aches or pains
6. 
   weight loss

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.

.

Trazodone Potential Side Effects

Trazodone is an antidepressant sometimes used in treating depressive symptoms in bipolar disorder. It is also often prescribed to treat insomnia across a broad variety of psychiatric illnesses.

It is also used off-label to treat aggressive behavior in dementia. Trazodone was originally solid under the brand name is Desyrel; there is also an extended-release form sold under the brand name Oleptro.

Common Side Effects

These common side effects of trazodone may lessen or stop altogether once your body gets used to the medication. Check with your doctor if any of the following side effects don’t go away or are bothersome:

• Back pain
• Blurred vision
• Constipation
• Diarrhea
• Dizziness or lightheadedness
• Drowsiness
• Dry mouth
• Fatigue
• Headache
• Nausea

Trazodone’s sedating effect is so common that the drug is prescribed for sleep problems. Consequently, do not engage in potentially hazardous activities, including driving, until you know how this drug affects you.

Less Common Side Effects

Always notify your doctor as soon as possible if you experience any of these less common side effects.

• Abdominal pain
• Abnormal gait
• Agitation
• Amnesia
• Bladder pain or incontinence
• Confusion
• Disorientation
• Fainting (syncope)
• Fast or slow heartbeat
• Flushing (skin becoming red and warm)
• Hearing problems
• Migraine
• Muscle aches
• Muscle tremors
• Muscle twitching
• Night sweats
• Problems with coordination or memory
• Sensitivity to light
• Shortness of breath
• Skin rash
• Speech problems
• Tingling
• Tinnitus
• Unusual excitement
• Urgent need to urinate
• Visual disturbance
• Vomiting

When to Seek Medical Attention

In addition to the above unusual side effects requiring a medical evaluation, painful, prolonged erection of the penis can occur after taking trazodone. Stop taking this medicine and seek emergency medical attention if this happens. This condition, called priapism, can result in permanent damage to erectile tissues if not treated promptly.

Other Rare But Serious Side Effects

Seek medical help immediately if you or a loved one experiences symptoms of these conditions:

• Serotonin syndrome, a serious, potentially life-threatening illness caused by too much serotonin in the body
• Hyponatremia, a low concentration of sodium in the blood

Black Box Warning

Like all antidepressants, trazodone is required to carry a warning regarding the increased possibility of suicidal thinking or behavior in young adults (24 and under), adolescents, and children. Talk to your doctor right away if you or a family member is experiencing suicidal thoughts.

Signs of Overdose

Call your doctor or a poison control center immediately if you or a loved one have potentially overdosed on trazodone. Symptoms of overdose can include:

• Drowsiness
• Loss of muscle coordination
• Nausea and vomiting
• Painful erection that does not go away
• Respiratory arrest
• Seizures
• Slower or faster heartbeat

Withdrawal Symptoms

As with other antidepressants, it’s important to not discontinue trazodone without your doctor’s approval and guidance. You will likely be put on a tapering schedule so that the medication has a chance to gradually work its way out of your system, decreasing your risk for unpleasant effects. Withdrawal symptoms that may occur, especially if you stop using trazodone suddenly, include:

• Anxiety
• Agitation
• Sleep disturbances

Trazodone (Desyrel) – Side Effects, Interactions, Uses, Dosage, Warnings

You should not use trazodone if you are allergic to it.

Do not use trazodone if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

After you stop taking trazodone, you must wait at least 14 days before you start taking an MAOI.

Tell your doctor if you have ever had:

• liver or kidney disease;
• heart disease, or a recent heart attack;
• a bleeding or blood clotting disorder;
• seizures or epilepsy;
• narrow-angle glaucoma;
• long QT syndrome;
• drug addiction or suicidal thoughts; or
• bipolar disorder (manic depression).

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with trazodone and cause a serious condition called serotonin syndrome.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Ask your doctor about taking this medicine if you are pregnant. It is not known whether trazodone will harm an unborn baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor’s advice.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of trazodone on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Trazodone is not approved for use by anyone younger than 18 years old.

Trazodone: Antidepressant, Sleeping Pill or Both?

What is trazodone?

Trazodone was developed in Italy in the 1960s as an antidepressant medication. Due to negative side effects associated with the drug early on—including dizziness, fainting, irregular heartbeat (and in rare cases, priapism in men)—the antidepressant wasn’t widely favored in the medical community. Eventually, however, internists and clinicians recognized potential benefits of the drug, particularly when administered at low doses. In 1981, trazodone (the generic name of the pharmaceutical) was approved by the U.S. Food and Drug Administration (FDA) under the brand name Desyrel for use in treating major depressive disorder. Today, the medication is prescribed under the brand name Oleptro to treat sleep disorders such as insomnia as well as anxiety disorder and unipolar depression.

Does trazodone cause sleepiness?

For many patients, the drug has a sedative effect, inducing a relaxed, sleepy feeling. In prescribing the drug for sleep disorders, physicians typically recommend taking a low dose at bedtime in order to limit the effects of drowsiness. Still, some people report lingering effects, including sluggishness and feeling zapped of energy, particularly upon waking.

How does trazodone help to alleviate depression?

Trazodone increases natural neurotransmitters in the central nervous system, essentially restoring depleted chemicals in the brain. One of these important neurotransmitters—serotonin—regulates our internal clock for resting and being awake, as well as mood, appetite, digestion, memory, sexual function and desire. Many experts believe depression involves an imbalance among the brain’s neurotransmitters (acetylcholine, norepinephrine, dopamine and serotonin.) While the cause of depression is not fully understood, trazodone affects the brain’s neurotransmitters by inhibiting the uptake of serotonin by nerves and stimulating other nerves.

How quickly does the drug take effect?

Patients who take the drug for a sleep disorder can experience the sedative effects within 30 minutes, depending on the type used. Patients who take the drug as an antidepressant may not notice symptom relief for one to two weeks, and it may take up to four weeks to experience the full benefits.

Is it safe to take trazodone to treat depression?

Like all medications, trazodone can cause side effects in some people. Ask your physician to discuss all potential side effects as well as drug interactions and potential withdrawal symptoms associated with the medication.

Do all antidepressant drugs work the same way?

While all antidepressant medications are designed to affect brain chemistry, various pharmaceutical formulations of the drugs have different targets and paths. The most commonly prescribed antidepressants are reuptake inhibitors. Reuptake, as described by WebMD, is “the process in which neurotransmitters are naturally reabsorbed back into nerve cells in the brain after they are released to send messages between nerve cells.” A reuptake inhibitor, then, keeps levels of neurotransmitters in the gap between nerves, potentially strengthening circuits in the brain that regulate mood. There are three different types: selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and norepinephrine and dopamine reuptake inhibitors (NDRIs). Common SSRIs are Prozac, Zoloft, Paxil, Lexapro, Celexa and Luvox; common SNRIs include Cymbalta and Effexor; and NDRIs are found in only one drug: Wellbutrin.

Because trazodone doesn’t fall under any of these categories, it’s often referred to as an “atypical antidepressant.”

Is it safe to take trazodone for insomnia?

Although trazodone was designed to treat depression and anxiety disorders, the medication is now widely prescribed as a nighttime sleep aid for patients who suffer from acute insomnia.

How is trazodone different from other “sleeping pill” drugs?

Trazodone differs from Ambien, Sonata, Lunesta and other “sleeping pill” medications in a few ways:

• Both Ambien and Lunesta are classified by the FDA as controlled substances because they have the potential for misuse and abuse, including dependence or addiction
• Because trazodone is not a controlled substance, physicians aren’t limited in how many pills they can prescribe
• It’s an inexpensive generic drug covered by most insurance companies
• It’s not considered to be an addictive substance when used as prescribed

Trazodone should not be taken by pregnant women or women who are breastfeeding. 

What risks are associated with taking trazodone to treat depression?

There are heightened risks for patients under age 24, particularly with regard to mental health. According to Medline Plus, the following side effects and symptoms can occur among patients under age 24: “new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement.” If any of these symptoms or side effects are experienced, it’s crucial to consult a physician or medical professional immediately.

It’s also imperative that patients know what to avoid while taking SSRIs, SNRIs or other antidepressants. Whether a person has a cold, is having trouble sleeping or is searching for allergy relief, they should talk to their doctor before self-treating with an over-the-counter medication. According to Psychiatry Advisor, one patient who was taking melatonin for insomnia while also prescribed an SSRI woke up with a “headache, dizziness and feeling like his face was on fire”—signs of elevated blood pressure that could have been severe had he taken higher doses. Taking an antidepressant medication in combination with supplements, such as St. John’s wort or aspirin, can increase the likelihood of upper gastrointestinal bleeding. To avoid adverse drug reactions, experts advise making a list of all medications, supplements and other OTC drugs, and sharing it with your physician prior to taking trazodone.

Is it safe to use trazodone with alcohol or other drugs?

Absolutely not. Since both alcohol and trazodone affect the central nervous system, the consequences of mixing the two can be deadly. And mixing the medication with drugs of abuse can result in the onset of serotonin syndrome, a potentially lethal adverse drug reaction. While the potential for trazodone abuse is fairly low, any amount over 600 mg. in 24 hours is an overdose.

What happens if you take too much trazodone? Can it cause serotonin syndrome?

Serotonin syndrome occurs when, according to Mayo Clinic, “high levels of serotonin accumulate in the body.” This is a drug-to-drug interaction involving the over-stimulation of central and peripheral receptors. According to the journal U.S. Pharmacist, “Serotonin syndrome (SS) is caused most often when certain antidepressant agents are taken concurrently with other drugs that modulate synaptic serotonin levels. When patients take two or more antidepressants from different pharmacologic classes, drug-drug interactions may occur; these interactions may lead to potentially severe serotonin toxicity, or serotonin syndrome.” Clinical symptoms of serotonin syndrome can develop within two hours—or up to 24 hours—after taking an increased dose or adding another serotonergic drug.

Signs and symptoms of serotonin syndrome:

• Tremors
• Muscle aches
• Sweating
• Anxiety
• Confusion
• Tachycardia
• Delirium
• Hallucinations
• Seizures
• Renal failure
• Death

What are the side effects of trazodone?

Trazodone usage can cause a decrease in sodium levels in the body, a disruption of the nervous system or serotonin syndrome. The most common side effects include:

• Drowsiness (including feeling groggy the next day)
• Dizziness (including an increased risk of fainting/falling)
• Dry mouth
• Constipation
• Headache
• Fatigue
• Tingling or numbness in hands, arms or legs
• Blurred vision
• Disorientation
• Vertigo
• Nasal congestion
• Shaking
• Anxiety
• Muscle aches
• Prolonged and painful erections lasting longer than six hours (priapism) 
• Abnormally low blood pressure
• Heart rhythm disorders 
• Increased risk of suicidal thoughts and behavior in children and adolescents (even when taken at approved doses for depression)
• Acting on dangerous impulses
• Insomnia (at high doses)
• Weight gain or loss

The drug can stay in a person’s system for 42 hours after the final dose. Higher doses can produce more severe side effects.

Can you become addicted to trazodone?

While the drug is considered non-addictive and non-habit-forming, it should only be taken as prescribed and under a physician’s care in order to avoid misuse. This is especially important for individuals who have a history of substance abuse or other drug addiction. Warning signs of drug misuse include using the sleep aid/antidepressant without a prescription, using the medication at higher doses than prescribed, or snorting or crushing the tablets to speed up the intended effects.

Can you fail a drug test while taking trazodone?

Even though the antidepressant/sleep aid is not classified as a narcotic, it can cause false positives on drug tests. According to the National Center for Biotechnology Information, “The trazodone metabolite meta-Chlorophenylpiperazine [m-CPP] can cause false-positive urine amphetamine immunoassay results.…Further, we found that patients taking trazodone can produce urine with sufficient m-CPP to result in false-positive Amphetamines II results.”

What are trazodone’s withdrawal symptoms?

Although technically a non-addictive substance, regular use of the medication can result in mild physical dependence. For this reason, trazodone withdrawal is a concern. Rather than discontinuing use “cold-turkey,” physicians typically recommend a gradual tapering. This approach is considered a better protocol to avoid potential discomfort associated with trazadone withdrawal syndrome, also known as discontinuation syndrome.

Symptoms of trazodone withdrawal include:

• Agitation
• Confusion
• Rapid mood swings
• Muscle pain
• Weakness
• Dizziness
• Stomach pain
• Sweating
• Insomnia
• Fatigue

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Side Effects Of Taking Trazodone For Sleep

While primarily an antidepressant, more doctors are now prescribing trazodone for sleep issues.

We’ll look today at whether or not trazodone is an effective agent for insomnia and other sleep disorders and, more importantly, whether it’s safe to use in this capacity.

Before anything else, though, what is trazodone?

What Is Trazodone

Trazodone is an antidepressant drug mainly prescribed to treat the symptoms of depression. Doctors also commonly prescribe trazodone for the treatment of anxiety, schizophrenia, and uncontrollable movements that crop up as a side effect of other meds.

First approved by the FDA in 1981 (under the brand name Desyrel), trazodone is now available as a generic medication produced by several leading drug companies. Oleptro is the only remaining brand name for trazodone.

Trazodone belongs to a class of medications called serotonin modulators. These drugs work by moderating levels of serotonin – a neurotransmitter – in the brain and increasing its availability in the CNS (central nervous system).

Categorized as a SARI (serotonin antagonist reuptake inhibitor), trazodone stops neurons from reabsorbing serotonin once the neurotransmitter has been released into the CNS. It’s through this mechanism that trazodone can help with some cases of depression.

Unfortunately, many other antidepressants are much more effective for treating depression while the chemical composition of trazodone gives it mild sedating properties, often unwanted if being used to treat depression.

So, although not designed as a sedative or hypnotic to address sleep disorders, doctors are now prescribing trazodone off-label to mitigate insomnia.

Before we move on to examine the side effects of using trazodone for sleep, what is insomnia? We’ll briefly highlight that right now.

What Is Insomnia?

There are many different types of insomnia, and the word is used to describe a range of sleep problems from difficulty falling asleep to waking up in the night and being unable to sleep again.

There are 2 broad categories of insomnia, primary and secondary:

• Primary insomnia: With primary insomnia, you have standalone problems with sleep not brought about by other physical or psychological disorders.
• Secondary insomnia: Difficulties sleeping caused by either a medical condition or a mental health disorder is known as secondary insomnia.

Treatment of primary insomnia involves addressing and attacking the sleep problem itself.

With secondary insomnia, the condition causing the insomnia needs to be dealt with alongside medical or behavioral treatment of the insomnia itself.

There are multiple sub-types of insomnia.

• Acute insomnia: Typically triggered by a stressful life event, acute insomnia is a brief, fleeting episode of sleep disturbance that often resolves with no need for treatment.
• Chronic insomnia: Insomnia is normally labelled chronic if you have problems falling asleep or staying asleep for at least 3 nights weekly over 3 months or more. There are many causes and treatment varies accordingly.
• Comorbid insomnia: If insomnia occurs alongside another condition, it’s termed comorbid insomnia. Conditions like anxiety and depression often precipitate sleeping problems. Debilitating back pain or conditions like arthritis can also make it hard to sleep.
• Late insomnia: Waking extremely early in the morning and being unable to sleep again.
• Maintenance insomnia: An inability to stay asleep is known as maintenance insomnia and it’s characterized by waking during the night then finding it tough to get back to sleep.
• Sleep onset insomnia: You’re suffering from onset insomnia if you find it tough to fall asleep when you climb into bed.

Many medications are used to address the issues that come with insomnia including Ambien and trazodone.

So, does taking an antidepressant really work if you’ve got insomnia?

Does This Help You Sleep

In 2017, a systematic review of trazodone for insomnia yielded 45 studies into the safety and efficacy of off-label use of this medication. The study concluded that trazodone is useful for treating both primary and secondary insomnia. Trazodone was also shown to be effective for treating symptoms caused by depression and dementia.

That said, physicians and sleep scientists often baulk at the idea of using antidepressants like trazodone for the treatment of insomnia. Popular alternatives like Lunesta and Ambien better deal with the neurological upset often associated with insomnia. CBT (cognitive behavioral therapy) is also promoted as an effective non-pharmacologic solution.

A key advantage of using trazodone to counter sleep issues is that it can be safely used for much longer than most common sleep aids. Normally, prescription sleeping pills are used for no more than 2 weeks. Trazodone can be safely used for longer than this.

The 3 to 6 hour half-life of trazodone makes it most suitable for treating sleep onset insomnia or maintenance insomnia.

Trazodone as a sleep aid has several core benefits:

• Scientifically proven to effectively treat both primary insomnia and secondary insomnia
• Trazodone can be used to treat sleep issues at low doses
• This medication is safely than the alternative medications for elderly patients
• You can find generic trazodone much more cheaply than Ambien
• Trazodone has fewer side effects than most common sleep aids
• Unlike benzodiazepines, trazodone is not addictive
• Trazodone can be used to treat sleep apnea

Sleep scientists recommend CBT along with other appropriate behavioral modifications as a first line of attack against insomnia. If these modalities are not suitable for you or don’t work, the sedative effects of trazodone can be beneficial.

So, how much do you need?

Dosage for Sleep

Trazodone tablets come in multiple doses:

When used as a sleep aid, start off with 25 to 50mg and increase the dose if necessary up to 100mg. Studies have also shown that trazodone has utility even in lower doses.

So, you can see that trazodone works well for combatting insomnia and that you don’t need to take this non-addictive medication in high doses either.

What about the downside of trazodone for sleep, though?

We’ll look now at what side effects you can expect if trazodone is prescribed for insomnia.

Side Effects of Trazodone

If you use trazodone to alleviate insomnia and suddenly discontinue use, you might experience symptoms like anxiety, irritability, depression and mild flu-like symptoms. These side effects can be largely eliminated by slowly tapering off and using less trazodone over time.

When compared to Ambien, withdrawal symptoms are pretty mild.

How about more general side effects, then?

Experiencing any of the following is commonplace:

• Blurred vision
• Confusion
• Constipation
• Diarrhea
• Difficulties with walking or coordination
• Dizziness
• Dry mouth
• Fatigue
• Headache
• Lightheadedness
• Low blood pressure
• Muscle pain
• Nausea or vomiting
• Nervousness
• Palpitations
• Rapid heart rate
• Sleepiness
• Skin reactions, such as a rash
• Tremors
• Weight changes

While much less common, you might also experience the following serious side effects:

• Abnormal heart rhythms
• Anemia
• Extrapyramidal symptoms
• Fainting
• Hallucinations
• Heart attack
• Hepatitis (liver inflammation)
• Hypertension (high blood pressure)
• Hypomania
• Mania
• Neutropenia (low white blood cell count)
• Orthostatic hypotension (low blood pressure when standing)
• Priapism (persistent painful erection)
• Psychosis exacerbation
• Seizures
• SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone secretion)
• Stroke
• Suicidal thoughts
• Tardive dyskinesia
• Worsening depression

In rare instances, trazodone can provoke serious reactions. If you find difficulty breathing or experience any other severe reaction, call 911 immediately.

According to the Food and Drug Administration, trazodone poses the following serious risks:

• Cardiac arrhythmias: Changed in heart rhythm can occur. The risk is heightened if you have existing heart problems.
• Serotonin syndrome: Too much serotonin accumulating in the body can trigger negative reactions. If you’re taking migraine medication or other supplements, the risk of this is magnified. Symptoms include dizziness, seizures, agitation, and hallucinations.
• Suicidal thoughts: There’s a risk of suicidal thoughts when using trazodone. This is most prevalent in young adults.
• Hypotension: When you stand up, hypotension is an abrupt drop in blood pressure. This happens more frequently when some people use trazodone.
• Heightened danger of bleeding: If you’re taking blood-thinning drugs like Warfarin or Heparin along with trazodone, you should be aware that your risk of bleeding increases.
• Mania: Trazodone can induce feelings of hyperactivity, euphoria, and excessive excitement.
• Priapism: In very rare cases, trazodone can cause priapism, an erection that lasts a long time and causes pain.

We reiterate, you are highly unlikely to experience most of the above side effects if you use trazodone for insomnia. You should nevertheless be aware of everything that could happen.

How about overdose, then? Is this a danger with trazodone?

Trazodone Overdose

Although uncommon, there have been a handful of reports of trazodone overdose.

The risk of overdose is heightened if you’re drinking alcohol. You should also avoid taking benzodiazepines or any other CNS depressant drugs. All of these can arrest your breathing and slow your reactions.

Symptoms of a trazodone overdose include:

• Drowsiness
• Heart rhythm changes
• Respiratory arrest (breathing stops)
• Seizures
• Vomiting

Any drug overdose can be fatal so call 911 immediately if you think you might have taken too many trazodone tablets.

If you or someone you know is struggling with an addiction to Trazodone or other antidepressants and is searching for an inpatient rehab facility, call us at 888-448-0302 to chat with a recovery specialist. We are available 24/7 to answer your questions and get you the information you need to make the best recovery decision for you. Your call is 100% confidential, and we are ready to help you get started whenever you decide that it’s the right time

Trazodone: FDA Warning

Just like a number of antidepressants, this medication has been issued with an FDA Black Box Warning.

This concerns the increased risk of suicidal thoughts or behaviors in children and young adults. The FDA states that anyone taking trazodone should be “closely monitored” and add that this medication “is not approved for use in pediatric patients”.

The Bottom Line

Despite generally positive results with trazodone for both primary insomnia and secondary insomnia, the American Academy of Sleep Medicine suggests that the potential damage and risk of using trazodone for insomnia outweigh the advantages.

Studies have shown that you might only shave off 10 minutes from the time it takes you to fall asleep, and you only reduce the amount of time you’re awake by 8 minutes. Admittedly, these are not impressive stats.

While not recommended the first line of treatment against insomnia, trazodone can be a highly effective sleep aid. If you haven’t had much luck with behavioral therapy or other types of medication from Ambien to Valium, you could find some benefit from trying trazodone.

Final Word

If you’d like advice about any aspect of medication, don’t hesitate to get in touch. Since trazodone is non-addictive and you won’t experience severe withdrawal symptoms, you won’t need residential rehab to stop taking it.

You may, however, like the idea of exploring cognitive behavioral therapy as an alternative to medication for sleep. If so, call us on 888-448-0302 and we can help you out.

Your Path to Recovery Starts Here

Recovery starts here. Talk to a Recovery Specialist now.

888-448-0302

Your Path to Recovery Starts Here

Recovery starts here. Talk to a Recovery Specialist now.

888-448-0302

About the Author

Landmark Recovery Staff

This post was written by a Landmark Recovery staff member. If you have any questions, please contact us at 888-448-0302.

Nov 26, 2019

Posted in: Drug

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Description TRAZODONE indications, dosages, contraindications of the active substance TRAZODONE

Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ^® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: Canada

APO-TraZODone; APO-TraZODone D; DOM-TraZODone; Oleptro; PMS-TraZODone; RATIO-TraZODone [DSC]; TEVA-TraZODone; TraZODone-100; TraZODone-150; TraZODone-50

Warning

For all patients taking this drug:

• Drugs like this have increased the likelihood of suicidal thoughts or actions in children and young people. This risk may be higher in people who have attempted suicide or have had suicidal thoughts in the past.All people taking this drug must be closely monitored. Call your doctor right away if you have signs such as depressed mood (depression), nervousness, anxiety, grumpiness, or anxiety attacks, or if other mood or behavior changes occur or worsen. Call your doctor right away if you have suicidal thoughts or attempted suicides.

Children:

• This drug is not approved for use in children.However, your doctor may decide that the benefits of using this drug outweigh the risks associated with it. If your child has received this drug, ask the doctor about the benefits and risks. Talk to your doctor if you have any questions about how your child is using this drug.

What is this drug used for?

• The drug is used to treat depression.
• This medicinal product may be used for other indications.Consult your doctor.

What do I need to tell my doctor BEFORE taking this drug?

• If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
• If you have recently had a myocardial infarction.
• If you have ever had an increase in the duration of the QT interval on an ECG or other heart rhythm disturbances.
• If you have any of the following health problems: low magnesium, low potassium, or bradycardia.
• If you are taking any of the following drugs: linezolid or methylene blue.
• If you have taken a drug for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
• If you are taking any medication that can cause some type of heart rhythm disorder (prolonged QT interval). There are many medications that can cause these problems. If you are unsure, check with your doctor or pharmacist.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems.You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

• Tell all healthcare providers that you are taking this drug.These are doctors, nurses, pharmacists and dentists.
• Avoid driving or other activities that require increased attention until you see how this drug affects you.
• To reduce the risk of dizziness or loss of consciousness, get up slowly from a lying or sitting position. Use caution when climbing and descending stairs.
• Consult your doctor before using alcohol, marijuana, or other forms of cannabis, or prescription and over-the-counter drugs that may slow you down.
• A dangerous heart rhythm disorder (prolonged QT interval on the ECG) has happened with this drug. This may increase the likelihood of sudden death. Consult your doctor.
• This drug may increase the risk of bleeding. Sometimes bleeding can be life-threatening. Consult your doctor.
• The risk of eye problems may be increased in some patients with this drug. Your doctor may order you to see an ophthalmologist to see if you are at increased risk of developing these eye problems.Call your doctor right away if you have eye pain, change in vision, swelling, or redness around the eye.
• This drug may lower sodium levels. Very low sodium levels can be life-threatening, leading to seizures, fainting, difficulty breathing, or death.
• If you are 65 years of age or older, use this drug with caution. You may have more side effects.
• Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:

• Signs of an allergic reaction, such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
• Signs of low sodium levels such as headache, trouble concentrating, memory impairment, confusion, weakness, seizures, balance problems.
• Signs of bleeding such as vomiting or coughing up blood; vomiting of the type of coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; non-cyclic vaginal bleeding; bruising that occurs or increases for no reason; bleeding that you cannot stop.
• Signs of high or low blood pressure, such as very severe headache or dizziness, fainting, or vision changes.
• Increased or abnormal heart rhythm.
• Inflammation.
• Confusion of consciousness.
• Call your doctor right away if you have a painful erection or if an erection lasts more than 4 hours. This can happen even if you are not having sex at the time. If not addressed immediately, it can lead to long-term erection problems and you may not be able to have sex.
• A serious and sometimes fatal complication called serotonin syndrome may occur. This risk may increase with the concomitant use of certain other drugs. Call your doctor right away if you develop agitation, imbalance, confusion, hallucinations, fever, tachycardia or irregular heartbeat, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , very severe headache.

What are some other side effects of this drug?

Any medicine can have side effects. However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:

• Feeling dizzy, sleepy, tired, or weak.
• Constipation, diarrhea, abdominal pain, nausea or vomiting.
• Dry mouth.
• Headache.
• Nervous tension and agitation.
• Shiver.
• Muscle pain.
• stuffy nose.
• Weight gain or loss.

This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.

All forms of issue:

• If you feel drowsy after using this drug, talk to your doctor.Your doctor may change the dose or schedule for this drug.
• Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.
• It may take several weeks to achieve full effect.
• Do not stop taking this drug suddenly without talking to your doctor. This can increase the risk of side effects. If necessary, this drug should be stopped gradually as directed by your doctor.

Immediate-release tablets:

• This drug should be taken right after a meal or light snack.
• The tablet can be broken in half.
• Do not chew or crush.

Extended release tablets:

• Take this medicine on an empty stomach.
• Swallow whole. Do not chew or crumble.
• Long-acting tablets can be split in half.

What to do if a dose of a drug is missed?

• Take the missed dose as soon as you can.
• If it is time for your next dose, do not take the missed dose and then return to your normal dose.
• Do not take 2 doses at the same time or an additional dose.

How do I store and / or discard this drug?

• Store at room temperature, protected from light.Store in a dry place. Do not store in the bathroom.
• Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicinal products

• If your health does not improve or even worsens, see your doctor.
• Do not give your medicine to anyone or take other people’s medicines.
• Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
• A separate patient instruction sheet is attached to the product. Please read this information carefully. Reread it every time you replenish your supply. If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
• If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.

Consumer use of information and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are suitable for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. Check with your doctor for complete information on the possible risks and benefits of taking this drug.

Copyright

© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

instructions for use, classification, articles »Drug guide

Application for children and adolescents

Trazodone should not be used in children and adolescents. In a clinical study in children and adolescents, suicidal behavior (attempted suicide and planning suicide) and hostility (mainly aggressiveness, protest behavior, and anger) were more common in the antidepressant group than in the placebo group.In addition, there are currently no data on the long-term safety of the drug in children and adolescents, given its effects on growth, puberty, and cognitive and behavioral development.

Suicide / suicidal ideation or clinical deterioration

Depression is associated with an increased risk of suicidal thoughts, self-harm and suicide (manifestations of suicidal behavior) by the patient. This risk persists until significant remission occurs. There may be no improvement in the condition during the first few weeks of therapy or longer.Patients should be carefully monitored until such improvement occurs. General clinical experience indicates a possible increased risk of suicide in the early stages of recovery.

It is known that patients with a history of suicidal behavior or patients who had a significant degree of suicidal thinking before starting therapy have a higher risk of developing suicidal thoughts or suicidal attempts, therefore, they need careful supervision during treatment.In a meta-analysis of placebo-controlled clinical trials of antidepressants for mental disorders, it was shown that among patients under 25 years of age, individuals in the antidepressant group had a higher risk of suicidal behavior than in the placebo group.

Drug therapy should be accompanied by careful monitoring of patients, including those from a high-risk group, especially at the beginning of treatment and after changing the dose of the drug. Patients (and their caregivers) should be warned to watch for any clinical signs of deterioration, suicidal behavior or thoughts, and unusual changes in behavior, and if they are found, seek medical advice immediately.

To minimize the potential risk of suicidal attempts, especially at the beginning of therapy, the physician should only prescribe a limited amount of trazodone to the patient at each visit.

It is recommended to carefully select the dosing regimen and carry out regular monitoring of patients with the following conditions:

• epilepsy, particularly in such patients, do not sharply increase or decrease the dose;
• impaired liver or kidney function, especially severe;
• heart diseases such as angina pectoris, cardiac conduction disorders or various degrees of blockade; recent myocardial infarction
• hyperthyroidism
• Violation of urination, for example with prostatic hypertrophy, although such problems are not expected since the anticholinergic effect of trazodone is negligible;
• Acute glaucoma, increased intraocular pressure, although significant changes in position are not expected because the anticholinergic effect of trazodone is negligible.

If the patient develops jaundice, trazodone therapy should be discontinued.

With the use of antidepressants in patients with schizophrenia or other psychotic disorders, psychotic symptoms may increase. Paranoid thoughts may become more pronounced. Against the background of trazodone therapy, the depressive phase in manic-depressive psychosis can change into the manic phase. In this case, the use of trazodone should be discontinued.

Against the background of simultaneous use with other serotonergic drugs, such as other antidepressants (for example, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors and MAO inhibitors) and antipsychotics, drug interactions with the development of serotonin malignant syndrome have been reported syndrome.Cases of fatal neuroleptic malignant syndrome have been reported with simultaneous use with antipsychotics, for which this syndrome is a known possible adverse reaction. For more information, see sections Interaction with other medicinal products and other forms of interaction and Adverse reactions.

Since agranulocytosis can clinically present as a flu-like condition, sore throat and fever, laboratory blood counts should be checked if these symptoms occur.

The occurrence of arterial hypotension, including orthostatic hypotension and syncope, has been reported in patients treated with trazodone. With the simultaneous use of antihypertensive drugs and trazodone, it may be necessary to reduce the dose of the antihypertensive drug. Elderly patients are often more susceptible to the unwanted effects of antidepressants, especially orthostatic hypotension and other anticholinergic effects.

At the end of the course of trazodone therapy, especially if this course was long, it is recommended to gradually reduce the dose until the drug is completely discontinued in order to minimize the likelihood of withdrawal symptoms, which include nausea, headache and general malaise.

There is currently no indication that trazodone hydrochloride is addictive.

During the use of trazodone, very rare cases of prolongation of the QT interval have been reported – an effect characteristic of other antidepressants. It is necessary to use trazodone with caution simultaneously with drugs with a known ability to prolong the QT interval. Trazodone should be used with caution in patients with diagnosed cardiovascular diseases, including those accompanied by lengthening of the QT interval.

Against the background of the use of powerful inhibitors of cytochrome CYP3A4, the level of trazodone in the serum may increase. For more information, see section Interaction with other medicinal products and other forms of interaction.

Like other drugs with alpha-adrenergic blocking activity, trazodone in very rare cases causes priapism. If it occurs, an intracavernous injection of an alpha-adrenergic agent such as epinephrine or metaraminol should be administered.However, cases of trazodone-induced priapism have been reported when surgery was required or when permanent sexual dysfunction resulted. In patients with suspicion of this adverse reaction, trazodone should be discontinued immediately.

Trittico sustained release tablets contain sucrose. This drug should not be used in patients with rare hereditary diseases such as fructose intolerance, glucose-galactose malabsorption syndrome or sucrase-isomaltose deficiency.

pregnancy

Data from a limited number (<200) of pregnant women exposed to trazodone indicate no adverse effects on pregnancy or fetal / newborn health. There is currently no other adequate epidemiological data available. Data from animal studies does not indicate the presence of any direct or indirect harmful effects of this substance, used in therapeutic doses, on the course of pregnancy, embryo / fetal development, childbirth or postnatal development of offspring.

Pregnant women should use this drug with caution. If trazodone is administered to the mother before delivery, the infant should be monitored after birth to identify possible withdrawal symptoms based on the maternal benefit / fetal risk ratio.

breastfeeding

Limited data indicate that trazodone passes into breast milk in small quantities. Due to insufficient data, the decision to prolong / discontinue breastfeeding or continue / discontinue trazodone therapy should be made in view of the benefits of breastfeeding for the baby and the benefits of trazodone therapy for the mother.

Trazodone insignificantly or moderately affects the ability to drive vehicles and mechanisms. Patients should be warned that before driving and operating machinery, it is necessary to make sure that there is no drowsiness, sedation, dizziness, states of confusion or blurred vision while taking trazodone.

Trazodone dependence * What you need to know about trazodone dependence

Side effects and risks of trazodone

Trazodone may cause side effects in people who take it.The good news for users is that the side effects of trazodone are neither life threatening nor long lasting. However, the side effects of trazodone can be serious enough to be needed by a healthcare professional. The most common side effects of trazodone are:

• Blurred vision
• Drowsiness, drowsiness, dizziness or fatigue
• sweating
• Swelling of the body and / or face
• Weight loss without diet
• Nasal congestion may occur

Other

for taking trazodone, but they are less common.Less likely side effects include:

• Dry mouth and throat
• Constipation or diarrhea
• Sexual dysfunction
• Painful and persistent penile or clitoris erection
• Heart arrhythmias

There are some serious side effects that can occur in people. If any of these problems occur, patients should seek immediate medical attention. These side effects include:

• Rash / hives
• Rapid heartbeat
• Shortness of breath
• Sudden dizziness
• Feel like fainting
• Decreased heart rate
• Sodium bleeding

Uncommon