nefazodone

Generic Name: nefazodone

What is nefazodone?

Nefazodone is an antidepressant medication. It affects chemicals in the brain that may become unbalanced and cause depression.

Nefazodone is used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide.

Nefazodone may also be used for purposes other than those listed in this medication guide.

Uses Side Effects Precautions Interactions Overdose
What should I discuss with my healthcare provider before taking nefazodone?

While you are taking nefazodone you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking nefazodone. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with nefazodone. Do not stop taking nefazodone.

In rare cases, treatment with nefazodone has been associated with serious liver problems, sometimes resulting in liver transplant or death. Contact your doctor immediately if you experience yellowing of the skin or eyes; unusually dark urine; loss of appetite that lasts several days or longer; severe nausea; or stomach pain. These may be early signs of liver problems.

Do not take nefazodone if you are taking any of the following drugs:

  • a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);

  • cisapride (Propulsid);

  • pimozide (Orap);

  • triazolam (Halcion); or

  • carbamazepine (Tegretol, Tegretol XR, Epitol, Carbatrol).

These drugs can cause very serious interactions with nefazodone that could lead to seizures, heart damage, and even death.

Before taking this medication, tell your doctor if you have

  • heart disease, high or low blood pressure, or irregular heartbeats;

  • seizures;

  • had manic episodes (extreme agitation or excitability);

  • kidney disease; or

  • liver disease.

You may not be able to take nefazodone, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Nefazodone is in the FDA pregnancy category C. This means that it is not known whether nefazodone will harm an unborn baby. Do not take nefazodone without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether nefazodone passes into breast milk. Do not take nefazodone without first talking to your doctor if you are breast-feeding.

If you are over 60 years of age, you may be more likely to experience side effects from nefazodone.

How should I take nefazodone?

Take nefazodone exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Take each dose with a full glass of water.

It is important to take nefazodone regularly to get the most benefit.

Do not stop taking nefazodone without first talking to your doctor. It may be several weeks before you begin to feel better, and you may require continuous treatment for quite some time.

Your doctor may want you to have blood tests or other medical evaluations during treatment with nefazodone to monitor progress and side effects.

Store nefazodone at room temperature away from moisture and heat.

What happens if I miss a dose of nefazodone?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take only the next one as directed. Do not take a double dose of this medication.

Where can I get more information about nefazodone?
Your pharmacist has information about nefazodone written for health professionals that you may read.
What are the possible side effects of nefazodone?

If you experience any of the following uncommon but serious side effects, stop taking nefazodone and seek emergency medical attention or contact your doctor immediately:

  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • fainting; or

  • prolonged, painful, or inappropriate erections (this could lead to a serious condition requiring surgery).

Other, less serious side effects may be more likely to occur. Continue to take nefazodone and talk to your doctor when it is convenient if you experience:

  • dizziness, lightheadedness, or drowsiness;

  • upset stomach;

  • insomnia;

  • dry mouth;

  • constipation; or

  • blurred or abnormal vision.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What is the most important information I should know about nefazodone?

While you are taking nefazodone you may need to be monitored for worsening symptoms of depression and/or suicidal thoughts at the start of therapy or when doses are changed. This concern about the increased risk of suicidal thoughts or behaviors may be greater if you are 18 years of age or younger and are taking nefazodone. In patients younger than 18 years, the period of risk may extend beyond start of therapy or when doses are changed. Your doctor may want you to monitor for the following symptoms: anxiety, panic attacks, difficulty sleeping, irritability, hostility, impulsivity, severe restlessness, and mania (mental and/or physical hyperactivity). These symptoms may be associated with the development of worsening symptoms of depression and/or suicidal thoughts or actions. Contact your healthcare provider if you develop any new or worsening mental health symptoms during treatment with nefazodone. Do not stop taking nefazodone.

Do not take nefazodone if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days, or if you are taking cisapride (Propulsid), pimozide (Orap), triazolam (Halcion), or carbamazepine (Tegretol, Tegretol XR, Epitol, Carbatrol).

In rare cases, treatment with nefazodone has been associated with serious liver problems, sometimes resulting in liver transplant or death. Contact your doctor immediately if you experience yellowing of the skin or eyes; unusually dark urine; loss of appetite that lasts several days or longer; severe nausea; or stomach pain. These may be early signs of liver problems.

Use caution when driving, operating machinery, or performing other hazardous activities. Nefazodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Avoid alcohol during treatment with nefazodone. Alcohol may increase drowsiness and dizziness while taking nefazodone.

What should I avoid while taking nefazodone?

Use caution when driving, operating machinery, or performing other hazardous activities. Nefazodone may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall.

Avoid alcohol during treatment with nefazodone. Alcohol may increase drowsiness and dizziness while taking nefazodone.

What other drugs will affect nefazodone?

Do not take nefazodone if you are taking any of the following drugs:

  • a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate);

  • cisapride (Propulsid);

  • carbamazepine (Tegretol, Tegretol XR, Epitol, Carbatrol);

  • triazolam (Halcion); or

  • pimozide (Orap).

These drugs can have very serious interactions with nefazodone that could lead to seizures, heart damage, and even death.

Many other drugs may interact with nefazodone. Talk to your doctor before taking any other medications during treatment with nefazodone, especially any of the following:

  • haloperidol (Haldol);

  • alprazolam (Xanax);

  • lorazepam (Ativan);

  • cyclosporine (Neoral, Sandimmune);

  • tacrolimus (Prograf);

  • digoxin (Lanoxin, Lanoxicaps);

  • phenytoin (Dilantin);

  • warfarin (Coumadin); or

  • atorvastatin (Lipitor), lovastatin (Mevacor), or simvastatin (Zocor).

You may require a dosage adjustment or special monitoring during treatment if you are taking any of these medicines.

Drugs other than those listed here may also interact with nefazodone. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

What happens if I have an overdose of nefazodone?

Seek emergency medical attention if an overdose is suspected.

Symptoms of a nefazodone overdose include drowsiness, nausea, vomiting, and seizures.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Content provided by Multum - Last Updated 2/11/2008