Trazodone Indinavir

Drugs that may affect venlafaxine include cimetidine, cyproheptadine, and MAOIs. Drugs that may be affected by venlafaxine include clozapine, desipramine, haloperidol, indinavir, St. John s wort, trazodone, sibutramine, sumatriptan, and warfarin. 

Drugs that may be affected by indinavir include antiarrhythmics, clarithromycin, dihydropyridine calcium channel blockers, HMG-CoA reductase inhibitors, immunosuppressant agents, phosphodiesterase type 5 inhibitors, pimozide, saquinavir, trazodone, cisapride, amiodarone, benzodiazepines, ergot alkaloids, fentanyl, rifamycins, ritonavir. 

Drugs that might be affected by amprenavir include antiarrhythmics, anticonvulsants, azole antifungals, benzodiazepines, calcium channel blockers, cisapride, clarithromycin, cyclosporine, ergot alkaloids, fentanyl, HMG-CoA reductase inhibitors, indinavir, methadone, nelfinavir, oral contraceptives, pimozide, rifabutin, ritonavir, saquinavir, sildenafil, tacrolimus, trazodone, tricyclic antidepressants, warfarin, and zidovudine. 

Others Acetaminophen, amiodarone, carbamazepine, delavirdine, efavirenz, nevirapine, quinidine, repaglinide, sildenafil, tadalafil, trazodone, vardenafil Amiodarone, amprenavir, atazanavir, ciprofloxacin, cisapride, clarithromycin, diltiozem, erythromycin, fluconazole, fluvoxamine, grapefruit juice (in high ingestion), indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, norfloxacin, ritonavir, telithromycin, troleandomycin, verapamil, voriconazole Carbamazepine, efavirenz, glucocorticoids, macrolide antibiotics, nevirapine, phenytoin, phenobarbital, rifabutin, rifapentine, rifampin, St. John s wort... 

A 35-year old Caucasian man with AIDS and multiple opportunistic infections, including Mycobacterium kansasii and Mycobacterium avium complex (MAC) disease developed moderate to severe primary sensorineural hearing loss after 4—5 months of therapy with oral azithromycin 500 mg/day. Other medications included ethambutol, isoniazid, rifabutin, ciprofloxacin, co-trimoxazole, fluconazole, zidovudine (later switched to stavudine), lamivudine, indinavir, methadone, mod-ified-release oral morphine, pseudoephedrine, diphenhydramine, megestrol acetate, trazodone, sorbitol, salbutamol by metered-dose inhaler and nebulizer, ipratropium, and oral morphine solution as needed. Significant improvement of the hearing impairment was documented 3 weeks after drug withdrawal. 

Two cases of serotonin syndrome were attributed to adding ritonavir to established fluoxetine treatment. In one patient this was managed by halving the fluoxetine dose, and in the other ritonavir was withdrawn. Other cases of the serotonin syndrome have been seen in patients taking ritonavir or indinavir with fluoxetine. One involved the additional use of trazodone , (p.l229), and the other involved large quantities of grapefruit , (p.1217). 

An in vitro study demonstrated that the metabolism of trazodone to its principal metabolite, meta-chlorophenylpiperazine (mCPP), was inhibited by ritonavir, which is a potent inhibitor of the cytochrome P450 isoenzyme CYP3A4. Indinavir was also a strong inhibitor of mCPP formation, whereas saquinavir and nelflnavir were considerably less potent inhibitors. ... 

Trazodone is a substrate for CYP3A4 and inhibitors of this enzyme such as ritonavir and indinavir may inhibit its metabolism, leading to substantial increases in trazodone plasma concentrations with the potential for adverse effects. ... 

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