Trazodone HCl dosage, forms, and strengths

Trazodone hydrochloride is a generic prescription antidepressant. As a tricyclic antidepressant, trazodone balances chemicals in the brain that transmit nerve signals, allowing people greater control over their mood. Trazodone is FDA-approved to treat major depressive disorder, but healthcare providers may prescribe trazodone off-label to manage insomnia, generalized anxiety disorder (GAD), or other medical conditions. Trazodone can only be taken as an immediate-release tablet. An extended-release version, sold under the Oleptro brand name, is no longer sold, and no generic extended-release versions exist. Because it is an immediate-release tablet, trazodone is taken two or three times per day for depression. The dose varies based on a person’s response to the drug. Off-label dosages are different and can vary widely. 

Trazodone HCl forms and strengths

• Immediate-release tablets: 50 milligrams (mg), 100 mg, 150 mg, 300 mg

Trazodone HCl dosage for adults

The FDA has approved trazodone to treat adults for depression, but healthcare professionals sometimes prescribe it off-label for insomnia or anxiety. Trazodone may also be used off-label for fibromyalgia, Alzheimer’s disease, post-traumatic stress disorder (PTSD), and eating disorders. There are no standardized dosages for off-label uses.

Check our best Trazodone HCl prices

Sources: Epocrates, PDR

Trazodone HCl dosage for depression

Healthcare professionals commonly prescribe trazodone for major depressive disorder, but it’s rarely a first choice. It’s as effective at treating depression as many selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine), and it is less likely to cause side effects, such as sexual dysfunction, erectile dysfunction, sleeplessness, and anxiety. 

• Standard adult dosage for major depressive disorder: 50–100 mg taken two to three times per day 

• Maximum adult dosage for major depressive disorder: 400 mg per day for outpatient use or 600 mg per day for inpatient use

Source: Epocrates, StatPearls

Trazodone HCl dosage for anxiety

Lower doses of trazodone have a sedative effect and can relieve anxiety. For this reason, healthcare providers may prescribe trazodone to treat generalized anxiety disorder or other anxiety disorders. Again, it’s rarely a first choice. Dosages are not officially standardized, but the usual starting dose is 150 mg daily. In one study, the average effective trazodone dose for anxiety was around 250 mg daily in divided doses. 

Source: PDR, StatPearls

Trazodone HCl dosage for insomnia

Low-dose trazodone acts like a sedative. For this reason, healthcare providers sometimes prescribe it to treat insomnia or other sleep disorders. Dosages are not officially standardized. Expect to take trazodone at night right before bedtime to help induce sleep.

• Standard adult dosage for insomnia: 25–50 mg taken at bedtime 

• Maximum adult dosage for insomnia: 200 mg per day

Source: Epocrates, StatPearls

Trazodone HCl dosage for children

The Food and Drug Administration (FDA) has not approved trazodone for use in pediatric patients younger than 18 years of age. 

Trazodone HCl dosage restrictions

Trazodone does not have dosage reductions for people with kidney or liver disease.

Trazodone HCl dosage for pets 

Veterinarians commonly prescribe trazodone for dogs and cats to treat anxiety, panic, phobias, aggression, or cognitive dysfunction. Single-dose trazodone may calm animals during vet visits, minor procedures, grooming, nail clipping, or after surgery. As in humans, trazodone works well at calming a pet without harmful side effects. Dosages are based on the animal’s weight, usually about 2–3.5 mg of trazodone per pound.

Source: Plumb’s Veterinary Medical Guides, VeterinaryPartner, Forbes

How to take trazodone HCl

Trazodone HCl can only be taken as an immediate-release tablet. That means it is usually taken twice to three times daily unless prescribed for insomnia. 

• Follow all instructions given by the prescriber or written on the medication label. Do not increase or decrease the dose. The dose may need to be changed several times to find the best dose.

• Take each trazodone tablet right after a meal or light snack.

• The tablet can be swallowed whole or broken along the score line. Do not break the tablet unless a doctor states to do so. Do not crush or chew the tablet.

• This medicine should come with a medication guide. Ask a pharmacist for a copy if one has not been provided.

• Take a missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and take a regular dose at the next scheduled time. Do not take extra medicine to make up for a missed dose.

• Do not stop taking trazodone before talking to the prescriber or other healthcare professional. Abrupt discontinuation of trazodone could cause withdrawal symptoms.

• Store the medicine in a closed, child-resistant container at room temperature, away from heat, moisture, and direct light.

Trazodone HCl dosage FAQs

Trazodone HCl vs. trazodone HCl ER: What’s the difference in doses? 

Extended-release trazodone is no longer sold in the United States. It used to be available under the brand name Oleptro, but that brand has been discontinued.

How long does it take trazodone HCl to work?

Trazodone has been well-studied in comparison with other antidepressants. These studies have shown that people generally show improvement in depression symptoms as early as two weeks after starting the medicine, but the most pronounced effects occur within 4–6 weeks. To ensure maximum effectiveness, always take trazodone right after eating. This can increase the body’s absorption of the drug by 20%.

For people taking trazodone to sleep, the sedative effects occur about 30 minutes after taking it.

How long does trazodone HCl stay in your system?

It takes the body about five to nine hours to eliminate half a dose of trazodone. Older adults are usually less efficient at clearing a dose than younger adults. It can take about 13 hours to clear half a dose in older adults, compared to six hours for younger people.

What happens if I miss a dose of trazodone HCl?

If a dose of trazodone is missed, take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take the next dose on schedule. Never take extra medicine or double a dose to compensate for a missed trazodone dose.

How long can you take trazodone HCl?

Trazodone is intended for long-term treatment of depression. There are no limits placed on the duration of trazodone treatment for depression. 

Healthcare professionals typically use trazodone for occasional short-term treatment for insomnia because it has fewer side effects and risks than other sleep-inducing medicines. The American Academy of Sleep Medicine (AASM) discourages its use for anything but occasional insomnia because it may not be very effective. Chronic insomnia is usually treated with other medications.

How do I stop taking trazodone HCl?

Do not stop taking trazodone unless directed by a doctor.

Stopping trazodone suddenly can cause withdrawal symptoms, such as agitation, anxiety, and trouble sleeping. When it is time to stop taking trazodone, seek medical advice from the prescribing healthcare provider. The healthcare provider will gradually taper the dose and discuss other treatment options.

What is the maximum dosage for trazodone HCl?

When taken in an outpatient setting, the maximum dosage for trazodone is 400 mg per day. If administered to patients observed in a hospital or facility, the maximum dosage is 600 mg per day.

Can you overdose on trazodone HCl?

Trazodone overdose can occur, and the most common effects of it are drowsiness, vomiting, and other side effects. A trazodone overdose can cause severe problems, such as seizures, heart rhythm abnormalities, racing heartbeats, slowed breathing, respiratory arrest, and priapism. A trazodone overdose can be fatal if other central nervous system depressants are also taken, including alcohol, sedatives, and barbiturates.

What interacts with trazodone HCl?

Trazodone should never be taken with monoamine oxidase inhibitors (MAOIs), a small group of drugs that includes linezolid and methylene blue. The combination can bring on serotonin syndrome, a potentially severe or life-threatening side effect that is caused by brain chemistry being thrown off balance. Ask the prescriber or a pharmacist if any drugs you take are MAOIs.

Trazodone interacts with many prescription drugs, over-the-counter medicines, and supplements. Combining trazodone with these drugs is not always a contraindication, but extra monitoring might be needed. Among the medications that may cause trouble when combined with trazodone are any that cause sedation, including alcohol, sleeping pills, barbiturates, or antihistamines. Drugs that affect heartbeats might also cause problems. Finally, taking trazodone with other medications that affect serotonin levels, such as SSRIs, SNRIs, or antipsychotics, increases the risk of serotonin syndrome. 

Because many trazodone drug interactions can be serious, tell the prescriber about any drugs or supplements being taken. Inform the prescribing healthcare provider if any new drug is started while on trazodone.

What happens when you mix trazodone HCl and alcohol?

Do not drink alcohol when taking trazodone. The combination will amplify the sedative effects of the medication and the alcohol, such as drowsiness or lightheadedness. The combination also creates an increased risk of accidents and injuries, particularly when driving or engaging in risky activities.

Is it safe to take trazodone HCl during pregnancy?

There is no evidence that trazodone poses a risk to a mother or fetus during pregnancy. However, there may be some risks, so healthcare professionals encourage pregnant patients taking trazodone to register with the National Pregnancy Registry for Antidepressants.

Is it safe to take trazodone HCl while breastfeeding?

Trazodone can be taken by women who are breastfeeding. While trazodone does show up in breast milk, there’s no evidence of any adverse effects in a nursing child. 

What are the most common side effects of trazodone HCl?

People taking trazodone commonly experience side effects. The most common adverse reactions are drowsiness, sleepiness, lightheadedness, dry mouth, headache, nausea, diarrhea, constipation, low blood pressure (hypotension), blurred vision, orthostatic hypotension, and trouble sleeping. Heart rhythm abnormalities are a common serious side effect, particularly a heart arrhythmia called QT prolongation. Other serious side effects include low sodium (hyponatremia), seizures, closed-angle glaucoma, and serotonin syndrome. The most serious side effect is a worsening depression and increased suicidal thoughts and behaviors. Teens and young adults taking trazodone are particularly at risk. For this reason, the FDA has added a black box warning to trazodone.

Related resources for trazodone HCl dosages:

• How trazodone can help anxious dogs, SingleCare

• Trazodone, StatPearls

• Trazodone adult dosing, Epocrates

• Trazodone hydrochloride drug summary, Prescriber’s Digital Reference (PDR)

• Trazodone hydrochloride tablet prescribing information, Food and Drug Administration (FDA)