Chemical: Drug
nefazodone

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last updated 10/25/2013

1. FDA Label for nefazodone and CYP2D6

Informative PGx

Summary

Nefazodone treatment adjustment is not required based on CYP2D6 metabolizer status. Caution should be used when co-prescribing nefazodone with other drugs metabolized by CYP3A4.

Annotation

PGx information can be found in the Drug Interactions label section.

Excerpts from the nefazodone label:

A subset (3% to 10%) of the population has reduced activity of the drug-metabolizing enzyme CYP2D6. Such individuals are referred to commonly as "poor metabolizers" of drugs such as debrisoquin, dextromethorphan, and the tricyclic antidepressants. The pharmacokinetics of nefazodone and its major metabolites are not altered in these "poor metabolizers." Plasma concentrations of one minor metabolite (mCPP) are increased in this population; the adjustment of nefazodone dosage is not required when administered to "poor metabolizers." Nefazodone and its metabolites have been shown in vitro to be extremely weak inhibitors of CYP2D6. Thus, it is not likely that nefazodone will decrease the metabolic clearance of drugs metabolized by this isozyme.

Nefazodone has been shown in vitro to be an inhibitor of CYP3A4. Consequently, it is recommended that nefazodone not be used in combination with either terfenadine, astemizole, cisapride, or pimozide.

For the complete drug label text with sections containing pharmacogenetic information highlighted, see the nefazodone drug label.

*Disclaimer: The contents of this page have not been endorsed by the FDA and are the sole responsibility of PharmGKB.

Genes and/or phenotypes found in this label

  • Anxiety Disorders
    • Warnings section
    • source: PHONT
  • Depressive Disorder, Major
    • Indications & usage section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Obsessive-Compulsive Disorder
    • Warnings section
    • source: PHONT
  • Toxic liver disease
    • Warnings section, Precautions section
    • source: PHONT
  • CYP2D6
    • metabolism/PK, Drug interactions section, Precautions section
    • source: U.S. Food and Drug Administration
  • CYP3A4
    • metabolism/PK, Warnings section, Drug interactions section, Precautions section
    • source: U.S. Food and Drug Administration

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all variant annotations for nefazodone

Gene ? Variant?
(147)
Alternate Names ? Chemicals ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available CA VA
rs130058 NC_000006.11:g.78173281T>A, NC_000006.12:g.77463564T>A, NM_000863.2:c.-161A>T, XR_942706.1:n.545-10962T>A, XR_942707.1:n.545-10962T>A, XR_942708.1:n.545-10962T>A, XR_942709.1:n.545-10962T>A, rs17273665
T > A
SNP
No VIP available CA VA
rs1360780 NC_000006.11:g.35607571T>C, NC_000006.12:g.35639794T>C, NG_012645.2:g.93790A>G, NM_001145775.2:c.106-2636A>G, NM_001145776.1:c.106-2636A>G, NM_001145777.1:c.106-2636A>G, NM_004117.3:c.106-2636A>G, XR_926743.1:n.287+5974T>C, rs58091271
T > C
SNP
No VIP available CA VA
rs2032582 NC_000007.13:g.87160618A>C, NC_000007.13:g.87160618A>T, NC_000007.14:g.87531302A>C, NC_000007.14:g.87531302A>T, NG_011513.1:g.186947T>A, NG_011513.1:g.186947T>G, NM_000927.4:c.2677T>A, NM_000927.4:c.2677T>G, NP_000918.2:p.Ser893Ala, NP_000918.2:p.Ser893Thr, rs10228331, rs2229106, rs386553610, rs57135550, rs9641018
A > C
SNP
S893A
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 147

Overview

Generic Names
  • Nefazodona [Spanish]
  • Nefazodone Hcl
  • Nefazodone Hydrochloride
  • Nefazodonum [Latin]
Trade Names
  • Dutonin
  • Serzone
Brand Mixture Names

PharmGKB Accession Id

PA450603

Type(s):

Drug

Description

Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. Its sale was discontinued in 2003 in some countries, due to the small possibility of hepatic (liver) injury, which could lead to the need for a liver transplant, or even death. The incidence of severe liver damage is approximately 1 in 250,000 to 300,000 patient-years. On May 20, 2004, Bristol-Myers Squibb discontinued the sale of Serzone in the United States. Wikipedia

Source: Drug Bank

Indication

For the treatment of depression.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Within the serotonergic system, nefazodone acts as an antagonist at type 2 serotonin (5-HT 2) post-synaptic receptors and, like fluoxetine-type antidepressants, inhibits pre-synaptic serotonin (5-HT) reuptake. These mechanisms increase the amount of serotonin available to interact with 5-HT receptors. Within the noradrenergic system, nefazodone inhibits norepinephrine uptake minimally. Nefazodone also antagonizes alpha(1)-adrenergic receptors, producing sedation, muscle relaxation, and a variety of cardiovascular effects. Nefazodone's affinity for benzodiazepine, cholinergic, dopaminergic, histaminic, and beta or alpha(2)-adrenergic receptors is not significant.

Source: Drug Bank

Pharmacology

Nefazodone, an antidepressant synthetically derived phenylpiperazine, is used to treat major depression. Although it is structurally similar to trazodone, nefazodone has a mechanism of action different from other antidepressants and, hence, lacks the risk for major cardiovascular toxicity seen with tricyclics and insomnia and inhibition of REM sleep seen with the selective serotonin reuptake inhibitors.

Source: Drug Bank

Food Interaction

Avoid alcohol.|Avoid avocado.|Limit garlic, ginger, gingko, and horse chestnut.|Take this medication either consistently with or without food as instructed by your doctor.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic.

Source: Drug Bank

Protein Binding

Greater than 99% (in vitro, human plasma proteins).

Source: Drug Bank

Absorption

Nefazodone is rapidly and completely absorbed. Its absolute bioavailability is low (about 20%).

Source: Drug Bank

Half-Life

2-4 hours

Source: Drug Bank

Toxicity

Cases of life-threatening hepatic failure have been reported in patients treated
with nefazodone.

Source: Drug Bank

Route of Elimination

Nefazodone is extensively metabolized after oral administration by n-dealkylation and aliphatic and aromatic hydroxylation, and less than 1% of administered nefazodone is excreted unchanged in urine.

Source: Drug Bank

Volume of Distribution

  • 0.22 to 0.87 L/kg

Source: Drug Bank

Chemical Properties

Chemical Formula

C25H32ClN5O2

Source: Drug Bank

Isomeric SMILES

CCc1nn(c(=O)n1CCOc2ccccc2)CCCN3CCN(CC3)c4cccc(c4)Cl

Source: OpenEye

Canonical SMILES

CCC1=NN(CCCN2CCN(CC2)C2=CC(Cl)=CC=C2)C(=O)N1CCOC1=CC=CC=C1

Source: Drug Bank

Average Molecular Weight

470.007

Source: Drug Bank

Monoisotopic Molecular Weight

469.224453

Source: Drug Bank

SMILES

CCC1=NN(CCCN2CCN(CC2)C2=CC(Cl)=CC=C2)C(=O)N1CCOC1=CC=CC=C1

Source: Drug Bank

InChI String

InChI=1S/C25H32ClN5O2/c1-2-24-27-31(25(32)30(24)18-19-33-23-10-4-3-5-11-23)13-7-12-28-14-16-29(17-15-28)22-9-6-8-21(26)20-22/h3-6,8-11,20H,2,7,12-19H2,1H3

Source: Drug Bank

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
ADRA1A (source: Drug Bank)
ADRA1B (source: Drug Bank)
ADRA2A (source: Drug Bank)
HTR1A (source: Drug Bank)
HTR2A (source: Drug Bank)
HTR2C (source: Drug Bank)
SLC6A2 (source: Drug Bank)
SLC6A3 (source: Drug Bank)
SLC6A4 (source: Drug Bank)

Drug Interactions

Interaction Description
almotriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
almotriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
aprepitant - nefazodone This CYP3A4 inhibitor increases the effect and toxicity of aprepitant (source: Drug Bank)
astemizole - nefazodone Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
astemizole - nefazodone Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
atorvastatin - nefazodone Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
atorvastatin - nefazodone Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
bromazepam - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of bromazepam by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of bromazepam if nefazodone is initiated, discontinued or dose changed. Dosage adjustments may be required. (source: Drug Bank)
buspirone - nefazodone Nefazodone increases the effect of buspirone (source: Drug Bank)
buspirone - nefazodone Nefazodone increases the effect of buspirone (source: Drug Bank)
carbamazepine - nefazodone Nefazodone increases the effect of carbamazepine (source: Drug Bank)
carbamazepine - nefazodone Nefazodone increases the effect of carbamazepine (source: Drug Bank)
cerivastatin - nefazodone Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
cerivastatin - nefazodone Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
cilostazol - nefazodone Nefazodone increases the effect of cilostazol (source: Drug Bank)
cisapride - nefazodone Nefazodone increases serum levels of cisapride (source: Drug Bank)
cisapride - nefazodone Nefazodone increases serum levels of cisapride (source: Drug Bank)
cyclosporine - nefazodone The antidepressant increases the effect and toxicity of cyclosporine (source: Drug Bank)
cyclosporine - nefazodone The antidepressant increases the effect and toxicity of cyclosporine (source: Drug Bank)
dantrolene - nefazodone Nefazodone may increase the serum concentration of dantrolene by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dantrolene if nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
darifenacin - nefazodone This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
darifenacin - nefazodone This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
dihydroergotamine - nefazodone Possible ergotism and severe ischemia with this combination (source: Drug Bank)
dihydroergotamine - nefazodone Possible ergotism and severe ischemia with this combination (source: Drug Bank)
eletriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
eletriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
eplerenone - nefazodone Nefazodone increases the effect and toxicity of eplerenone (source: Drug Bank)
ergotamine - nefazodone Possible ergotism and severe ischemia with this combination (source: Drug Bank)
ergotamine - nefazodone Possible ergotism and severe ischemia with this combination (source: Drug Bank)
frovatriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
isocarboxazid - nefazodone Possible severe adverse reaction with this combination (source: Drug Bank)
isocarboxazid - nefazodone Possible severe adverse reaction with this combination (source: Drug Bank)
linezolid - nefazodone Combination associated with possible serotoninergic syndrome (source: Drug Bank)
linezolid - nefazodone Combination associated with possible serotoninergic syndrome (source: Drug Bank)
loratadine - nefazodone Increased risk of cardiotoxicity (source: Drug Bank)
loratadine - nefazodone Increased risk of cardiotoxicity (source: Drug Bank)
lovastatin - nefazodone Nefazodone increases the effect and toxicity of the statin (source: Drug Bank)
lovastatin - nefazodone Nefazodone increases the effect and toxicity of the statin (source: Drug Bank)
naratriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
naratriptan - nefazodone Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - almotriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - almotriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - aprepitant This CYP3A4 inhibitor increases the effect and toxicity of aprepitant (source: Drug Bank)
nefazodone - astemizole Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
nefazodone - astemizole Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
nefazodone - atorvastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - atorvastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - buspirone Nefazodone increases the effect of buspirone (source: Drug Bank)
nefazodone - buspirone Nefazodone increases the effect of buspirone (source: Drug Bank)
nefazodone - carbamazepine Nefazodone increases the effect of carbamazepine (source: Drug Bank)
nefazodone - carbamazepine Nefazodone increases the effect of carbamazepine (source: Drug Bank)
nefazodone - cerivastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - cerivastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - cilostazol Nefazodone increases the effect of cilostazol (source: Drug Bank)
nefazodone - cisapride Nefazodone increases serum levels of cisapride (source: Drug Bank)
nefazodone - cisapride Nefazodone increases serum levels of cisapride (source: Drug Bank)
nefazodone - cyclosporine The antidepressant increases the effect and toxicity of cyclosporine (source: Drug Bank)
nefazodone - cyclosporine The antidepressant increases the effect and toxicity of cyclosporine (source: Drug Bank)
nefazodone - darifenacin This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
nefazodone - dihydroergotamine Possible ergotism and severe ischemia with this combination (source: Drug Bank)
nefazodone - eletriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - eletriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - eplerenone Nefazodone increases the effect and toxicity of eplerenone (source: Drug Bank)
nefazodone - ergotamine Possible ergotism and severe ischemia with this combination (source: Drug Bank)
nefazodone - erlotinib This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
nefazodone - erlotinib This CYP3A4 inhibitor increases levels/toxicity of erlotinib (source: Drug Bank)
nefazodone - frovatriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - isocarboxazid Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - isocarboxazid Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - linezolid Combination associated with possible serotoninergic syndrome (source: Drug Bank)
nefazodone - linezolid Combination associated with possible serotoninergic syndrome (source: Drug Bank)
nefazodone - loratadine Increased risk of cardiotoxicity (source: Drug Bank)
nefazodone - loratadine Increased risk of cardiotoxicity (source: Drug Bank)
nefazodone - lovastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - lovastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - naratriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - naratriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - phenelzine Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - phenelzine Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - pimozide Nefazodone increases the effect and toxicity of pimozide (source: Drug Bank)
nefazodone - pimozide Nefazodone increases the effect and toxicity of pimozide (source: Drug Bank)
nefazodone - rasagiline Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - rizatriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - rizatriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - sibutramine Risk of serotoninergic syndrome (source: Drug Bank)
nefazodone - sibutramine Risk of serotoninergic syndrome (source: Drug Bank)
nefazodone - simvastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - simvastatin Nefazodone increases the effect and toxicity of the statin drug (source: Drug Bank)
nefazodone - solifenacin This potent CYP3A4 inhibitor slows darifenacin/solifenacin metabolism (source: Drug Bank)
nefazodone - sumatriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - sumatriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - sunitinib Possible increase in sunitinib levels (source: Drug Bank)
nefazodone - sunitinib Possible increase in sunitinib levels (source: Drug Bank)
nefazodone - tacrolimus Nefazodone increases the effect and toxicity of tacrolimus (source: Drug Bank)
nefazodone - tacrolimus Nefazodone increases the effect and toxicity of tacrolimus (source: Drug Bank)
nefazodone - terfenadine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
nefazodone - terfenadine Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
nefazodone - tramadol Increased risk of serotonin syndrome (source: Drug Bank)
nefazodone - tramadol Increased risk of serotonin syndrome (source: Drug Bank)
nefazodone - tranylcypromine Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - tranylcypromine Possible severe adverse reaction with this combination (source: Drug Bank)
nefazodone - trazodone This strong CYP3A4 inhibitor increases the effect and toxicity of trazodone (source: Drug Bank)
nefazodone - trazodone This strong CYP3A4 inhibitor increases the effect and toxicity of trazodone (source: Drug Bank)
nefazodone - triazolam Nefazodone increases the effect of triazolam (source: Drug Bank)
nefazodone - triazolam Nefazodone increases the effect of triazolam (source: Drug Bank)
nefazodone - zolmitriptan Increased risk of CNS adverse effects (source: Drug Bank)
nefazodone - zolmitriptan Increased risk of CNS adverse effects (source: Drug Bank)
phenelzine - nefazodone Possible severe adverse reaction with this combination (source: Drug Bank)
phenelzine - nefazodone Possible severe adverse reaction with this combination (source: Drug Bank)
pimozide - nefazodone increases the effect and toxicity of pimozide (source: Drug Bank)
pimozide - nefazodone increases the effect and toxicity of pimozide (source: Drug Bank)
rasagiline - nefazodone Possible severe adverse reaction with this combination (source: Drug Bank)
tadalafil - nefazodone Nefazodone may reduce the metabolism of Tadalafil. Concomitant therapy should be avoided if possible due to high risk of Tadalafil toxicity. (source: Drug Bank)
tamoxifen - nefazodone Nefazodone may increase the serum concentration of Tamoxifen by decreasing its metabolism. Monitor for increased adverse/toxic effects of Tamoxifen. (source: Drug Bank)
tamoxifen - nefazodone Nefazodone may increase the serum concentration of Tamoxifen by decreasing its metabolism. Monitor for increased adverse/toxic effects of Tamoxifen. (source: Drug Bank)
tamsulosin - nefazodone Nefazodone, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Nefazodone is initiated, discontinued, or dose changed. (source: Drug Bank)
tamsulosin - nefazodone Nefazodone, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Nefazodone is initiated, discontinued, or dose changed. (source: Drug Bank)
telithromycin - nefazodone Co-administration may result in altered plasma concentrations of Nefazodone and/or Telithromycin. Consider alternate therapy or monitor the therapeutic/adverse effects of both agents. (source: Drug Bank)
teniposide - nefazodone The strong CYP3A4 inhibitor, Nefazodone, may decrease the metabolism and clearance of Teniposide, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Teniposide if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
terfenadine - nefazodone Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
terfenadine - nefazodone Increased risk of cardiotoxicity and arrhythmias (source: Drug Bank)
tiagabine - nefazodone The strong CYP3A4 inhibitor, Nefazodone, may decrease the metabolism and clearance of Tiagabine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Tiagabine if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
tolterodine - nefazodone Nefazodone may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity. (source: Drug Bank)
tolterodine - nefazodone Nefazodone may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity. (source: Drug Bank)
tramadol - nefazodone Nefazodone may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Increased risk of serotonin syndrome. Monitor for Tramadol toxicity and symptoms of serotonin syndrome. (source: Drug Bank)
tranylcypromine - nefazodone Increased risk of serotonin syndrome. Use caution during concomitant therapy and monitor for symptoms of serotonin syndrome. (source: Drug Bank)
trazodone - nefazodone Increased risk of serotonin syndrome. The CYP3A4 inhibitor, Nefazodone, may increase Trazodone efficacy/toxicity by decreasing Trazodone metabolism and clearance. The CYP2D6 inhibitor, Trazodone, may increase the efficacy of Nefazodone by decreaseing Nefazodone metabolism and clearance. Consider alternate therapy or monitor for symtpoms of sertonin syndrome and changes in Trazodone and Nefazodone efficacy/toxicity if either agent is initiated, discontinued or dose changed. (source: Drug Bank)
trazodone - nefazodone This strong CYP3A4 inhibitor increases the effect and toxicity of trazodone (source: Drug Bank)
trazodone - nefazodone Increased risk of serotonin syndrome. The CYP3A4 inhibitor, Nefazodone, may increase Trazodone efficacy/toxicity by decreasing Trazodone metabolism and clearance. Consider alternate therapy or monitor for symtpoms of sertonin syndrome and changes in Trazodone efficacy/toxicity if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
triazolam - nefazodone Nefazodone increases the effect of triazolam (source: Drug Bank)
triazolam - nefazodone Nefazodone increases the effect of triazolam (source: Drug Bank)
trimipramine - nefazodone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. Nefazodone, a strong CYP3A4 inhibitor, may also decrease the metabolism and clearance of Trimipramine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Trimipramine if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
triprolidine - nefazodone The CNS depressants, Triprolidine and Nefazodone, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
triprolidine - nefazodone The CNS depressants, Triprolidine and Nefazodone, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy. (source: Drug Bank)
vardenafil - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may reduce the metabolism and clearance of Vardenafil. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of Vardenafil. (source: Drug Bank)
venlafaxine - nefazodone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome. (source: Drug Bank)
verapamil - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of Veramapil, a CYP3A4 substrate, by decreasing its metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Verapamil if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
vincristine - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of Vincristine by decreasing its metabolism. Consider alternate therapy to avoid Vincristine toxicity. Monitor for changes in the therapeutic and adverse effects of Vincristine if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
vinorelbine - nefazodone Nafazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of Vinorelbine by decreasing its metabolism. Consider alternate therapy to avoid Vinorelbine toxicity. Monitor for changes in the therapeutic and adverse effects of Vinorelbine if Nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
voriconazole - nefazodone Voriconazole, a strong CYP3A4 inhibitor, may increase the serum concentration of nefazodone by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of nefazodone if voriconazole is initiated, discontinued or dose changed. (source: Drug Bank)
zolmitriptan - nefazodone Use of two serotonin modulators, such as zolmitriptan and nafazodone, increases the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy. (source: Drug Bank)
zolpidem - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of zolpidem by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zolpidem if nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
zonisamide - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)
zopiclone - nefazodone Nefazodone, a strong CYP3A4 inhibitor, may increase the serum concentration of zopiclone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zopiclone if nefazodone is initiated, discontinued or dose changed. (source: Drug Bank)

Curated Information ?

Relationships from National Drug File - Reference Terminology (NDF-RT)

May Treat
Contraindicated With

Publications related to nefazodone: 11

No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Pharmacogenetics in major depression: a comprehensive meta-analysis. Progress in neuro-psychopharmacology & biological psychiatry. 2013. Niitsu Tomihisa, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Clinical and genetic correlates of suicidal ideation during antidepressant treatment in a depressed outpatient sample. Pharmacogenomics. 2011. Perroud Nader, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Meta-analysis of FKBP5 gene polymorphisms association with treatment response in patients with mood disorders. Neuroscience letters. 2010. Zou Yan-Feng, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
FKBP5 polymorphisms and antidepressant response in geriatric depression. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2010. Sarginson Jane E, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Genetic variants in FKBP5 affecting response to antidepressant drug treatment. Pharmacogenomics. 2008. Kirchheiner Julia, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA : the journal of the American Medical Association. 2007. Bridge Jeffrey A, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Genetic variability at HPA axis in major depression and clinical response to antidepressant treatment. Journal of affective disorders. 2007. Papiol Sergi, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Idiosyncratic drug hepatotoxicity. Nature reviews. Drug discovery. 2005. Kaplowitz Neil. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Polymorphisms in FKBP5 are associated with increased recurrence of depressive episodes and rapid response to antidepressant treatment. Nature genetics. 2004. Binder Elisabeth B, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Med-psych drug-drug interactions update. Psychosomatics. 2002. Armstrong Scott C, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
CYP2B6 mediates the in vitro hydroxylation of bupropion: potential drug interactions with other antidepressants. Drug metabolism and disposition: the biological fate of chemicals. 2000. Hesse L M, et al. PubMed

LinkOuts

Web Resource:
Wikipedia
National Drug Code Directory:
0087-0031-47
DrugBank:
DB01149
ChEBI:
7494
KEGG Compound:
C07256
PubChem Compound:
4449
PubChem Substance:
205126
46508323
Drugs Product Database (DPD):
2242822
ChemSpider:
4294
Therapeutic Targets Database:
DAP000042

Clinical Trials

These are trials that mention nefazodone and are related to either pharmacogenetics or pharmacogenomics.

No trials found.

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Sources for PharmGKB drug information: DrugBank, PubChem.