Combination with other antidepressants
Trazodone is often used in combination with other antidepressants such as selective serotonin reuptake inhibitors in order to augment their antidepressant and anxiolytic effects and to reduce side effects such as sexual dysfunction, anxiety, and insomnia. Available forms
Trazodone is provided as the hydrochloride salt and is available in the form of 50 mg, 100 mg, 150 mg, and 300 mg oral tablets.An extended-release oral tablet formulation at doses of 150 mg and 300 mg is also available. Side effects
Because of its lack of anticholinergic side effects, trazodone is especially useful in situations in which antimuscarinic effects are particularly problematic (e.g., in patients with benign prostatic hyperplasia, closed-angle glaucoma, or severe constipation). Trazodones propensity to cause sedation is a dual-edged sword. For many patients, the relief from agitation, anxiety, and insomnia can be rapid; for other patients, including those individuals with considerable psychomotor retardation and feelings of low energy, therapeutic doses of trazodone may not be tolerable because of sedation. Trazodone elicits orthostatic hypotension in some people, probably as a consequence of α1-adrenergic receptor blockade. The unmasking of bipolar disorder may occur with trazodone and other antidepressants.Precautions for trazodone include known hypersensitivity to trazodone and under 18 years and combined with other antidepressant medications, it may increase the possibility of suicidal thoughts or actions.While trazodone is not a true member of the SSRI class of antidepressants, it does still share many properties of SSRIs, especially the possibility of discontinuation syndrome if the medication is stopped too quickly.
Netupitant/palonosetron, sold under the brand name Akynzeo, is a fixed-dose combination medication used for the prevention of acute and delayed chemotherapy-induced nausea and vomiting. It is marketed and distributed by Helsinn Therapeutics. Netupitant is an NK1 receptor antagonist and palonosetron is a 5-HT3 receptor antagonist.The capsules contain netupitant and palonosetron hydrochloride. The intravenous version is a combination of fosnetupitant chloride hydrochloride and palonosetron hydrochloride. Contraindications
Netupitant/palonosetron may be contraindicated during pregnancy. Adverse effects
The most common side effects include headache, weakness, fatigue, upset stomach, constipation, and skin redness. The overall profile of adverse effects is comparable to that of palonosetron (see Palonosetron#Adverse effects); no common adverse effects can be attributed to netupitant. Interactions
Pharmacology
History
Netupitant/palonosetron was approved for use in the United States in October 2014. It was approved for use in the European Union in May 2015. The intravenous version, which contains the prodrug fosnetupitant in place of netupitant, was approved in the United States in April 2018. References
External links
"Netupitant mixture with palonosetron". Drug Information Portal. U.S. National Library of Medicine. "Fosnetupitant". Drug Information Portal. U.S. National Library of Medicine. "Fosnetupitant and Palonosetron (Professional Patient Advice)". Drugs.com.