Medication: Trazodone

Your cat has been prescribed trazodone for management of both ongoing or anticipated fear or anxiety (eg fireworks, thunderstorms, veterinary appointments). It should be used alongside a desensitizing behavior program to help control your pet’s fear and anxiety. It may have been prescribed if your cat has recently had surgery and needs to be confined in a crate for the recovery period or will be housed in a high stress situation for a short period of time (eg boarding kennel).  It is also prescribed, typically in combination with gabapentin, prior to veterinary appointments for sedation and calming during transport and examination.

Key points: 
• Serotonin receptor agonist and reuptake inhibitor (SARI).
• Do not use with MAO inhibitors eg Selegiline or Amitraz.
• Decrease dosage by half for first 3 days when combining with tramadol.
• Do not use in cats with bleeding disorders.
• Use with care in animals with epilepsy.
• Use with care in animals with liver or kidney disease.
• Use with care in animals with heart disease and avoid if cardiac arrhythmias.
• Use with care in pregnant animals and lactating queens as can enter the milk.
• Use with care in cats with certain types of glaucoma.
• Dosage: usually used as needed just before known stressful situations. Can be given daily for use in anxiety.
• If used long term do not stop suddenly – taper dose when stopping.

This information sheet is designed to help answer commonly asked questions and help you give the medication safely and effectively to your pet. It does not contain all available information for this medication. If you have other questions or need more information, contact your veterinarian or pharmacist. Always follow the dosing instructions provided by your veterinarian. 

Name

• Trazodone (TRAZ-oh-dough-n).

Brand name

• There is no product licensed for use in pets but human drugs can be given with special consent or used in an extralabel fashion in the US.
• Desyrel® (US).
• Oleptro® (US).
• Molipaxin® (UK).

Class of medication

• Serotonin (5-HT2A) Antagonist/Reuptake Inhibitor
• Phenylpiperazine antidepressant

Storage

• Store at room temperature (15-25°C/59-77°F).
• Store away from heat, moisture and sunlight.

Your veterinarian has prescribed trazodone to help in the management of fear or anxiety. For long term behavior change, trazodone should be used under veterinary supervision and alongside a program of behavioral change to help control your pet’s anxiety. If your pet has chronic fear/anxiety then medication may need to be given once or twice every day. If your pet has a fear of a specific known event that can be predicted in advance (eg fireworks or a trip to the veterinary clinic) then medication may be given 1-2 hours before the event. Your veterinarian may have prescribed trazodone for your pet if they have had surgery and need a prolonged period or rest or confinement to aid healing and recovery.

The product is available as tablets can be given by mouth. The tablets are usually given with  small amount of food but can be administered directly into your cat’s mouth. Trazodone has a bitter taste and may best be hidden in a small bit of food. For anticipated fear-inducing events, trazodone is usually administered at least 90 minutes prior to the onset of the event (eg fireworks, thunderstorms, veterinary appointments).

The following side-effects have been reported:

• Sedation/ wobbliness.
• Vomiting and or diarrhea.
• Loss of appetite.
• Increased anxiety or aggression.
• Depression and lethargy.
• Prolonged erection in male cats.
• Serotonin syndrome (trembling, shivering, difficulty breathing, dilated eyes, seizures, vomiting, unexplained aggression).

Drug interactions can occur with:

• MAOIs, eg selegiline or amitraz which are used for parasite control increase risk of serotonin syndrome.
• Risk of serotonin syndrome increases with use of some other drugs for pain relief such as fentanyl and tramadol. The dosage of tramadol is usually halved when combined with trazodone.
• Risk of bleeding increased with use of drugs such as NSAIDs for arthritis, warfarin or other anti-coagulants.
• Increases effect of digoxin and phenytoin (for heart disease) and some drugs used for sedation or anesthesia.
• Antifungals such as itraconazole, ketoconazole increase effects of trazodone.
• Cimetidine and erythromycin reduced breakdown of trazodone and can increase effect of drug.

Trazodone should be administered according to your veterinarian’s instructions. It may be used on a short term basis in anticipation of fear-inducing events, or it may be given for an ongoing basis. If used chronically, treatment is started at a low dose and then gradually increased over time. If treatment is effective the drug may be continued lifelong. If no improvement is seen within a few months, your veterinarian may recommend a different course of therapy. You should never change or stop any treatment without consulting your veterinarian.

Dispose of any unused trazodone safely – do not flush down the toilet or sink. Ask your veterinary team if they take back medication for disposal. Do not save for future use or give to other pets.

If you miss a dose, give the dose as soon as possible but do not give a double dose. Make sure the dose given does not exceed the total recommended dose in any 24-hour period.

If your pet is unwell, contact your veterinarian for advice. If you suspect your cat has serotonin syndrome (shivering, seizures, difficulty breathing, or unexplained aggression) do not give any more trazodone and your cat must be seen by a veterinarian immediately.

Trazodone should only be given to the cat that it has been prescribed for:

• Do not give to other pets in the household.
• Use with care in pregnant or lactating queens and only if advised by your veterinarian.
• If accidentally given to other pets, contact your veterinarian for advice.

If accidentally consumed by a human, speak to your primary care physician or poison control center.

Your veterinarian will want to make regular checks on your pet if they are receiving any long term therapy to ensure the drugs they are receiving are effective and to adjust the doses if necessary. Ongoing management of the underlying fear/anxiety disorder may be needed.

Further information 

If you have any concerns, further information on trazodone can be found on the package insert and the following websites:

Europe & UK

• There are no licensed products for cats or dogs.
• Trazodone generic (50 mg, 100 mg, 150 mg, 300 mg tablets or 50 mg, 100 mg capsules or 50 mg/ml oral solution).
• Molipaxin® (50 mg, 100 mg tablets): www.hpra.ie/img/uploaded/swedocuments/8522420f-b0b7-487c-8a6e-a9fdb5a6f4e2.pdf 

USA

• There are no licensed product for cats or dogs.
• Olpetro® (150 mg, 300 mg tablets): https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022411lbl.pdf; www.drugs.com/pro/oleptro.html
• Desyrel® (50 mg, 100 mg, 150 mg, 300 mg tablets): www.accessdata.fda.gov/drugsatfda_docs/label/2017/018207s032lbl.pdf 
• Trazodone generic (50 mg, 100 mg, 150 mg, and 300 mg tablets).

Always follow the recommended dosage and contact your veterinary team or pharmacist if you have any questions regarding your cat’s medication.