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  <title>These highlights do not include all the information needed to use TRAZODONE HYDROCHLORIDE TABLETS safely and effectively. See full prescribing information for TRAZODONE HYDROCHLORIDE TABLETS.
 <br/>
TRAZODONE HYDROCHLORIDE tablets, for oral use
 <br/>
Initial U.S. Approval: 1981
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                  <value code="C48345" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="OVAL" xsi:type="CE">
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                  <routeCode code="C38288" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="ORAL"/>
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      </component>
      <component>
        <section ID="ID271">
          <id root="04c90bfc-096c-4b37-e063-6294a90a7978"/>
          <code code="34066-1" codeSystem="2.16.840.1.113883.6.1" displayName="BOXED WARNING SECTION"/>
          <title>WARNING: SUICIDAL THOUGHTS and BEHAVIORS</title>
          <text>
            <paragraph>
              <content styleCode="bold">Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors 
   <content styleCode="italics">[see 
    <linkHtml href="#ID139">Warnings and Precautions (5.1)</linkHtml>].
   </content> Trazodone is not approved for use in pediatric patients 
   <content styleCode="italics">[see 
    <linkHtml href="#ID187">Use in Specific Populations (8.4)</linkHtml>]. 
   </content>
              </content>
            </paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <paragraph>
                  <content styleCode="bold">WARNING: SUICIDAL THOUGHTS and BEHAVIORS</content>
                </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">See full prescribing information for complete boxed warning.</content>
                  </content>
                </paragraph>
                <list listType="unordered">
                  <item>
                    <content styleCode="bold">Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients 
      <linkHtml href="#ID139">(5.1)</linkHtml>
                    </content>
                  </item>
                  <item>
                    <content styleCode="bold">Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors 
      <linkHtml href="#ID139">(5.1)</linkHtml>
                    </content>
                  </item>
                  <item>
                    <content styleCode="bold">Trazodone is not approved for use in pediatric patients 
      <linkHtml href="#ID187">(8.4)</linkHtml>
                    </content>
                  </item>
                </list>
              </text>
            </highlight>
          </excerpt>
        </section>
      </component>
      <component>
        <section ID="ID124">
          <id root="04c93808-2aad-4593-e063-6394a90a98a8"/>
          <code code="34067-9" codeSystem="2.16.840.1.113883.6.1" displayName="INDICATIONS &amp; USAGE SECTION"/>
          <title>1 INDICATIONS AND USAGE</title>
          <text>
            <paragraph>Trazodone hydrochloride tablets are indicated for the treatment of major depressive disorder (MDD) in adults.</paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <paragraph>Trazodone is a selective serotonin reuptake inhibitor indicated for the treatment of major depressive disorder (MDD) 
    <linkHtml href="#ID124">(1)</linkHtml>.
   </paragraph>
              </text>
            </highlight>
          </excerpt>
        </section>
      </component>
      <component>
        <section ID="ID127">
          <id root="04c9260e-03f8-829f-e063-6394a90a571b"/>
          <code code="34068-7" codeSystem="2.16.840.1.113883.6.1" displayName="DOSAGE &amp; ADMINISTRATION SECTION"/>
          <title>2 DOSAGE AND ADMINISTRATION</title>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <list listType="unordered">
                  <item>Starting dose: 150 mg in divided doses daily. May be increased by 50 mg per day every three to four days. Maximum dose: 400 mg per day in divided doses 
     <linkHtml href="#ID127">(2)</linkHtml>.
    </item>
                  <item>Trazodone hydrochloride tablets should be taken shortly after a meal or light snack 
     <linkHtml href="#ID127">(2)</linkHtml>.
    </item>
                  <item>Tablets should be swallowed whole or broken in half along the score line, and should not be chewed or crushed 
     <linkHtml href="#ID127">(2)</linkHtml>.
    </item>
                  <item>When discontinued, gradual dose reduction is recommended 
     <linkHtml href="#ID127">(2)</linkHtml>.
    </item>
                </list>
              </text>
            </highlight>
          </excerpt>
          <component>
            <section ID="ID322">
              <id root="04c8a345-0a22-5a01-e063-6294a90a40d2"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.1 Dose Selection</title>
              <text>
                <paragraph>An initial dose of 150 mg/day in divided doses is suggested. The dosage should be initiated at a low-dose and increased gradually, noting the clinical response and any evidence of intolerance. Occurrence of drowsiness may require the administration of a major portion of the daily dose at bedtime or a reduction of dosage.</paragraph>
                <paragraph>The dose may be increased by 50 mg/day every 3 to 4 days. The maximum dose for outpatients usually should not exceed 400 mg/day in divided doses. Inpatients (i.e., more severely depressed patients) may be given up to but not in excess of 600 mg/day in divided doses.</paragraph>
                <paragraph>Once an adequate response has been achieved, dosage may be gradually reduced, with subsequent adjustment depending on therapeutic response.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID323">
              <id root="04c8a345-0a23-5a01-e063-6294a90a40d2"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.2 Important Administration Instructions</title>
              <text>
                <paragraph>Trazodone hydrochloride tablets can be swallowed whole or administered as a half tablet by breaking the tablet along the score line.</paragraph>
                <paragraph>Trazodone hydrochloride tablets should be taken shortly after a meal or light snack.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID324">
              <id root="04c931fa-b966-38ef-e063-6294a90af07b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.3 Screen for Bipolar Disorder Prior to Starting Trazodone</title>
              <text>
                <paragraph>Prior to initiating treatment with trazodone hydrochloride tablets or another antidepressant, screen patients for a personal or family history of bipolar disorder, mania, or hypomania 
  <content styleCode="italics">[see 
   <linkHtml href="#ID153">Warnings and Precautions (5.7)</linkHtml>]. 
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID325">
              <id root="04c8ff03-37ff-0ade-e063-6294a90a9156"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.4 Switching to or from Monoamine Oxidase Inhibitor Antidepressant</title>
              <text>
                <paragraph>At least 14 days must elapse between discontinuation of a monoamine oxidase inhibitor (MAOI) antidepressant and initiation of trazodone hydrochloride tablets. In addition, at least 14 days must elapse after stopping trazodone hydrochloride tablets before starting an MAOI antidepressant 
  <content styleCode="italics">[see 
   <linkHtml href="#ID135">Contraindications (4)</linkHtml>, 
   <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml>] 
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID326">
              <id root="04c931fa-b967-38ef-e063-6294a90af07b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.5 Dosage Recommendations for Concomitant Use with Strong CYP3A4 Inhibitors or Inducers</title>
              <text>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Coadministration with Strong CYP3A4 Inhibitors</content>
                  </content>
                  <br/>
Consider reducing trazodone dose based on tolerability when trazodone is coadministered with a strong CYP3A4 inhibitor 
  <content styleCode="italics">[see 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>
                </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Coadministration with Strong CYP3A4 Inducers</content>
                  </content>
                  <br/>
Consider increasing trazodone dose based on therapeutic response when trazodone is coadministered with a strong CYP3A4 inducer 
  <content styleCode="italics">[see 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID327">
              <id root="04c9260e-03f9-829f-e063-6394a90a571b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>2.6 Discontinuation of Treatment with Trazodone</title>
              <text>
                <paragraph>Adverse reactions may occur upon discontinuation of trazodone 
  <content styleCode="italics">[See 
   <linkHtml href="#ID155">Warnings and Precautions (5.8)</linkHtml>]. 
  </content>Gradually reduce the dosage rather than stopping trazodone abruptly whenever possible.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID132">
          <id root="4121a249-6dc7-b7aa-e063-6394a90a49b5"/>
          <code code="43678-2" codeSystem="2.16.840.1.113883.6.1" displayName="DOSAGE FORMS &amp; STRENGTHS SECTION"/>
          <title>3 DOSAGE FORMS AND STRENGTHS</title>
          <text>
            <paragraph>Trazodone hydrochloride tablets, USP are available in the following strengths:</paragraph>
            <paragraph>Trazodone hydrochloride tablets USP, 50 mg are white to off-white, round-shape, biconvex beveled tablets, bisect on one side and plain on other side. The bisected side of tablet is debossed with '8' on upper side of bisect and '05' on lower side of bisect.</paragraph>
            <paragraph>Trazodone hydrochloride tablets USP, 100 mg are white to off-white, round-shape, biconvex beveled tablets, bisect on one side and plain on other side. The bisected side of tablet is debossed with '8' on upper side of bisect and '06' on lower side of bisect.</paragraph>
            <paragraph>Trazodone hydrochloride tablets USP, 150 mg are white to off-white, oval-shape, flat faced beveled tablets having one full bisect and two trisect notches on one side and two trisects on other side. The full bisected side of tablet is debossed with '8' on one side of bisect and '07' on other bisect segments.</paragraph>
            <paragraph>Trazodone hydrochloride tablets USP, 300 mg are white to off-white, oval-shape, flat faced beveled tablets having one full bisect and two trisect notches on one side and two trisects on other side. The full bisected side of tablet is debossed with '8' on one side of bisect and '08' on other bisect segment.</paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <list listType="unordered">
                  <item>Scored tablets of 50 mg, 100 mg, 150 mg and 300 mg 
     <linkHtml href="#ID132">(3)</linkHtml>.
    </item>
                </list>
              </text>
            </highlight>
          </excerpt>
        </section>
      </component>
      <component>
        <section ID="ID135">
          <id root="04c94469-18f5-46fd-e063-6394a90a391e"/>
          <code code="34070-3" codeSystem="2.16.840.1.113883.6.1" displayName="CONTRAINDICATIONS SECTION"/>
          <title>4 CONTRAINDICATIONS</title>
          <text>
            <paragraph>Trazodone hydrochloride tablets are contraindicated in:</paragraph>
            <list listType="unordered">
              <item>Patients taking, or within 14 days of stopping, monoamine oxidase inhibitors (MAOIs), including MAOIs such as linezolid or intravenous methylene blue, because of an increased risk of serotonin syndrome 
   <content styleCode="italics">[see 
    <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml>, 
    <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
   </content>
              </item>
            </list>
          </text>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <list listType="unordered">
                  <item>Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs 
     <linkHtml href="#ID135">(4)</linkHtml>.
    </item>
                </list>
              </text>
            </highlight>
          </excerpt>
        </section>
      </component>
      <component>
        <section ID="ID138">
          <id root="04c8a345-0a24-5a01-e063-6294a90a40d2"/>
          <code code="43685-7" codeSystem="2.16.840.1.113883.6.1" displayName="WARNINGS AND PRECAUTIONS SECTION"/>
          <title>5 WARNINGS AND PRECAUTIONS</title>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <list listType="unordered">
                  <item>
                    <content styleCode="bold">Serotonin Syndrome: </content>Increased risk when co-administered with other serotonergic agents (e.g., SSRI, SNRI, triptans), but also when taken alone. If it occurs, discontinue trazodone and initiate supportive treatment 
     <linkHtml href="#ID143">(5.2)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Cardiac Arrhythmias: </content>Increases the QT interval. Avoid use with drugs that also increase the QT interval and in patients with risk factors for prolonged QT interval 
     <linkHtml href="#ID145">(5.3)</linkHtml>
                  </item>
                  <item>
                    <content styleCode="bold">Orthostatic Hypotension and Syncope: </content>Warn patients of risk and symptoms of hypotension 
     <linkHtml href="#ID147">(5.4)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Increased Risk of Bleeding: </content>Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), other antiplatelet drugs, warfarin, and other anticoagulants may increase this risk 
     <linkHtml href="#ID149">(5.5)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Priapism: </content>Cases of painful and prolonged penile erections and priapism have been reported. Immediate medical attention should be sought if signs and symptoms of prolonged penile erections or priapism are observed 
     <linkHtml href="#ID151">(5.6)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Activation of Mania or Hypomania: </content>Screen for bipolar disorder and monitor for mania or hypomania 
     <linkHtml href="#ID153">(5.7)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Potential for Cognitive and Motor Impairment: </content>Has potential to impair judgment, thinking, and motor skills. Advise patients to use caution when operating machinery 
     <linkHtml href="#ID157">(5.9)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Angle-Closure Glaucoma: </content>Avoid use of antidepressants, including trazodone, in patients with untreated anatomically narrow angles. 
     <linkHtml href="#ID159">(5.10)</linkHtml>.
    </item>
                </list>
              </text>
            </highlight>
          </excerpt>
          <component>
            <section ID="ID139">
              <id root="04c8ff03-3800-0ade-e063-6294a90a9156"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.1 Suicidal Thoughts and Behaviors in Pediatric and Young Adult Patients</title>
              <text>
                <paragraph>In pooled analyses of placebo-controlled trials of antidepressant drugs (SSRIs and other antidepressant classes) that included approximately 77,000 adult patients and over 4,400 pediatric patients, the incidence of suicidal thoughts and behaviors in pediatric and young adult patients was greater in antidepressant-treated patients than in placebo-treated patients. The drug-placebo differences in the number of cases of suicidal thoughts and behaviors per 1,000 patients treated are provided in Table 1.</paragraph>
                <paragraph>No suicides occurred in any of the pediatric studies. There were suicides in the adult studies, but the number was not sufficient to reach any conclusion about antidepressant drug effect on suicide.</paragraph>
                <table ID="_RefID141" width="100%">
                  <caption>Table 1 Risk Differences of the Number of Cases of Suicidal Thoughts or Behaviors in the Pooled Placebo-Controlled Trials of Antidepressants in Pediatric and Adult Patients</caption>
                  <colgroup>
                    <col width="35%"/>
                    <col width="65%"/>
                  </colgroup>
                  <tbody>
                    <tr>
                      <td align="center" styleCode="Rrule Botrule Lrule Toprule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Age Range</content>
                        </paragraph>
                        <paragraph>
                          <content styleCode="bold">(years)</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule Toprule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Drug-Placebo Difference in Number of Patients of</content>
                        </paragraph>
                        <paragraph>
                          <content styleCode="bold">Suicidal Thoughts or Behaviors per 1,000 Patients Treated</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Lrule Botrule " valign="middle"/>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Increases Compared to Placebo</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>&lt; 18</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>14 additional patients</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>18 to 24</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5 additional patients</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Lrule Botrule " valign="middle"/>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Decreases Compared to Placebo</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>25 to 64</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1 fewer patient</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Botrule Lrule " valign="middle">
                        <paragraph>≥ 65</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6 fewer patients</paragraph>
                      </td>
                    </tr>
                  </tbody>
                </table>
                <paragraph>It is unknown whether the risk of suicidal thoughts and behaviors in pediatric and young adult patients extends to longer-term use, i.e., beyond four months. However, there is substantial evidence from placebo-controlled maintenance trials in adults with MDD that antidepressants delay the recurrence of depression.</paragraph>
                <paragraph>Monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors, especially during the initial few months of drug therapy and at times of dosage changes. Counsel family members or caregivers of patients to monitor for changes in behavior and to alert the healthcare provider. Consider changing the therapeutic regimen, including possibly discontinuing trazodone, in patients whose depression is persistently worse, or who are experiencing emergent suicidal thoughts or behaviors.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID143">
              <id root="04c9489c-bbcd-6f21-e063-6394a90ad393"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.2 Serotonin Syndrome</title>
              <text>
                <paragraph>Serotonin-norepinephrine reuptake inhibitors (SNRIs) and SSRIs, including trazodone, can precipitate serotonin syndrome, a potentially life-threatening condition. The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs 
  <content styleCode="italics">[see 
   <linkHtml href="#ID135">Contraindications (4)</linkHtml>, 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>Serotonin syndrome can also occur when these drugs are used alone.
 </paragraph>
                <paragraph>Serotonin syndrome signs and symptoms may include mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, and gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).</paragraph>
                <paragraph>The concomitant use of trazodone with MAOIs is contraindicated. In addition, do not initiate trazodone in a patient being treated with MAOIs such as linezolid or intravenous methylene blue. No reports involved the administration of methylene blue by other routes (such as oral tablets or local tissue injection). If it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking trazodone, discontinue trazodone before initiating treatment with the MAOI 
  <content styleCode="italics">[see 
   <linkHtml href="#ID135">Contraindications (4)</linkHtml>, 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>
                </paragraph>
                <paragraph>Monitor all patients taking trazodone for the emergence of serotonin syndrome. Discontinue treatment with trazodone and any concomitant serotonergic agents immediately if the above symptoms occur, and initiate supportive symptomatic treatment. If concomitant use of trazodone with other serotonergic drugs is clinically warranted, inform patients of the increased risk for serotonin syndrome and monitor for symptoms.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID145">
              <id root="04c8f4f4-245e-e675-e063-6394a90a96f1"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.3 Cardiac Arrhythmias</title>
              <text>
                <paragraph>Clinical studies indicate that trazodone hydrochloride may be arrhythmogenic in patients with preexisting cardiac disease. Arrhythmias identified include isolated PVCs, ventricular couplets, tachycardia with syncope, and 
  <content styleCode="italics">torsade de pointes</content>. Postmarketing events, including 
  <content styleCode="italics">torsade de pointes</content> have been reported at doses of 100 mg or less with the immediate-release form of trazodone. Trazodone should also be avoided in patients with a history of cardiac arrhythmias, as well as other circumstances that may increase the risk of the occurrence of 
  <content styleCode="italics">torsade de pointes </content>and/or sudden death, including symptomatic bradycardia, hypokalemia or hypomagnesemia, and the presence of congenital prolongation of the QT interval. Trazodone is not recommended for use during the initial recovery phase of myocardial infarction. Caution should be used when administering trazodone to patients with cardiac disease and such patients should be closely monitored, since antidepressant drugs (including trazodone) may cause cardiac arrhythmias 
  <content styleCode="italics">[see 
   <linkHtml href="#ID177">Adverse Reactions (6.2)</linkHtml>].
  </content>
                </paragraph>
                <paragraph>Trazodone prolongs the QT/QTc interval. The use of trazodone should be avoided in patients with known QT prolongation or in combination with other drugs that are inhibitors of CYP3A4 (e.g., itraconazole, clarithromycin, voriconazole), or known to prolong QT interval including Class 1A antiarrhythmics (e.g., quinidine, procainamide) or Class 3 antiarrhythmics (e.g., amiodarone, sotalol), certain antipsychotic medications (e.g., ziprasidone, chlorpromazine, thioridazine), and certain antibiotics (e.g., gatifloxacin). Concomitant administration of drugs may increase the risk of cardiac arrhythmia 
  <content styleCode="italics">[see 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID147">
              <id root="04c8a345-0a25-5a01-e063-6294a90a40d2"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.4 Orthostatic Hypotension and Syncope</title>
              <text>
                <paragraph>Hypotension, including orthostatic hypotension and syncope has been reported in patients receiving trazodone hydrochloride. Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID149">
              <id root="04c930e7-f7ff-5f98-e063-6294a90aae6b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.5 Increased Risk of Bleeding</title>
              <text>
                <paragraph>Drugs that interfere with serotonin reuptake inhibition, including trazodone, increase the risk of bleeding events. Concomitant use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), other antiplatelet drugs, warfarin, and other anticoagulants may add to this risk. Case reports and epidemiological studies (case-control and cohort design) have demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleeding. Bleeding events related to drugs that interfere with serotonin reuptake have ranged from ecchymosis, hematoma, epistaxis, and petechiae to life-threatening hemorrhages.</paragraph>
                <paragraph>Inform patients about the risk of bleeding associated with the concomitant use of trazodone and antiplatelet agents or anticoagulants. For patients taking warfarin, carefully monitor coagulation indices when initiating, titrating, or discontinuing trazodone.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID151">
              <id root="04c8f4f4-245f-e675-e063-6394a90a96f1"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.6 Priapism</title>
              <text>
                <paragraph>Cases of priapism (painful erections greater than 6 hours in duration) have been reported in men receiving trazodone. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Men who have an erection lasting greater than 4 hours, whether painful or not, should immediately discontinue the drug and seek emergency medical attention 
  <content styleCode="italics">[see 
   <linkHtml href="#ID177">Adverse Reactions (6.2)</linkHtml>, 
   <linkHtml href="#ID199">Overdosage (10)</linkHtml>]. 
  </content>
                </paragraph>
                <paragraph>Trazodone should be used with caution in men who have conditions that might predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, or leukemia), or in men with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease).</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID153">
              <id root="04c930e7-f801-5f98-e063-6294a90aae6b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.7 Activation of Mania or Hypomania</title>
              <text>
                <paragraph>In patients with bipolar disorder, treating a depressive episode with trazodone or another antidepressant may precipitate a mixed/manic episode. Activation of mania/hypomania has been reported in a small proportion of patients with major affective disorder who were treated with antidepressants. Prior to initiating treatment with trazodone, screen patients for any personal or family history of bipolar disorder, mania, or hypomania 
  <content styleCode="italics">[see 
   <linkHtml href="#ID324">Dosage and Administration (2.3)</linkHtml>]
  </content>.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID155">
              <id root="04c8ff03-3801-0ade-e063-6294a90a9156"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.8 Discontinuation Syndrome</title>
              <text>
                <paragraph>Adverse reactions after discontinuation of serotonergic antidepressants, particularly after abrupt discontinuation, include: nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible 
  <content styleCode="italics">[See 
   <linkHtml href="#ID327">Dosage and Administration (2.6)</linkHtml>]. 
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID157">
              <id root="04c931fa-b968-38ef-e063-6294a90af07b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.9 Potential for Cognitive and Motor Impairment</title>
              <text>
                <paragraph>Trazodone may cause somnolence or sedation and may impair the mental and/or physical ability required for the performance of potentially hazardous tasks. Patients should be cautioned about operating hazardous machinery, including automobiles, until they are reasonably certain that the drug treatment does not affect them adversely.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID159">
              <id root="04c8ff03-3802-0ade-e063-6294a90a9156"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.10 Angle-Closure Glaucoma</title>
              <text>
                <paragraph>The pupillary dilation that occurs following use of many antidepressant drugs including trazodone may trigger an angle closure attack in a patient with anatomically narrow angles who does not have a patent iridectomy. Avoid use of antidepressants, including trazodone, in patients with untreated anatomically narrow angles.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID161">
              <id root="04c93808-2ab4-4593-e063-6394a90a98a8"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>5.11 Hyponatremia</title>
              <text>
                <paragraph>Hyponatremia may occur as a result of treatment with SNRIs and SSRIs, including trazodone. Cases with serum sodium lower than 110 mmol/L have been reported. Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which can lead to falls. Signs and symptoms associated with more severe and/or acute cases have included hallucination, syncope, seizure, coma, respiratory arrest, and death. In many cases, this hyponatremia appears to be the result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH).</paragraph>
                <paragraph>In patients with symptomatic hyponatremia, discontinue trazodone and institute appropriate medical intervention. Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs 
  <content styleCode="italics">[see 
   <linkHtml href="#ID189">Use in Specific Populations (8.5)</linkHtml>].
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID167">
          <id root="04c9260e-03fc-829f-e063-6394a90a571b"/>
          <code code="34084-4" codeSystem="2.16.840.1.113883.6.1" displayName="ADVERSE REACTIONS SECTION"/>
          <title>6 ADVERSE REACTIONS</title>
          <text>
            <paragraph>The following serious adverse reactions are described elsewhere in the labeling:</paragraph>
            <list listType="unordered">
              <item>Suicidal Thoughts and Behavior in Children, Adolescents and Young Adults 
   <content styleCode="italics">[see 
    <linkHtml href="#ID271">Boxed Warning</linkHtml> and 
    <linkHtml href="#ID139">Warnings and Precautions (5.1)</linkHtml>] 
   </content>
              </item>
              <item>Serotonin Syndrome 
   <content styleCode="italics">[see 
    <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml>] 
   </content>
              </item>
              <item>Cardiac Arrythmias 
   <content styleCode="italics">[see 
    <linkHtml href="#ID145">Warnings and Precautions (5.3)</linkHtml>] 
   </content>
              </item>
              <item>Orthostatic Hypotension and Syncope 
   <content styleCode="italics">[see 
    <linkHtml href="#ID147">Warnings and Precautions (5.4)</linkHtml>] 
   </content>
              </item>
              <item>Increased Risk of Bleeding 
   <content styleCode="italics">[see 
    <linkHtml href="#ID149">Warnings and Precautions (5.5)</linkHtml>] 
   </content>
              </item>
              <item>Priapism 
   <content styleCode="italics">[see 
    <linkHtml href="#ID151">Warnings and Precautions (5.6)</linkHtml>] 
   </content>
              </item>
              <item>Activation of Mania or Hypomania 
   <content styleCode="italics">[see 
    <linkHtml href="#ID153">Warnings and Precautions (5.7)</linkHtml>] 
   </content>
              </item>
              <item>Discontinuation Syndrome 
   <content styleCode="italics">[see 
    <linkHtml href="#ID155">Warnings and Precautions (5.8)</linkHtml>] 
   </content>
              </item>
              <item>Potential for Cognitive and Motor Impairment 
   <content styleCode="italics">[see 
    <linkHtml href="#ID157">Warnings and Precautions (5.9)</linkHtml>] 
   </content>
              </item>
              <item>Angle-Closure Glaucoma 
   <content styleCode="italics">[see 
    <linkHtml href="#ID159">Warnings and Precautions (5.10)</linkHtml>] 
   </content>
              </item>
              <item>Hyponatremia 
   <content styleCode="italics">[see 
    <linkHtml href="#ID161">Warnings and Precautions (5.11)</linkHtml>] 
   </content>
              </item>
            </list>
          </text>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <paragraph>Most common adverse reactions (incidence ≥ 5% and twice that of placebo) are: edema, blurred vision, syncope, drowsiness, fatigue, diarrhea, nasal congestion, weight loss 
    <linkHtml href="#ID167">(6)</linkHtml>.
   </paragraph>
                <paragraph>
                  <content styleCode="bold">To report SUSPECTED ADVERSE REACTIONS, contact Zydus Pharmaceuticals (USA) Inc. at 1-877-993-8779 or FDA at 1-800-FDA-1088 or 
     <linkHtml href="http://www.fda.gov/medwatch">www.fda.gov/medwatch</linkHtml>. 
    </content>
                </paragraph>
              </text>
            </highlight>
          </excerpt>
          <component>
            <section ID="ID173">
              <id root="04c931fa-b96a-38ef-e063-6294a90af07b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>6.1 Clinical Trials Experience</title>
              <text>
                <paragraph>Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.</paragraph>
                <table ID="_RefID175" width="100%">
                  <caption>Table 2 Common Adverse Reactions Occurring in ≥ 2% of Trazodone-treated Patients and Greater than the Rate of Placebo-Treated Patients as Observed in Controlled Clinical Studies</caption>
                  <colgroup>
                    <col width="23%"/>
                    <col width="23%"/>
                    <col width="23%"/>
                    <col width="16%"/>
                    <col width="16%"/>
                  </colgroup>
                  <tbody>
                    <tr>
                      <td rowspan="2" styleCode="Rrule Botrule Lrule Toprule " valign="middle"/>
                      <td align="center" colspan="2" styleCode="Rrule Botrule Toprule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Inpatients</content>
                        </paragraph>
                      </td>
                      <td align="center" colspan="2" styleCode="Rrule Botrule Toprule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Outpatients</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Trazodone</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Placebo</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Trazodone</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Placebo</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle"/>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">N=142</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">N=95</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">N=157</content>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">N=158</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Allergic</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Skin Condition/Edema</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>7%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Autonomic</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Blurred Vision</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>15%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Constipation</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>7%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>8%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Dry Mouth</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>15%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>8%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>34%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>20%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Cardiovascular</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Hypertension</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>20%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <footnote ID="_Ref3211226">Incidence less than 1%.</footnote>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Hypotension</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>7%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Syncope</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>2%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">CNS</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Confusion</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>8%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Decreased Concentration</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>2%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Disorientation</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>2%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <footnoteRef IDREF="_Ref3211226"/>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Dizziness/Light-Headedness</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>20%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>28%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>15%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Drowsiness</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>24%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>41%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>20%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Fatigue</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>11%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Headache</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>10%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>20%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>16%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Nervousness</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>15%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>11%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>8%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Gastrointestinal</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Abdominal/Gastric Disorder</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Diarrhea</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Nausea/Vomiting</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>10%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>13%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>10%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Musculoskeletal</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Aches/Pains</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Neurological</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Incoordination</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>2%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <footnoteRef IDREF="_Ref3211226"/>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Tremors</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>4%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Other</content>
                        </paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                      <td styleCode="Rrule Botrule " valign="middle"/>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Eyes Red/Tired/Itching</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Head Full-Heavy</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Malaise</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Nasal/Sinus Congestion</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Weight Gain</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>1%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>0</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>5%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>2%</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td styleCode="Rrule Botrule Lrule " valign="middle">
                        <paragraph>Weight Loss</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>
                          <footnoteRef IDREF="_Ref3211226"/>
                        </paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>6%</paragraph>
                      </td>
                      <td align="center" styleCode="Rrule Botrule " valign="middle">
                        <paragraph>3%</paragraph>
                      </td>
                    </tr>
                  </tbody>
                </table>
                <paragraph>Other adverse reactions occurring at an incidence of &lt;2% with the use of trazodone hydrochloride in the controlled clinical studies: akathisia, allergic reaction, anemia, chest pain, delayed urine flow, early menses, flatulence, hallucinations/delusions, hematuria, hypersalivation, hypomania, impaired memory, impaired speech, impotence, increased appetite, increased libido, increased urinary frequency, missed periods, muscle twitches, numbness, paresthesia, retrograde ejaculation, shortness of breath, and tachycardia/palpitations. Occasional sinus bradycardia has occurred in long-term studies.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID177">
              <id root="04c94469-18f8-46fd-e063-6394a90a391e"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>6.2 Postmarketing Experience</title>
              <text>
                <paragraph>The following adverse reactions have been identified during post-approval use of trazodone. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency or establish a causal relationship to drug exposure:</paragraph>
                <paragraph>
                  <content styleCode="bold">Blood and lymphatic system disorders: </content>hemolytic anemia, leukocytosis
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Cardiac disorders: </content>cardiospasm, congestive heart failure, conduction block, orthostatic hypotension and syncope, palpitations, bradycardia, atrial fibrillation, myocardial infarction, cardiac arrest, arrhythmia, ventricular ectopic activity, including ventricular tachycardia and QT prolongation. Prolonged QT interval, 
  <content styleCode="italics">torsade de pointes</content>, and ventricular tachycardia have been reported at doses of 100 mg per day or less 
  <content styleCode="italics">[see 
   <linkHtml href="#ID145">Warnings and Precautions (5.3)</linkHtml>]. 
  </content>
                </paragraph>
                <paragraph>
                  <content styleCode="bold">Endocrine disorders: </content>inappropriate ADH syndrome
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Eye disorders: </content>diplopia
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Gastrointestinal disorders: </content>increased salivation, nausea/vomiting
 </paragraph>
                <paragraph>
                  <content styleCode="bold">General disorders and administration site conditions: </content>chills, edema, unexplained death, weakness
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Hepatobiliary disorders: </content>cholestasis, jaundice, hyperbilirubinemia, liver enzyme alterations
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Investigations: </content>increased amylase
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Metabolism and nutrition disorders: </content>methemoglobinemia
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Nervous system disorders: </content>aphasia, ataxia, cerebrovascular accident, extrapyramidal symptoms, grand mal seizures, paresthesia, tardive dyskinesia, vertigo
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Psychiatric disorders: </content>abnormal dreams, agitation, anxiety, hallucinations, insomnia, paranoid reaction, psychosis, stupor
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Renal and urinary disorders: </content>urinary incontinence, urinary retention
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Reproductive system and breast disorders: </content>breast enlargement or engorgement, clitorism, lactation, priapism 
  <content styleCode="italics">[see 
   <linkHtml href="#ID151">Warnings and Precautions (5.6)</linkHtml>] 
  </content>
                </paragraph>
                <paragraph>
                  <content styleCode="bold">Respiratory, thoracic and mediastinal disorders: </content>apnea
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Skin and subcutaneous tissue disorders: </content>alopecia, hirsutism, leukonychia, pruritus, psoriasis, rash, urticaria
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Vascular disorders: </content>vasodilation
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID179">
          <id root="04c930e7-f812-5f98-e063-6294a90aae6b"/>
          <code code="34073-7" codeSystem="2.16.840.1.113883.6.1" displayName="DRUG INTERACTIONS SECTION"/>
          <title>7 DRUG INTERACTIONS</title>
          <effectiveTime value="20221130"/>
          <excerpt>
            <highlight>
              <text>
                <list listType="unordered">
                  <item>
                    <content styleCode="bold">CNS Depressants: </content>Trazodone may enhance effects of alcohol, barbiturates, or other CNS depressants 
     <linkHtml href="#ID179">(7)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">CYP3A4 Inhibitors: </content>Consider trazodone dose reduction based on tolerability 
     <linkHtml href="#ID326">(2.5</linkHtml>, 
     <linkHtml href="#ID179">7)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">CYP3A4 Inducers: </content>Increase in trazodone dosage may be necessary 
     <linkHtml href="#ID326">(2.5</linkHtml>, 
     <linkHtml href="#ID179">7)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Digoxin or Phenytoin: </content>Monitor for increased digoxin or phenytoin serum levels 
     <linkHtml href="#ID179">(7)</linkHtml>.
    </item>
                  <item>
                    <content styleCode="bold">Warfarin: </content>Monitor for increased or decreased prothrombin time 
     <linkHtml href="#ID179">(7)</linkHtml>.
    </item>
                </list>
              </text>
            </highlight>
          </excerpt>
          <component>
            <section ID="ID328">
              <id root="04c93808-2ab5-4593-e063-6394a90a98a8"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>7.1 Drugs Having Clinically Important Interactions with Trazodone</title>
              <text>
                <table width="100%">
                  <caption>Table 3 Clinically Important Drug Interactions with Trazodone</caption>
                  <colgroup>
                    <col width="25%"/>
                    <col width="75%"/>
                  </colgroup>
                  <tbody>
                    <tr>
                      <td colspan="2" styleCode="Rrule Botrule Lrule Toprule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Monoamine Oxidase Inhibitors (MAOIs)</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>The concomitant use of MAOIs and serotonergic drugs including trazodone increases the risk of serotonin syndrome.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Trazodone is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue 
      <content styleCode="italics">[see 
       <linkHtml href="#ID135">Contraindications (4)</linkHtml>, 
       <linkHtml href="#ID324">Dosage and Administration (2.3</linkHtml>, 
       <linkHtml href="#ID325">2.4)</linkHtml>, and 
       <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml>]. 
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>isocarboxazid, moclobemide, phenelzine, selegiline, tranylcypromine</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Other Serotonergic Drugs</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>The concomitant use of serotonergic drugs including trazodone and other serotonergic drugs increases the risk of serotonin syndrome.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Monitor patients for signs and symptoms of serotonin syndrome, particularly during trazodone initiation. If serotonin syndrome occurs, consider discontinuation of trazodone and/or concomitant serotonergic drugs 
      <content styleCode="italics">[see 
       <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml>]. 
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>triptans, antidepressants (tricyclic and serotonin uptake inhibitors), fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's Wort</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Antiplatelet Agents and Anticoagulants</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Serotonin release by platelets plays an important role in hemostasis. The concurrent use of an antiplatelet agent or anticoagulant with trazodone may potentiate the risk of bleeding.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Inform patients of the increased risk of bleeding with the concomitant use of trazodone and antiplatelet agents and anticoagulants. For patients taking warfarin, carefully monitor the international normalized ratio (INR) when initiating or discontinuing trazodone 
      <content styleCode="italics">[see 
       <linkHtml href="#ID149">Warnings and Precautions (5.5)</linkHtml>]. 
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>warfarin, rivaroxaban, dabigatran, clopidogrel</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Strong CYP3A4 Inhibitors</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>The concomitant use of trazodone and strong CYP3A4 inhibitors increased the exposure of trazodone compared to the use of trazodone alone.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>If trazodone is used with a potent CYP3A4 inhibitor, the risk of adverse reactions, including cardiac arrhythmias, may be increased and a lower dose of trazodone should be considered 
      <content styleCode="italics">[see 
       <linkHtml href="#ID326">Dosage and Administration (2.5)</linkHtml>, 
       <linkHtml href="#ID145">Warnings and Precautions (5.3)</linkHtml>]. 
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>itraconazole, ketoconazole, clarithromycin, indinavir</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Strong CYP3A4 Inducers</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>The concomitant use of trazodone and strong CYP3A4 inducers decreased the exposure of trazodone compared to the use of trazodone alone.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Patients should be closely monitored to see if there is a need for an increased dose of trazodone when taking CYP3A4 inducers 
      <content styleCode="italics">[see 
       <linkHtml href="#ID326">Dosage and Administration (2.5)</linkHtml>]. 
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>rifampin, carbamazepine, phenytoin, St. John's wort</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Digoxin and Phenytoin</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Digoxin and phenytoin are narrow therapeutic index drugs. Concomitant use of trazodone can increase digoxin or phenytoin concentrations.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Measure serum digoxin or phenytoin concentrations before initiating concomitant use of trazodone. Continue monitoring and reduce digoxin or phenytoin dose as necessary.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>digoxin, phenytoin</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">Central Nervous System (CNS) Depressants</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Trazodone may enhance the response CNS depressants.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Patients should be counseled that trazodone may enhance the response to alcohol, barbiturates, and other CNS depressants.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>alcohol, barbiturates</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td colspan="2" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>
                          <content styleCode="bold">QT Interval Prolongation</content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Clinical Impact:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Concomitant use of drugs that prolong the QT interval may add to the QT effects of trazodone and increase the risk of cardiac arrhythmia.</paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Lrule Botrule " valign="middle">
                        <paragraph>Intervention:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Avoid the use of trazodone in combination with other drugs known to prolong QTc 
      <content styleCode="italics">[see 
       <linkHtml href="#ID145">Warnings and Precautions (5.3)</linkHtml>].
      </content>
                        </paragraph>
                      </td>
                    </tr>
                    <tr>
                      <td align="center" styleCode="Rrule Botrule Lrule " valign="middle">
                        <paragraph>Examples:</paragraph>
                      </td>
                      <td styleCode="Rrule Botrule " valign="middle">
                        <paragraph>Class 1A antiarrhythmics: quinidine, procainamide, disopyramide; Class 3 antiarrhythmics: amiodarone, sotalol; Antipsychotics: ziprasidone, chlorpromazine, thioridazine; Antibiotics: gatifloxacin</paragraph>
                      </td>
                    </tr>
                  </tbody>
                </table>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID182">
          <id root="412441bf-b8d3-e989-e063-6294a90acab0"/>
          <code code="43684-0" codeSystem="2.16.840.1.113883.6.1" displayName="USE IN SPECIFIC POPULATIONS SECTION"/>
          <title>8 USE IN SPECIFIC POPULATIONS</title>
          <text>
            <paragraph/>
          </text>
          <effectiveTime value="20221130"/>
          <component>
            <section ID="ID183">
              <id root="4121b7a9-3f63-d17f-e063-6394a90a41a8"/>
              <code code="42228-7" codeSystem="2.16.840.1.113883.6.1" displayName="PREGNANCY SECTION"/>
              <title>8.1 Pregnancy</title>
              <text>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Pregnancy Exposure Registry</content>
                  </content>
                  <br/>
There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at 
  <linkHtml href="https://womensmentalhealth.org/clinical-and-research-programs/%20pregnancyregistry/%20antidepressants/">https://womensmentalhealth.org/clinical-and-research-programs/ pregnancyregistry/ antidepressants/</linkHtml>
                </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Risk Summary</content>
                  </content>
                  <br/>
Published prospective cohort studies, case series, and case reports over several decades with trazodone hydrochloride tablets use in pregnant women have not identified any drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes (see Data). Trazodone hydrochloride has been shown to cause increased fetal resorption and other adverse effects on the fetus in the rat when given at dose levels approximately 7.3 times to 11 times the maximum recommended human dose (MRHD) of 400 mg/day in adults on a mg/m
  <sup>2</sup> basis. There was also an increase in congenital anomalies in the rabbit at approximately 7.3 times to 22 times the MRHD on a mg/m
  <sup>2</sup> basis (see Data).
 </paragraph>
                <paragraph>The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.</paragraph>
                <paragraph>
                  <content styleCode="italics">
                    <content styleCode="bold">Clinical Considerations</content>
                    <br/>
Disease-associated maternal and/or embryofetal risk
  </content>
                  <br/>
A prospective, longitudinal study followed 201 pregnant women with a history of major depressive disorder who were euthymic and taking antidepressants at the beginning of pregnancy. The women who discontinued antidepressants during pregnancy were more likely to experience a relapse of major depression that women who continued antidepressants. Consider the risk of untreated depression when discontinuing or changing treatment with antidepressant medication during pregnancy and postpartum.
 </paragraph>
                <paragraph>
                  <content styleCode="italics">
                    <content styleCode="bold">Data</content>
                    <br/>
Human Data
  </content>
                  <br/>
While available studies cannot definitively establish the absence of risk, published data from prospective cohort studies, case series, and case reports over several decades have not identified an association with trazodone use during pregnancy and major birth defects, miscarriage, or other adverse maternal or fetal outcomes. All available studies have methodological limitations, including small sample size and inconsistent comparator groups.
 </paragraph>
                <paragraph>
                  <content styleCode="italics">Animal Data</content>
                  <br/>
No teratogenic effects were observed when trazodone was given to pregnant rats and rabbits during the period of organogenesis at oral doses up to 450 mg/kg/day. This dose is 11 times and 22 times, in rats and rabbits, respectively, the maximum recommended human dose (MRHD) of 400 mg/day in adults on a mg/m
  <sup>2</sup> basis. Increased fetal resorption and other adverse effects on the fetus in rats at 7.3 times to 11 times the MRHD and increase in congenital anomalies in rabbits at 7.3 times to 22 times the MRHD on a mg/m
  <sup>2</sup> basis were observed. No further details on these studies are available.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID185">
              <id root="04c931fa-b96b-38ef-e063-6294a90af07b"/>
              <code code="77290-5" codeSystem="2.16.840.1.113883.6.1" displayName="LACTATION SECTION"/>
              <title>8.2 Lactation</title>
              <text>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Risk Summary</content>
                  </content>
                  <br/>
Data from published literature report the transfer of trazodone into human milk. There are no data on the effect of trazodone on milk production. Limited data from postmarketing reports have not identified and association of adverse effects on the breastfed child. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for trazodone hydrochloride tablets and any potential adverse effects on the breastfed child from trazodone hydrochloride tablets or from the underlying maternal condition.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID187">
              <id root="04c9489c-bbd2-6f21-e063-6394a90ad393"/>
              <code code="34081-0" codeSystem="2.16.840.1.113883.6.1" displayName="PEDIATRIC USE SECTION"/>
              <title>8.4 Pediatric Use</title>
              <text>
                <paragraph>Safety and effectiveness in the pediatric population have not been established. Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric patients 
  <content styleCode="italics">[see 
   <linkHtml href="#ID271">Boxed Warning</linkHtml>, 
   <linkHtml href="#ID139">Warnings and Precautions (5.1)</linkHtml>].
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID189">
              <id root="04c9260e-0400-829f-e063-6394a90a571b"/>
              <code code="34082-8" codeSystem="2.16.840.1.113883.6.1" displayName="GERIATRIC USE SECTION"/>
              <title>8.5 Geriatric Use</title>
              <text>
                <paragraph>Reported clinical literature and experience with trazodone has not identified differences in responses between elderly and younger patients. However, as experience in the elderly with trazodone hydrochloride is limited, it should be used with caution in geriatric patients.</paragraph>
                <paragraph>Serotonergic antidepressants have been associated with cases of clinically significant hyponatremia in elderly patients who may be at greater risk for this adverse reaction 
  <content styleCode="italics">[see 
   <linkHtml href="#ID161">Warnings and Precautions (5.11)</linkHtml>].
  </content>
                </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID191">
              <id root="04c8ff03-3823-0ade-e063-6294a90a9156"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>8.6 Renal Impairment</title>
              <text>
                <paragraph>Trazodone has not been studied in patients with renal impairment. Trazodone should be used with caution in this population.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID193">
              <id root="04c94469-18f9-46fd-e063-6394a90a391e"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>8.7 Hepatic Impairment</title>
              <text>
                <paragraph>Trazodone has not been studied in patients with hepatic impairment. Trazodone should be used with caution in this population.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID195">
          <id root="04c90bfc-0971-4b37-e063-6294a90a7978"/>
          <code code="42227-9" codeSystem="2.16.840.1.113883.6.1" displayName="DRUG ABUSE AND DEPENDENCE SECTION"/>
          <title>9 DRUG ABUSE AND DEPENDENCE</title>
          <effectiveTime value="20221130"/>
          <component>
            <section ID="ID306">
              <id root="04c9489c-bbd3-6f21-e063-6394a90ad393"/>
              <code code="34085-1" codeSystem="2.16.840.1.113883.6.1" displayName="CONTROLLED SUBSTANCE SECTION"/>
              <title>9.1 Controlled Substance</title>
              <text>
                <paragraph>Trazodone hydrochloride tablets are not a controlled substance.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID310">
              <id root="04c93808-2ab8-4593-e063-6394a90a98a8"/>
              <code code="34086-9" codeSystem="2.16.840.1.113883.6.1" displayName="ABUSE SECTION"/>
              <title>9.2 Abuse</title>
              <text>
                <paragraph>Although trazodone hydrochloride has not been systematically studied in preclinical or clinical studies for its potential for abuse, no indication of drug-seeking behavior was seen in the clinical studies with trazodone hydrochloride.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID199">
          <id root="4121c80e-6432-2c53-e063-6294a90ac8cc"/>
          <code code="34088-5" codeSystem="2.16.840.1.113883.6.1" displayName="OVERDOSAGE SECTION"/>
          <title>10 OVERDOSAGE</title>
          <text>
            <paragraph>Death from overdose has occurred in patients ingesting trazodone and other CNS depressant drugs concurrently (alcohol; alcohol and chloral hydrate and diazepam; amobarbital; chlordiazepoxide; or meprobamate).</paragraph>
            <paragraph>The most severe reactions reported to have occurred with overdose of trazodone alone have been priapism, respiratory arrest, seizures, and ECG changes, including QT prolongation and syndrome of inappropriate antidiuretic hormone secretion (SIADH). The reactions reported most frequently have been drowsiness and vomiting. Overdosage may cause an increase in incidence or severity of any of the reported adverse reactions.</paragraph>
            <paragraph>There is no specific antidote for trazodone hydrochloride overdose. In managing overdosage, consider the possibility of multiple drug involvement. For current information on the management of poisoning or overdose, contact a poison control center (1-800-222-1222 or 
  <linkHtml href="http://www.poison.org">www.poison.org</linkHtml>).
 </paragraph>
          </text>
          <effectiveTime value="20221130"/>
        </section>
      </component>
      <component>
        <section ID="ID204">
          <id root="4121b1d4-188f-d046-e063-6394a90a7fa9"/>
          <code code="34089-3" codeSystem="2.16.840.1.113883.6.1" displayName="DESCRIPTION SECTION"/>
          <title>11 DESCRIPTION</title>
          <text>
            <paragraph>Trazodone hydrochloride is a selective serotonin reuptake inhibitor and 5HT2 receptor antagonist. Trazodone hydrochloride, USP is a triazolopyridine derivative designated as 2-[3-[4-(3-chlorophenyl)-1-piperazinyl]propyl]- 1,2,4-triazolo[4, 3-a]pyridin-3(2H)-one hydrochloride. It is a white to off-white, crystalline powder which is sparingly soluble in chloroform and in water. The structural formula is represented as follows:</paragraph>
            <paragraph>
              <renderMultiMedia referencedObject="ID_82f44414-30ec-4eb3-967a-02b54428bbd1"/>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Molecular Formula: </content>C
  <sub>19</sub>H
  <sub>22</sub>ClN
  <sub>5</sub>O•HCl
  <br/>
              <content styleCode="bold">Molecular Weight:</content>408.32
 </paragraph>
            <paragraph>Each trazodone hydrochloride tablet, USP for oral administration contains 50 mg, 100 mg, 150 mg or 300 mg of trazodone hydrochloride, USP. In addition, each tablet contains the following inactive ingredients: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium lauryl sulfate, and sodium starch glycolate.</paragraph>
            <paragraph>The product meets USP Dissolution Test #2.</paragraph>
          </text>
          <effectiveTime value="20221031"/>
          <component>
            <observationMedia ID="ID_82f44414-30ec-4eb3-967a-02b54428bbd1">
              <text>Structural Formula</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="Structure.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID208">
          <id root="04c930e7-f815-5f98-e063-6294a90aae6b"/>
          <code code="34090-1" codeSystem="2.16.840.1.113883.6.1" displayName="CLINICAL PHARMACOLOGY SECTION"/>
          <title>12 CLINICAL PHARMACOLOGY</title>
          <effectiveTime value="20221130"/>
          <component>
            <section ID="ID209">
              <id root="04c9260e-0401-829f-e063-6394a90a571b"/>
              <code code="43679-0" codeSystem="2.16.840.1.113883.6.1" displayName="MECHANISM OF ACTION SECTION"/>
              <title>12.1 Mechanism of Action</title>
              <text>
                <paragraph>The mechanism of trazodone's antidepressant action is not fully understood, but is thought to be related to its enhancement of serotonergic activity in the CNS. Trazodone is both a selective serotonin reuptake inhibitor (SSRI) and a 5HT2 receptor antagonist and the net result of this action on serotonergic transmission and its role in trazodone's antidepressant effect is unknown.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID211">
              <id root="04c9489c-bbd4-6f21-e063-6394a90ad393"/>
              <code code="43681-6" codeSystem="2.16.840.1.113883.6.1" displayName="PHARMACODYNAMICS SECTION"/>
              <title>12.2 Pharmacodynamics</title>
              <text>
                <paragraph>Preclinical studies have shown that trazodone selectively inhibits neuronal reuptake of serotonin (Ki = 367 nM) and acts as an antagonist at 5-HT-2A (Ki = 35.6 nM) serotonin receptors. Trazodone is also an antagonist at several other monoaminergic receptors including 5-HT2B (Ki = 78.4 nM), 5-HT2C (Ki = 224 nM), α1A (Ki = 153 nM), α2C (Ki = 155 nM) receptors and it is a partial agonist at 5HT1A (Ki = 118 nM) receptor.</paragraph>
                <paragraph>Trazodone antagonizes alpha 1-adrenergic receptors, a property which may be associated with postural hypotension.</paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
          <component>
            <section ID="ID213">
              <id root="04c9260e-0402-829f-e063-6394a90a571b"/>
              <code code="43682-4" codeSystem="2.16.840.1.113883.6.1" displayName="PHARMACOKINETICS SECTION"/>
              <title>12.3 Pharmacokinetics</title>
              <text>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Absorption</content>
                  </content>
                  <br/>
In humans, trazodone hydrochloride is absorbed after oral administration without selective localization in any tissue. When trazodone hydrochloride is taken shortly after ingestion of food, there may be an increase in the amount of drug absorbed, a decrease in maximum concentration and a lengthening in the time to maximum concentration. Peak plasma levels occur approximately one hour after dosing when trazodone hydrochloride is taken on an empty stomach or 2 hours after dosing when taken with food.
 </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Metabolism</content>
                  </content>
                  <br/>
                  <content styleCode="italics">In vitro </content>studies in human liver microsomes show that trazodone is metabolized, via oxidative cleavage, to an active metabolite, m-chlorophenylpiperazine (mCPP) by CYP3A4. Other metabolic pathways that may be involved in the metabolism of trazodone have not been well characterized. Trazodone is extensively metabolized; less than 1% of an oral dose is excreted unchanged in the urine.
 </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Elimination</content>
                  </content>
                  <br/>
In some patients trazodone may accumulate in the plasma.
 </paragraph>
                <paragraph>
                  <content styleCode="bold">
                    <content styleCode="italics">Protein Binding</content>
                  </content>
                  <br/>
Trazodone is 89 to 95% protein bound 
  <content styleCode="italics">in vitro </content>at concentrations attained with therapeutic doses in humans.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID340">
          <id root="04c93808-2ab9-4593-e063-6394a90a98a8"/>
          <code code="43680-8" codeSystem="2.16.840.1.113883.6.1" displayName="NONCLINICAL TOXICOLOGY SECTION"/>
          <title>13 NONCLINICAL TOXICOLOGY</title>
          <effectiveTime value="20221130"/>
          <component>
            <section ID="ID350">
              <id root="04c930e7-f817-5f98-e063-6294a90aae6b"/>
              <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
              <title>13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility</title>
              <text>
                <paragraph>
                  <content styleCode="bold">Carcinogenesis</content>
                  <br/>
No drug- or dose-related occurrence of carcinogenesis was evident in rats receiving trazodone in daily oral doses up to 7.3 times the maximum recommended human dose (MRHD) of 400 mg/day in adults on a mg/m
  <sup>2</sup> basis.
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Mutagenesis</content>
                  <br/>
No genotoxicity studies were conducted with trazodone.
 </paragraph>
                <paragraph>
                  <content styleCode="bold">Impairment of Fertility</content>
                  <br/>
Trazodone has no effect on fertility in rats at doses up to 7.3 times the MRHD in adults on a mg/m
  <sup>2</sup> basis.
 </paragraph>
              </text>
              <effectiveTime value="20221130"/>
            </section>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID218">
          <id root="04c94469-18fa-46fd-e063-6394a90a391e"/>
          <code code="34092-7" codeSystem="2.16.840.1.113883.6.1" displayName="CLINICAL STUDIES SECTION"/>
          <title>14 CLINICAL STUDIES</title>
          <text>
            <paragraph>The efficacy and safety of trazodone hydrochloride were established from inpatient and outpatient trials of the trazodone immediate release formulation in the treatment of major depressive disorder.</paragraph>
          </text>
          <effectiveTime value="20221130"/>
        </section>
      </component>
      <component>
        <section ID="ID220">
          <id root="4121cf31-d73a-ea62-e063-6394a90a956a"/>
          <code code="34069-5" codeSystem="2.16.840.1.113883.6.1" displayName="HOW SUPPLIED SECTION"/>
          <title>16 HOW SUPPLIED/STORAGE AND HANDLING</title>
          <text>
            <paragraph>Trazodone Hydrochloride Tablets USP, 50 mg are white to off-white, round-shape, biconvex beveled tablets, bisect on one side and plain on other side. The bisected side of tablet is debossed with '8' on upper side of bisect and '05' on lower side of bisect and are supplied as follows:
  <br/>
Unit dose packages of 100 (10 x 10) NDC 60687-443-01
 </paragraph>
            <paragraph>Trazodone Hydrochloride Tablets USP, 100 mg are white to off-white, round-shape, biconvex beveled tablets, bisect on one side and plain on other side. The bisected side of tablet is debossed with '8' on upper side of bisect and '06' on lower side of bisect and are supplied as follows:
  <br/>
Unit dose packages of 100 (10 x 10) NDC 60687-454-01
 </paragraph>
            <paragraph>Trazodone Hydrochloride Tablets USP, 150 mg are white to off-white, oval-shape, flat faced beveled tablets having one full bisect and two trisect notches on one side and two trisects on other side. The full bisected side of tablet is debossed with '8' on one side of bisect and '07' on other bisect segments and are supplied as follows:
  <br/>
Unit dose packages of 100 (10 x 10) NDC 60687-432-01
 </paragraph>
            <paragraph>Directions for using the correct score when breaking the tablet, please refer to the following:</paragraph>
            <paragraph>-For 50 mg, break the score on either the left or right side of the tablet (one-third of a tablet).</paragraph>
            <paragraph>
              <renderMultiMedia referencedObject="D9E903F5-47AB-4032-A70C-F1C6775AE464"/>
            </paragraph>
            <paragraph>-For 75 mg, break the score down the middle of the tablet (one-half of a tablet).</paragraph>
            <paragraph>
              <renderMultiMedia referencedObject="ID_2ffb6aa7-ef0a-4997-bf32-2fb75d6320ca"/>
            </paragraph>
            <paragraph>-For 100 mg, break the score on either the left or right side of the tablet (two-thirds of a</paragraph>
            <paragraph>tablet).</paragraph>
            <paragraph>
              <renderMultiMedia referencedObject="BE0D2E8B-E488-47B5-B13E-C704853BE5B3"/>
            </paragraph>
            <paragraph>-For 150 mg, use the entire tablet.</paragraph>
            <paragraph>
              <renderMultiMedia referencedObject="ID_09091ede-3945-4b30-8ba0-b3987b3979d8"/>
            </paragraph>
            <paragraph>Store at 20°C to 25°C (68°F to 77°F) [See USP Controlled Room Temperature].</paragraph>
            <paragraph>
              <content styleCode="bold">FOR YOUR PROTECTION: </content>Do not use if blister is torn or broken.
 </paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <component>
            <observationMedia ID="D9E903F5-47AB-4032-A70C-F1C6775AE464">
              <text>Trazodone Hydrochloride Tablets USP</text>
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              <text>Trazodone Hydrochloride Tablets USP</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="288890b7-bcd6-4e8e-a437-ac5cd56b27be-03.jpg"/>
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          <component>
            <observationMedia ID="BE0D2E8B-E488-47B5-B13E-C704853BE5B3">
              <text>Trazodone Hydrochloride Tablets USP</text>
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                <reference value="288890b7-bcd6-4e8e-a437-ac5cd56b27be-04.jpg"/>
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            </observationMedia>
          </component>
          <component>
            <observationMedia ID="ID_09091ede-3945-4b30-8ba0-b3987b3979d8">
              <text>Trazodone Hydrochloride Tablets USP</text>
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                <reference value="288890b7-bcd6-4e8e-a437-ac5cd56b27be-05.jpg"/>
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            </observationMedia>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID311">
          <id root="25907dee-c191-5725-e063-6394a90a53ce"/>
          <code code="34076-0" codeSystem="2.16.840.1.113883.6.1" displayName="INFORMATION FOR PATIENTS SECTION"/>
          <title>17 PATIENT COUNSELING INFORMATION</title>
          <text>
            <paragraph>Advise the patient to read the FDA-approved patient labeling (Medication Guide).</paragraph>
            <paragraph>
              <content styleCode="bold">Suicidal Thoughts and Behaviors</content>
              <br/>
Advise patients and caregivers to look for the emergence of suicidality, especially early during treatment and when the dosage is adjusted up or down and instruct them to report such symptoms to the healthcare provider 
  <content styleCode="italics">[see 
   <linkHtml href="#ID271">Box Warning</linkHtml> and 
   <linkHtml href="#ID139">Warnings and Precautions (5.1)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Dosage and Administration</content>
              <br/>
Advise patients that trazodone hydrochloride tablets should be taken shortly after a meal or light snack. Advise patients regarding the importance of following dosage titration instructions 
  <content styleCode="italics">[see 
   <linkHtml href="#ID127">Dosage and Administration (2)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Serotonin Syndrome</content>
              <br/>
Caution patients about the risk of serotonin syndrome, particularly with the concomitant use of trazodone hydrochloride tablets with other serotonergic drugs including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John's Wort, and with drugs that impair metabolism of serotonin (in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid). Patients should contact their health care provider or report to the emergency room if they experience signs or symptoms of serotonin syndrome 
  <content styleCode="italics">[see 
   <linkHtml href="#ID143">Warnings and Precautions (5.2)</linkHtml> and 
   <linkHtml href="#ID179">Drug Interactions (7)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Activation of Mania/Hypomania</content>
              <br/>
Advise patients and their caregivers to observe for signs of activation of mania/hypomania and instruct them to report such symptoms to the healthcare provider 
  <content styleCode="italics">[see 
   <linkHtml href="#ID153">Warnings and Precautions (5.7)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Increased Risk of Bleeding</content>
              <br/>
Inform patients about the concomitant use of trazodone hydrochloride tablets with aspirin, NSAIDs, other antiplatelet drugs, warfarin, or other anticoagulants because the combined use of drugs that interfere with serotonin reuptake and these medications has been associated with an increased risk of bleeding. Advise them to inform their health care providers if they are taking or planning to take any prescription or over-the-counter medications that increase the risk of bleeding 
  <content styleCode="italics">[see 
   <linkHtml href="#ID149">Warnings and Precautions (5.5)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Discontinuation Syndrome</content>
              <br/>
Advise patients not to abruptly discontinue trazodone hydrochloride tablets and to discuss any tapering regimen with their healthcare provider. Adverse reactions can occur when trazodone hydrochloride tablets are discontinued 
  <content styleCode="italics">[see 
   <linkHtml href="#ID155">Warnings and Precautions (5.8)</linkHtml>]. 
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Concomitant Medications</content>
              <br/>
Advise patients to inform their health care providers if they are taking, or plan to take any prescription or over-the-counter medications since there is a potential for interactions 
  <content styleCode="italics">[see 
   <linkHtml href="#ID328">Drug Interactions (7.1)</linkHtml>]. 
  </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">
                <content styleCode="italics">Pregnancy</content>
              </content>
              <br/>
Advise patients to notify their healthcare provider if they become pregnant or intend to become pregnant during therapy with trazodone hydrochloride tablets. Advise patients that there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to trazodone hydrochloride tablets during pregnancy 
  <content styleCode="italics">[see 
   <linkHtml href="#ID183">Use in Special Populations (8.1)</linkHtml>].
  </content>
            </paragraph>
            <paragraph>To order more Medication Guides call American Health Packaging at 1‐800‐707‐4621.</paragraph>
          </text>
          <effectiveTime value="20221130"/>
        </section>
      </component>
      <component>
        <section ID="ID_1c80fe55-80fe-4e7a-9d4b-4f3c29642cbc">
          <id root="4121d282-97f3-f1c8-e063-6394a90a03c5"/>
          <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
          <title>PACKAGING INFORMATION</title>
          <text>
            <paragraph>American Health Packaging unit dose blisters (see 
  <linkHtml href="#ID220">How Supplied</linkHtml> section) contain drug product from Zydus Pharmaceuticals (USA) Inc. as follows:
  <br/>
(50 mg / 100 UD) NDC 60687-443-01 packaged from NDC 68382-805
  <br/>
(100 mg / 100 UD) NDC 60687-454-01 packaged from NDC 68382-806
  <br/>
(150 mg / 100 UD) NDC 60687-432-01 packaged from NDC 68382-807
 </paragraph>
            <paragraph>Distributed by:
  <br/>
              <content styleCode="bold">American Health Packaging</content>
              <br/>
Columbus, OH 43217
 </paragraph>
            <paragraph>
              <content styleCode="bold">8443201/0925</content>
            </paragraph>
          </text>
          <effectiveTime value="20221031"/>
        </section>
      </component>
      <component>
        <section ID="ID_c559bc40-cbeb-4ad8-9207-c0dfdda35594">
          <id root="4121bd3f-2d6f-3bdd-e063-6294a90a3088"/>
          <code code="42231-1" codeSystem="2.16.840.1.113883.6.1" displayName="SPL MEDGUIDE SECTION"/>
          <title>Medication Guide</title>
          <text>
            <paragraph>
              <content styleCode="bold">8443201/0925</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Trazodone Hydrochloride (traz' oh done hye'' droe klor' ide) Tablets, USP</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">What is the most important information I should know about trazodone hydrochloride tablets?</content>
              <br/>
Antidepressant medicines, depression or other serious mental illnesses, and suicidal thoughts or actions: Talk to your healthcare provider about:
 </paragraph>
            <list listType="unordered">
              <item>All risks and benefits of treatment with antidepressant medicines</item>
              <item>All treatment choices for depression or other serious mental illnesses</item>
              <item>
                <content styleCode="bold">Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment.</content>
              </item>
              <item>
                <content styleCode="bold">Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions</content>. 
   <content styleCode="bold">Some people may have a higher risk of having suicidal thoughts or actions</content>. These include people who have or have a family history of 
   <content styleCode="bold">bipolar illness (also called manic-depressive illness) or suicidal thoughts or actions.</content>
              </item>
              <item>
                <content styleCode="bold">How can I watch for and try to prevent suicidal thoughts and actions?</content>
              </item>
              <item>Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. This is very important when an antidepressant medicine is started or when the dose is changed.</item>
              <item>Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts or feelings.</item>
              <item>Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you are worried about symptoms.</item>
            </list>
            <paragraph>
              <content styleCode="bold">Call a healthcare provider right away if you have any of the following symptoms, especially if they are new, worse, or worry you:</content>
            </paragraph>
            <list listType="unordered">
              <item>Thoughts about suicide or dying</item>
              <item>Attempts to commit suicide</item>
              <item>New or worse depression</item>
              <item>New or worse anxiety</item>
              <item>Feeling very agitated or restless</item>
              <item>Panic attacks</item>
              <item>Trouble sleeping (insomnia)</item>
              <item>New or worse irritability</item>
              <item>Acting aggressive, being angry or violent</item>
              <item>Acting on dangerous impulses</item>
              <item>An extreme increase in activity and talking (mania)</item>
              <item>Other unusual changes in behavior or mood</item>
            </list>
            <paragraph>
              <content styleCode="bold">What else do I need to know about antidepressant medicines?</content>
            </paragraph>
            <list listType="unordered">
              <item>
                <content styleCode="bold">Never stop an antidepressant medicine without first talking to a healthcare provider. </content>Stopping an antidepressant medicine suddenly can 
   <content styleCode="bold">cause other symptoms.</content>
              </item>
              <item>
                <content styleCode="bold">Antidepressants are medicines used to treat depression and other illnesses. </content>It is important to discuss all the risks of treating depression and 
   <content styleCode="bold">also the risks of not treating it. You should discuss all treatment choices with your healthcare provider, not just the use of antidepressants.</content>
              </item>
              <item>
                <content styleCode="bold">Antidepressant medicines have other side effects. </content>Talk to your healthcare provider about the side effects of your medicines.
  </item>
              <item>
                <content styleCode="bold">Antidepressant medicines can interact with other medicines. </content>Know all of the medicines that you take. Keep a list of all medicines to show your healthcare provider. Do not start new medicines without first checking with your healthcare provider.
  </item>
            </list>
            <paragraph>It is not known if trazodone hydrochloride tablets are safe and effective in children.</paragraph>
            <paragraph>
              <content styleCode="bold">What are trazodone hydrochloride tablets?</content>
              <br/>
Trazodone hydrochloride tablets are prescription medicine used in adults to treat major depressive disorder (MDD). Trazodone hydrochloride tablets belong to a class of medicines known as SSRIs (or selective serotonin reuptake inhibitors).
 </paragraph>
            <paragraph>
              <content styleCode="bold">Do not take trazodone hydrochloride tablets:</content>
            </paragraph>
            <list listType="unordered">
              <item>If you take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid, and intravenous methylene blue.</item>
              <item>Do not take an MAOI within 2 weeks of stopping trazodone hydrochloride tablets unless directed to do so by your healthcare provider.</item>
              <item>Do not start trazodone hydrochloride tablets if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider.</item>
            </list>
            <paragraph>
              <content styleCode="bold">Before you take trazodone hydrochloride tablets tell your healthcare provider about all of your medical conditions, including if you:</content>
            </paragraph>
            <list listType="unordered">
              <item>have heart problems, including QT prolongation or a family history of it</item>
              <item>have ever had a heart attack</item>
              <item>have bipolar disorder</item>
              <item>have liver or kidney problems</item>
              <item>have other serious medical conditions</item>
              <item>are pregnant or plan to become pregnant. It is not known if trazodone hydrochloride tablets will harm your unborn baby. Talk to your healthcare provider about the risk to your unborn baby if you take trazodone hydrochloride tablets.
	
   <list listType="unordered">
                  <item>If you become pregnant during treatment with trazodone hydrochloride tablets, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants. You can register by calling 1-844-405-6185.</item>
                </list>
              </item>
              <item>are breastfeeding or plan to breastfeed. Trazodone hydrochloride passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take trazodone hydrochloride tablets.</item>
              <item>have taken a Monoamine Oxidase Inhibitor (MAOI) or if you have stopped taking an MAOI in the last 2 weeks.</item>
            </list>
            <paragraph>
              <content styleCode="bold">Tell your healthcare provider about all the medicines you take</content>, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Using trazodone hydrochloride tablets with certain other medicines can affect each other causing serious side effects.
 </paragraph>
            <paragraph>Especially tell your healthcare provider if you take:</paragraph>
            <list listType="unordered">
              <item>triptans used to treat migraine headache</item>
              <item>medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, buspirone, or antipsychotics</item>
              <item>tramadol</item>
              <item>over-the-counter supplements such as tryptophan or St. John's Wort</item>
              <item>nonsteroidal anti-inflammatory drugs (NSAIDS)</item>
              <item>aspirin</item>
              <item>warfarin (Coumadin, Jantoven)</item>
              <item>phenytoin (Mesantoin)</item>
              <item>diuretics</item>
            </list>
            <paragraph>Know the medicines you take. Keep a list of them and show it to your healthcare provider and pharmacist when you get a new medicine.</paragraph>
            <paragraph>
              <content styleCode="bold">How should I take trazodone hydrochloride tablets?</content>
            </paragraph>
            <list listType="unordered">
              <item>Take trazodone hydrochloride tablets exactly as your healthcare provider tells you.</item>
              <item>Trazodone hydrochloride tablets should be taken shortly after a meal or light snack.</item>
              <item>If you feel drowsy after taking trazodone hydrochloride tablets, talk to your healthcare provider. Your healthcare provider may change your dose or the time of day you take your trazodone hydrochloride tablets.</item>
              <item>Do not stop taking trazodone hydrochloride tablets without talking to your healthcare provider.</item>
              <item>Trazodone hydrochloride tablets should be swallowed whole or broken in half along the score line. Do not chew or crush trazodone hydrochloride tablets. Tell your healthcare provider if you cannot swallow trazodone either whole or as a half tablet.</item>
              <item>If you take too much trazodone hydrochloride tablets, call your healthcare provider, your Poison Control Center at 1-800-222-1222, or go to the nearest emergency room right away.</item>
            </list>
            <paragraph>
              <content styleCode="bold">What should I avoid while taking trazodone hydrochloride tablets?</content>
            </paragraph>
            <list listType="unordered">
              <item>Do not drive, operate heavy machinery, or do other dangerous activities until you know how trazodone hydrochloride tablets affect you. Trazodone hydrochloride tablets can slow your thinking and motor skills.</item>
              <item>Do not drink alcohol or take other medicines that make you sleepy or dizzy while taking trazodone hydrochloride tablets until you talk with your healthcare provider. Trazodone hydrochloride tablets may make your sleepiness or dizziness worse if you take it with alcohol or other medicines that cause sleepiness or dizziness.</item>
            </list>
            <paragraph>
              <content styleCode="bold">What are the possible side effects of trazodone hydrochloride tablets?</content>
              <br/>
              <content styleCode="bold">Trazodone hydrochloride tablets can cause serious side effects or death, including:</content>
            </paragraph>
            <list listType="unordered">
              <item>
                <content styleCode="bold">See "What is the most important information I should know about Trazodone?"</content>
              </item>
              <item>
                <content styleCode="bold">Serotonin syndrome. </content>Symptoms of serotonin syndrome include: agitation, hallucinations, problems with coordination, fast heartbeat, tight muscles, trouble walking, sweating, fever, nausea, vomiting, and diarrhea.
  </item>
              <item>
                <content styleCode="bold">Irregular or fast heartbeat or faint (QT prolongation)</content>
              </item>
              <item>
                <content styleCode="bold">Low blood pressure. </content>You feel dizzy or faint when you change positions (go from sitting to standing)
  </item>
              <item>
                <content styleCode="bold">Unusual bruising or bleeding</content>
              </item>
              <item>
                <content styleCode="bold">Erection lasting for more than 6 hours (priapism)</content>
              </item>
              <item>
                <content styleCode="bold">Feeling high or in a very good mood, then becoming irritable, or having too much energy, feeling like you have to keep talking or do not sleep (mania</content>).
  </item>
              <item>
                <content styleCode="bold">Withdrawal symptoms. </content>Symptoms of withdrawal can include anxiety, agitation, and sleep problems. Do not stop taking trazodone without talking to your healthcare provider.
  </item>
              <item>
                <content styleCode="bold">Visual problems.</content>
              </item>
              <item>eye pain</item>
              <item>changes in vision</item>
              <item>swelling or redness in or around the eye
   <br/>
	Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
  </item>
              <item>
                <content styleCode="bold">Low sodium in your blood (hyponatremia). </content>Symptoms of hyponatremia include: headache, feeling weak, feeling confused, trouble concentrating, memory problems and feeling unsteady when you walk.
  </item>
            </list>
            <paragraph>Get medical help right away, if you have any of the symptoms listed above.</paragraph>
            <paragraph>
              <content styleCode="bold">The most common side effects of trazodone hydrochloride tablets include:</content>
            </paragraph>
            <list listType="unordered">
              <item>swelling</item>
              <item>blurred vision</item>
              <item>dizziness</item>
              <item>sleepiness</item>
              <item>tiredness</item>
              <item>diarrhea</item>
              <item>stuffy nose</item>
              <item>weight loss</item>
            </list>
            <paragraph>These are not all the possible side effects of trazodone hydrochloride tablets. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.</paragraph>
            <paragraph>
              <content styleCode="bold">How should I store trazodone hydrochloride tablets?</content>
            </paragraph>
            <list listType="unordered">
              <item>Store trazodone hydrochloride tablets between 20° to 25°C (68° to 77°F).</item>
              <item>Keep out of the light</item>
              <item>Safely throw away medicine that is out of date or no longer needed.</item>
            </list>
            <paragraph>
              <content styleCode="bold">Keep trazodone hydrochloride tablets and all medicines out of the reach of children.</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">General information about the safe and effective use of trazodone hydrochloride tablets.</content>
              <br/>
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use trazodone hydrochloride tablets for a condition for which it was not prescribed. Do not give trazodone hydrochloride tablets to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about trazodone hydrochloride tablets that is written for health professionals.
 </paragraph>
            <paragraph>Please address medical inquiries to, MedicalAffairs@zydususa.com Tel.: 1-877-993-8779.</paragraph>
            <paragraph>For more information about the packaging or labeling, call American Health Packaging at 1‐800‐707‐4621.</paragraph>
            <paragraph>
              <content styleCode="bold">What are the ingredients in trazodone hydrochloride tablets?</content>
              <br/>
              <content styleCode="bold">Active ingredient</content>: trazodone hydrochloride, USP
  <br/>
              <content styleCode="bold">Inactive ingredients</content>: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium lauryl sulfate, and sodium starch glycolate.
 </paragraph>
            <paragraph>This Medication Guide has been approved by the U.S. Food and Drug Administration.</paragraph>
            <paragraph>To order more Medication Guides call American Health Packaging at 1‐800‐707‐4621.</paragraph>
            <paragraph>Distributed by:
  <br/>
              <content styleCode="bold">American Health Packaging</content>
              <br/>
Columbus, OH 43217
 </paragraph>
            <paragraph>
              <content styleCode="bold">8443201/0925</content>
            </paragraph>
          </text>
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          <text>
            <paragraph>
              <renderMultiMedia referencedObject="img_259062af-5d95-28f9-e063-6394a90a4faa"/>
            </paragraph>
            <paragraph>NDC 60687-
  <content styleCode="bold">443</content>-01
 </paragraph>
            <paragraph>
              <content styleCode="bold">traZODONE</content>
              <br/>
              <content styleCode="bold">Hydrochloride</content>
              <br/>
Tablets, USP
 </paragraph>
            <paragraph>
              <content styleCode="bold">50 mg</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">100 Tablets (10 x 10)                Rx Only</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">PHARMACIST: </content>Dispense with Medication Guide to each patient.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Each Tablet Contains:</content>
              <br/>
Trazodone hydrochloride, USP........................................ 50 mg
 </paragraph>
            <paragraph>
              <content styleCode="bold">Usual Dosage: </content>See full prescribing information.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Store </content>at 20° to 25°C (68° to 77°F); excursions permitted between
  <br/>
15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].
 </paragraph>
            <paragraph>
              <content styleCode="bold">FOR YOUR PROTECTION: </content>Do not use if blister is torn or broken.
 </paragraph>
            <paragraph>The drug product contained in this package is from
  <br/>
NDC # 68382-805, Zydus Pharmaceuticals (USA) Inc.
 </paragraph>
            <paragraph>Distributed by: American Health Packaging, Columbus, Ohio 43217</paragraph>
            <paragraph>744301
  <br/>
0444301/0424
 </paragraph>
          </text>
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            <paragraph>traZODONE
  <br/>
Hydrochloride
  <br/>
Tablets, USP
 </paragraph>
            <paragraph>
              <content styleCode="bold">50 mg</content>
            </paragraph>
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            <paragraph>
              <renderMultiMedia referencedObject="img_25907dee-c193-5725-e063-6394a90a53ce"/>
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            <paragraph>NDC 60687-
  <content styleCode="bold">454</content>-01
 </paragraph>
            <paragraph>
              <content styleCode="bold">traZODONE</content>
              <br/>
              <content styleCode="bold">Hydrochloride</content>
              <br/>
Tablets, USP
 </paragraph>
            <paragraph>
              <content styleCode="bold">100 mg</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">100 Tablets (10 x 10)                Rx Only</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">PHARMACIST: </content>Dispense with Medication Guide to each patient.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Each Tablet Contains:</content>
              <br/>
Trazodone hydrochloride, USP...................................... 100 mg
 </paragraph>
            <paragraph>
              <content styleCode="bold">Usual Dosage: </content>See full prescribing information.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Store </content>at 20° to 25°C (68° to 77°F); excursions permitted between
  <br/>
15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].
 </paragraph>
            <paragraph>
              <content styleCode="bold">FOR YOUR PROTECTION: </content>Do not use if blister is torn or broken.
 </paragraph>
            <paragraph>The drug product contained in this package is from
  <br/>
NDC # 68382-806, Zydus Pharmaceuticals (USA) Inc.
 </paragraph>
            <paragraph>Distributed by: American Health Packaging, Columbus, Ohio 43217</paragraph>
            <paragraph>745401
  <br/>
0445401/0424
 </paragraph>
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          <effectiveTime value="20221130"/>
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            <paragraph>traZODONE
  <br/>
Hydrochloride
  <br/>
Tablets, USP    
  <content styleCode="bold">100 mg</content>
            </paragraph>
          </text>
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          <code code="51945-4" codeSystem="2.16.840.1.113883.6.1" displayName="PACKAGE LABEL.PRINCIPAL DISPLAY PANEL"/>
          <title>Package/Label Display Panel -Carton – 150 mg</title>
          <text>
            <paragraph>
              <renderMultiMedia referencedObject="img_25908a80-04de-29d5-e063-6294a90a7a85"/>
            </paragraph>
            <paragraph>NDC 60687-
  <content styleCode="bold">432</content>-01
 </paragraph>
            <paragraph>
              <content styleCode="bold">traZODONE</content>
              <br/>
              <content styleCode="bold">Hydrochloride</content>
              <br/>
Tablets, USP
 </paragraph>
            <paragraph>
              <content styleCode="bold">150 mg</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">100 Tablets (10 x 10)                Rx Only</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">PHARMACIST: </content>Dispense with Medication Guide to each patient.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Each Tablet Contains:</content>
              <br/>
Trazodone hydrochloride, USP...............................................150 mg
 </paragraph>
            <paragraph>
              <content styleCode="bold">Note to Pharmacist: </content>If other than a whole tablet is to be taken,
  <br/>
instruct patient as to the correct score to use when breaking the
  <br/>
tablet. See 
  <content styleCode="bold">HOW SUPPLIED </content>section.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Usual Dosage: </content>See full prescribing information.
 </paragraph>
            <paragraph>
              <content styleCode="bold">Store </content>at 20° to 25°C (68° to 77°F); excursions permitted between
  <br/>
15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature].
 </paragraph>
            <paragraph>
              <content styleCode="bold">FOR YOUR PROTECTION: </content>Do not use if blister is torn or broken.
 </paragraph>
            <paragraph>The drug product contained in this package is from
  <br/>
NDC # 68382-807, Zydus Pharmaceuticals (USA) Inc.
 </paragraph>
            <paragraph>Distributed by: American Health Packaging, Columbus, Ohio 43217</paragraph>
            <paragraph>743201
  <br/>
0443201/0424
 </paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <component>
            <observationMedia ID="img_25908a80-04de-29d5-e063-6294a90a7a85">
              <text>150 mg Trazodone Tablets Carton</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="150 mg Trazodone Tablets Carton.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
      <component>
        <section ID="ID_0a3792ee-840d-4cfa-9f78-c93d0100a263">
          <id root="04c9c667-039f-0dea-e063-6394a90ae6da"/>
          <code code="51945-4" codeSystem="2.16.840.1.113883.6.1" displayName="PACKAGE LABEL.PRINCIPAL DISPLAY PANEL"/>
          <title>Package/Label Display Panel – Blister – 150 mg</title>
          <text>
            <paragraph>
              <renderMultiMedia referencedObject="ID_17b6d460-5360-421a-af78-9997264bc9b8"/>
            </paragraph>
            <paragraph>traZODONE
  <br/>
Hydrochloride
  <br/>
Tablets, USP    
  <content styleCode="bold">150 mg</content>
            </paragraph>
          </text>
          <effectiveTime value="20221130"/>
          <component>
            <observationMedia ID="ID_17b6d460-5360-421a-af78-9997264bc9b8">
              <text>150mg traZODONE HCL Tablets Blister</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="150mg Blister.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
    </structuredBody>
  </component>
</document>