Administration of Trazodone 50 mg Tablet
Trazodone 50 mg tablets should be swallowed whole or broken in half along the score line and taken shortly after a meal or light snack. 1
Tablet Administration Methods
- Swallow the tablet whole as the preferred method of administration 1
- Break the tablet in half along the score line if needed—this is an acceptable alternative 1
- Do not chew or crush trazodone tablets, as this alters the intended release characteristics 1
Timing and Food Requirements
- Take shortly after a meal or light snack—this is essential for optimal absorption and tolerability 1
- Food delays absorption and reduces peak serum concentration but does not alter total drug exposure (area under the curve), making post-meal administration both safer and equally effective 2
Important Clinical Context for 50 mg Dosing
When 50 mg is NOT Appropriate
- The American Academy of Sleep Medicine explicitly recommends against using trazodone 50 mg for insomnia, as this dose provides clinically insignificant benefit (only 10.2 minutes reduction in sleep latency and 21.8 minutes increase in total sleep time) 3, 4
- For major depressive disorder, 50 mg is subtherapeutic—the FDA-approved starting dose is 150 mg/day in divided doses 1
If 50 mg is Being Used Off-Label for Sleep
- Begin with 25 mg at bedtime, not 50 mg, particularly in younger patients to assess tolerability 3
- The major portion of the daily dose should be given at bedtime if drowsiness occurs 1
- Assess every 1-2 weeks initially for suicidal ideation (FDA black box warning for patients under age 25), effectiveness, and adverse effects 3
Special Populations Requiring Dose Modification
- Elderly patients: Use lower doses due to increased volume of distribution (1.15 vs 0.89 L/kg in young men) and reduced clearance (1.65 vs 2.31 ml/min/kg), resulting in prolonged half-life (8.2 vs 4.7 hours) 5
- Obese patients: Dosing should be based on ideal body weight rather than total body weight, as volume of distribution increases dramatically (1.43 vs 1.04 L/kg) and elimination half-life is prolonged (13.3 vs 5.9 hours) 5
Critical Safety Warnings
- Priapism risk: Patients must be counseled that erections lasting more than 6 hours require immediate medical attention and may necessitate surgical intervention 1
- Orthostatic hypotension: Patients should be warned they may feel dizzy or faint when changing positions (sitting to standing) 1
- Do not stop abruptly: Gradually reduce the dosage to avoid withdrawal symptoms including anxiety, agitation, and sleep problems 1