Can I take Esomeprazole and Trazodone together?

Why this happens

Esomeprazole reduces stomach acid. Trazodone needs an acidic environment to dissolve properly so it can be absorbed into the bloodstream. Lower acid levels mean less medicine gets into your system. There is also a theoretical risk of 'QT prolongation' (a change in heart rhythm) when these types of drugs are used together.

What you should do

You can generally take these together, but monitor your mood or sleep patterns closely. If you feel your trazodone is not working as well as it used to, or if you experience any unusual heart palpitations or dizziness, speak with your doctor. They may need to adjust your dose or the timing of when you take your tablets.

Important precautions

Depression and mental health disorders

Trazodone can increase thoughts of self-harm or suicide, particularly when first starting the medicine or changing the dose. Monitor your mood closely and seek urgent medical help if you experience any distressing thoughts.

Drowsiness and alcohol interaction

Trazodone is highly sedating. You must not drink alcohol while taking it as this will dangerously increase the sedative effect. Do not drive or operate machinery until you know how it affects you.

Priapism (prolonged erection)

In rare cases, trazodone can cause a painful, persistent erection. If you experience an erection lasting more than two hours, seek emergency medical help immediately to prevent permanent damage.

Severe diarrhoea (C. difficile) - esomeprazole

Seek medical help if you develop severe or persistent watery diarrhoea, as this medicine can increase the risk of a serious bowel infection.

Vitamin B12 deficiency and bone fractures - esomeprazole

Long-term use (over a year) can weaken bones and lead to low magnesium or B12 levels; your doctor should monitor these if you are on long-term treatment.

Severe kidney or liver disease

Your doctor may need to prescribe a lower dose, as your body will take longer to clear esomeprazole.

Magnesium deficiency

Taking esomeprazole for more than three months can cause your blood magnesium levels to drop significantly, leading to fatigue, muscle spasms, or dizziness.

Masking stomach cancer symptoms

Esomeprazole can hide the symptoms of stomach cancer. You must tell your doctor if you have unexplained weight loss, persistent vomiting, or difficulty swallowing before starting this medicine.

Food and drink warnings

Alcohol

While alcohol does not directly interact with esomeprazole, it can increase stomach acid production and irritate the stomach lining, which may worsen the symptoms your medicine is intended to treat. It is best to limit alcohol intake.

It is best to avoid or strictly limit alcohol while taking trazodone. Alcohol can significantly increase the sedative effects of this medicine, making you feel very sleepy, dizzy, or unsteady on your feet. It can also increase the risk of breathing difficulties.

Grapefruit juice

Avoid drinking large amounts of grapefruit juice. Grapefruit can increase the level of trazodone in your blood, which may increase the risk of side effects.

Caffeine

Caffeine (found in coffee, tea, and some fizzy drinks) can trigger or worsen acid reflux and heartburn. This may make esomeprazole less effective at managing your symptoms.

Food (General)

Trazodone should ideally be taken with or shortly after a meal or a snack. Taking it on an empty stomach can increase the risk of feeling dizzy or lightheaded.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.