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Pliva 433, 434 and 441 (Trazodone hydrochloride) are oral, prescription medications to treat depression. They also treat the anxiety, psychological symptoms of fibromyalgia and insomnia attributed to depression. All require a prescription from a licensed physician.
- Trazodone is a Selective Serotonin Reuptake Inhibitors (SSRI).
- They are “scored” to help split them apart.
Each is indicated for the treatment of major depressive disorder (MDD) in adults only. For some people, Trazodone may improve their mood, increase energy levels and enhance appetite.
- It was approved by the FDA in 1981
- Trazodone was also the first non-trycylic antidepressant to be approved in the United States.
- All contain hydrochloride.
- First manufactured in Italy by Angelini Research Labs in the 1960s.
- Today, all these pills are made by PLIVA (Croatian pharmaceutical company).
- It is considered a “second generation” antidepressant.
- Other second generation antidepressants include Bupropion, Viloxazine and Iprindole.
Characterized by the era in which they were put on the market (specifically the 70s and 80s), second generation antidepressants have fundamentally similar chemical structures and pharmacological effects. At the time, Trazodone researchers developed this drug according to studies indicating that depression emerged due to a person’s inability to feel pain (mental pain hypothesis). In contrast to other antidepressants at that time, Trazodone exerted minimal effects on particular neurotransmitter receptors involved in depression.
Tablets branded Pliva 433 contain 50 mg of Trazodone Hydrochloride each. Prescription bottles are available in quantities of 100, 500 and 1,000.
Here are their NDC codes.
- 50111-433-01 50 mg (100 tablets per bottle)
- 50111-433-02 50 mg (500 tablets per bottle)
- 50111-433-03 50 mg (1,000 tablets per bottle)
Pliva 434 (Desyrel)
Each tablet contains 100 mg of Trazodone Hydrochloride. PLIVA 434 has its own a brand name. It is known as Desyrel. Here are the NDC codes and the configuration of each;
- 50111-434-01 100 mg (100 tablets per bottle)
- 50111-434-02 100 mg (500 tablets per bottle)
- 50111-434-03 100 mg (1,000 tablets per bottle)
Each Pliva 441 tablet contains 150 mg of Trazodone Hydrochloride. However, it is configured in order to be split them into thirds (50 mg each). Here are the NDC codes for the two types of this drug;
- 50111-441-01 150 mg (100 tablets per bottle)
- 50111-441-02 150 mg (500 tablets per bottle)
National Drug Codes (NDC)
According to Medhealth, by law, every pill, tablet, or capsule approved by the FDA must look unique from all others. This is done specifically to make identifying each easier. A pill’s design is a combination of:
- The shape
- The pattern (two-toned, has lines, speckled, etc.)
- The color(s)
Each pill will also be imprinted or debossed with a unique identifier. These can include a combination of numbers and letters or the name of the drug. In some cases, you might also see a logo. The word “Pliva” refers to the name of its manufacturer. The numbers refer to National Drug Codes (NDC). The 2 digits at the end are code indicating the number of tablets in a bottle. Here are the NDC codes for each of the three tablets.
The main ingredient in PLIVA 433 and 434 is Trazodone hydrochloride, a selective serotonin reuptake inhibitor (SSRI). Trazodone works to relieve depression and anxiety by preventing receptors on certain brain cells from “up-taking” or keeping serotonin in these receptors. This helps increase and regulate serotonin levels in the brain. Serotonin is a primary neurotransmitter responsible for moderating mood, sleep, appetite, motivation and libido.
Possible side effects of these pills are similar to those of most antidepressants, including:
- Diarrhea or constipation
- Dry mouth
- Muscle aches
After taking Trazodone for about six to eight weeks, side effects should diminish considerably. In rare cases, Trazodone may cause heart palpitations, rapid heartbeat, migraine or visual disturbances. Dosage amounts may need adjusted to stop more serious side effects or the patient’s doctor may decide to prescribe another type of antidepressant.
Although developed originally for treating depression, Trazodone is also prescribed “off-label” as a sleep aid. When drugs are prescribed “off-label”, this means doctors are prescribing them for purposes not approved by the FDA based on the drug’s proven effectiveness for a particular health issue.
Since it does not act on the “reward” center of the brain like opioids and alcohol, Trazodone is not physically or psychologically addicting.
- The U.S. DEA does NOT list Trazodone as a controlled substance.
However, if you suddenly stop taking Trazodone after being on the medication for several months, you could suffer antidepressant discontinuation syndrome (ADS) resulting from the brain trying to adjust to reduced levels of serotonin. Signs of ADS include extreme dizziness, anxiety, insomnia and a variety of flu-like symptoms that can make some Trazodone users feel quite ill.
Is it possible to get “high” on Trazodone?
Overdosing on Trazodone is rare. If Trazodone is taken with other SSRIs, a potentially serious condition called serotonin syndrome may cause agitation, headache, vomiting, fast heartbeat and profuse sweating. This happens when too much serotonin floods the brain. Severe cases of serotonin syndrome may require emergency treatment involving forced diuresis (stomach pumping) or administration of activated charcoal to counteract toxic serotonin levels in the brain.
These tablets are available in 50 mg, 100 mg and 150 mg tablets. Trazodone 150 mg tablets are not round but trapezoid-shaped. Initially, doctors may prescribe 150 mg per day to patients (three 50 mg tablets each day). If needed, Trazodone dosage can be increased by 50 mg daily every three to four days. The maximum safe dose of Trazodone per day is 600 mg.
According to the FDA, dosage suggestions are as follows;
- 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.
- DESYREL should be taken shortly after a meal or light snack.
- Tablets should be swallowed whole or broken in half along the score line.
- When discontinued, gradual dose reduction is recommended.