Updated on April 3, 2024
9 min read

The Guide to Taking Pliva 434/433: Uses, Side Effects, and Warnings

Key Takeaways

Is Pliva 434/433 Addictive?

In clinical studies with trazodone hydrochloride, investigators did not find drug-seeking behavior in individuals using the medication. The United States Drug Enforcement Agency (DEA) also does not classify trazodone hydrochloride as a controlled substance.7

This suggests that trazodone hydrochloride has little to no potential for misuse and dependence. However, you may experience additional side effects if you stop taking it suddenly.

Speak with your doctor about quitting or tapering off trazodone to prevent additional side effects. They will explain how to reduce your dose gradually and safely.


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Trazodone Withdrawal Symptoms and Detox

People who abuse Trazodone can develop a physical dependence on the substance. This can lead to uncomfortable withdrawal symptoms when they stop using trazodone. A medical detox will be necessary to help you manage withdrawal symptoms.3

Symptoms of Trazodone withdrawal include:3

  • Dizziness or lightheadedness
  • Nausea
  • Vomiting
  • Shock-like sensations
  • Suicidal Thoughts
  • Vertigo or issues walking
  • Difficulties concentrating 
  • Headaches
  • Irritability
  • Chills
  • Depersonalization

Experiencing withdrawal symptoms from trazodone does not always mean someone is addicted to the drug. But it does suggest physical dependency on the medicine.

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Side Effects of Pliva 434/433

Pliva 434 and 433 can cause common side effects. Adverse effects include:3

  • Headaches
  • Nausea/vomiting
  • Dry mouth
  • Diarrhea
  • Constipation
  • Tiredness or weakness
  • Unsteady gait 
  • Difficulty concentrating or remembering 
  • Confusion 
  • Pain in the muscles 
  • Sweating 
  • Stuffy nose
  • Allergic reaction
  • Changes in libido 

When Should You See a Doctor?

Seek medical attention if trazodone causes serious conditions, such as:3

  • Chest Pain
  • Arrhythmias
  • Coma 
  • Fainting 
  • Seizures 
  • Dyspnea (shortness of breath)
  • Unusual bruising or bleeding

It is important to speak to a healthcare professional about the full risks and benefits of Pliva 434 and 433, especially in younger individuals. The drug has been reported to increase suicidal thinking at the beginning of treatment or when dosing changes occur.3

Other Potential Risks of Pliva 434/433

Other health risks that have been associated with the use of trazodone hydrochloride include:3,6,7,8

  • Priapism: Long-lasting erections
  • Mania or hypomania: Extended period of mood disturbance involving abnormal amounts of energy and hyperactivity
  • QT prolongation: An electrical disturbance in the heart that can trigger tachycardia
  • Insomnia: A sleeping disorder that causes you to have trouble falling or staying asleep
  • Arrhythmia: An irregular heartbeat that makes your heart beat faster or slower than normal

If you notice new or worsening symptoms, call your doctor immediately.

Trazodone Hydrochloride Warnings

Trazodone hydrochloride has a Food and Drug Administration boxed warning. This is the highest level of warning from the FDA. A boxed warning indicates potential dangerous drug effects.

These effects may include:3

Suicidal Thoughts and Behaviors

Antidepressant medications, including trazodone hydrochloride, can increase suicidal thoughts or behaviors. The risk is increased in:2,3

  • Pediatric patients
  • Teenage patients
  • Young adult patients

Suicidal thoughts or behaviors are most common during the first few months of treatment or after changing doses. Because of this, trazodone hydrochloride is not approved for pediatric patients.

Serotonin Syndrome

Trazodone hydrochloride can cause serotonin syndrome, which results from excessive amounts of serotonin in the body.5 This is a life-threatening condition that can cause:9

  • Agitation
  • Hallucinations
  • Confusion (difficulty thinking)
  • Nausea, vomiting, and diarrhea
  • Muscle twitching
  • Increased heart rate
  • High or low blood pressure
  • Fever
  • Coma

Serotonin syndrome is more likely to occur if you mix Pliva 434/433 with other serotonergic drugs.5 If you experience any of the above symptoms, seek emergency medical attention immediately.

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What Does Pliva 434/433 Do to You?

Pliva 434 & 433 does not cure depression. It cannot change your personality or make you feel euphorically happy. It can only help manage symptoms of depression.3,7

Generally, these drugs won't take full effect until two weeks have passed. You should continue to follow the doctor's prescription to ensure treatment efficacy.3,7

You feel tired during the first few days of taking trazodone. Once the drug has taken effect, you will have less anxiety and better sleep.3,7

Does Pliva 434/433 Feel Like Xanax?

Although Xanax is similar to trazodone, they are different drugs. While trazodone is an antidepressant, Xanax is a benzodiazepine anti-anxiety drug.

Benzodiazepine drugs increase activity at receptors in your brain, known as GABA receptors. This process slows down your central nervous system (CNS), helping you feel calmer and relaxed.

Another main difference is that Xanax and other benzodiazepines can be addictive. On the other hand, trazodone is not.

What is Pliva 434/443 (Trazodone Hydrochloride)?

Pliva 434 is a 100 mg dose of trazodone hydrochloride. On the other hand, Pliva 433 is only 50 mg. Both drugs are a sedative that belongs to the drug class phenylpiperazine antidepressants.1,7

Trazodone hydrochloride is an FDA-approved, generic medication. It is in the class of medications called SSRIs or selective serotonin reuptake inhibitors. It's often used to treat depression and major depressive disorder (MDD).7

Healthcare professionals may prescribe these drugs when other therapeutic options are unsuitable. Common pill imprints of the drug include:1

Trazodone Hydrochloride 100 mg:

Pliva 434 Pill - Trazodone Hydrochloride

Trazodone Hydrochloride 50 mg:

Pliva 433 Pill - Trazodone Hydrochloride

Trazodone Hydrochloride 300 mg:

bar 733 Pill - Trazodone Hydrochloride

Trazodone Hydrochloride 150 mg:

Pliva 441 Pill - Trazodone Hydrochloride

How Does Pliva 434/433 Work?

Pliva 434 and 433 are serotonin receptor antagonists and reuptake inhibitors (SARIs). This means that these drugs help increase the production of serotonin in the brain to restore mental balance.2

Serotonin is a neurotransmitter produced in the brain that helps deliver nerve signals. It's responsible for good moods and happiness.2

These drugs are more commonly known by brand names like:7

  • Oleptro®
  • Desyrel®
  • Desyrel Dividose®
  • Trialodine®

Pliva 434 and 433 are available as oral tablets and extended-release tablets. These tablets should be stored at room temperature.3

Who is At Risk When Using Pliva 434/433?

Some people are at risk of experiencing side effects from Pliva 434/433 compared to others. People who have a personal or family medical history of the following should let their doctors know first before taking this drug:2

  • Bipolar disorder
  • Heart disease (including heart attacks or irregular heartbeat)
  • Glaucoma (angle-closure type)
  • Blood pressure issues
  • Suicide attempts
  • Liver or kidney disease 
  • Bleeding disorder
  • Seizures or epilepsy

Other Uses for Trazodone Hydrochloride

Because of their sedative effects, Pliva 434 and 433 can be used to treat other health conditions, such as:3

  • Insomnia
  • Schizophrenia
  • Anxiety

Healthcare professionals recommend taking the medication around bedtime. This can help you avoid feeling drowsy during the day. 

Trazodone Drug Interactions

Pliva 434 and 433 can interact with other medications. Be sure to talk to your doctor about any prescription drugs you're taking before using trazodone hydrochloride.

Combining the drug with other substances can cause unwanted and serious side effects. Here are some drugs that can interact with trazodone hydrochloride:7

Serotonergic medications

Using serotonergic drugs while taking trazodone hydrochloride increases the risk of developing serotonin syndrome. These types of drugs include:5

  • Triptans
  • Tricyclic
  • Antidepressants
  • Fentanyl
  • St. John’s Wort
  • Tramadol
  • Lithium
  • Monoamine oxidase inhibitors (MAOI or MAO inhibitors)

Aspirin, NSAIDs, Antiplatelet, and Anticoagulant Drugs

Taking trazodone hydrochloride with any of these drugs can increase the risk of bleeding. Combining these drugs can also interfere with serotonin reuptake, the process where nerve cells reuse serotonin.7

Macrolide Antibiotics

Macrolide antibiotics, including erythromycin, are commonly used to treat infections like:7

  • Pneumonia
  • Sinusitis
  • Pharyngitis
  • Tonsillitis

However, it can also affect the removal of trazodone from your body. This can affect how your body responds to Pliva 434 and 433.

Seizure Medication

Seizure or epilepsy medication like phenytoin can result in:7

  • Increased dizziness
  • Increased drowsiness
  • Confusion
  • Difficulty concentrating


Trazodone intake may increase digoxin levels in the body, leading to serious side effects and toxicity. These include:7

  • Vomiting
  • Dizziness
  • Vision problems
  • Irregular heart rate

CNS depressants

These drugs may worsen the drowsiness effect caused by trazodone hydrochloride. Examples of such medications include:7

  • Sleeping pills
  • Opioids
  • Alcohol
  • Benzodiazepines 


Mixing trazodone with diuretics can cause you to urinate more, leading to hyponatremia. This can lower your blood sodium to abnormally low levels.7

Medicines for Migraines and Headaches

Migraine and headache medication can increase serotonin levels in the blood and can cause severe hypertension and increased heart rate, which can be life-threatening. These drugs include:7

  • Sumatriptan
  • Imitrex
  • Maxalt
  • Treximet

How Long Does Pliva 434/433 Stay In Your System?

When individuals complete treatment with trazodone hydrochloride, it is important not to take MAOI within two weeks. Trazodone hydrochloride can still have some physiological effects on the body. When in doubt, it is best to seek medical advice to ensure a safe treatment. 

Can You Overdose on Pliva 434/433

Some cases of death from an overdose have been reported when the drug was ingested with other central nervous system (CNS) depressants. If you suspect an overdose, seek medical help immediately.7

CNS depressants can include:

  • Alcohol
  • Diazepam
  • Amobarbital
  • Narcotic pain medications
  • Opioids 

Trazodone Hydrochloride Statistics



Estimated number of prescriptions of trazodone hydrochloride in the U.S.



Average total drug cost for trazodone hydrochloride.



Average out-of-pocket costs for trazodone hydrochloride.

Treatment for Trazodone Abuse

Trazodone abuse requires an exhaustive assessment of your health and history of substance abuse. This will be important when developing an addiction treatment plan for you.

People respond to treatment differently, so talking to your doctor about your needs is important. An addiction treatment program for Trazodone abuse may include the following:

  • Medical detox: Medically supervised detox used to avoid harmful withdrawal effects
  • Inpatient treatment: Involves checking yourself into a rehab facility for 24-hour medical supervision
  • Outpatient treatment: A treatment program where patients are freely allowed to leave the rehab facility
  • Cognitive behavioral therapy (CBT): A short-term therapy technique that explores the link between thought patterns and addiction
  • Dual-diagnosis treatment: A treatment program that addresses substance use disorders alongside co-occurring disorders
  • 12-step programs: A support group designed to help guide you through the recovery process and maintain sobriety

What to Discuss With Your Healthcare Provider Before Taking Pliva 434

Are trazodone and Xanax the same thing?

No. Trazodone is an antidepressant, while Xanax is a benzodiazepine. Benzodiazepines are controlled substances under the U.S. Drug Enforcement Agency. This means that Xanax, unlike Trazodone, has a much higher potential for misuse and abuse. Also, Xanax helps to treat panic disorders, including panic attacks or anxiety. Xanax would not be a suitable option for depression.

Does trazodone work right away for sleep?

For those who are taking trazodone for insomnia, doctors will recommend taking the drug during bedtime. Because trazodone causes drowsiness, which may extend even a day after you take the pill, you must practice caution, especially in activities that require alertness.

Trazodone is not approved as a sleeping pill, but its side effect of increased sleepiness is the reason why it may help you fall asleep.

How long do you sleep on trazodone?

Trazodone helps provide a better night’s rest by letting individuals sleep approximately 7 to 8 hours.

Does Trazodone affect memory?

Trazodone may affect memory. A side effect reported in people taking the drug is difficulty concentrating or remembering.

What happens if I miss a dose?

There is no problem when it comes to a missed dose. Individuals just need to take the dose as soon as they remember (assuming it is not close to the next dose). 

Individuals should remember to avoid taking a double dose of the drug.

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Updated on April 3, 2024
9 sources cited
Updated on April 3, 2024
  1. DailyMed - TRAZODONE HYDROCHLORIDE Tablet.U.S. National Library of Medicine, National Institutes of Health.

  2. Trazodone.NHS Choices, NHS, 2018.

  3. Trazodone: MedlinePlus Drug Information.MedlinePlus, U.S. National Library of Medicine, 2017.

  4. Kane, S. “Trazodone Hydrochloride.” Trazodone Hydrochloride - Drug Usage Statistics, ClinCalc DrugStats Database, 2020.

  5. Shin J.J., and Saadabadi A. "Trazodone." Treasure Island (FL): StatPearls Publishing, 2022.

  6. Jaffer et al. "Trazodone for Insomnia: A Systematic Review." Innov Clin Neurosci, 2017.

  7. "Trazodone." Drugs.com, 2022.

  8. Shah et al. "Pretreatment screening and counseling on prolonged erections for patients prescribed trazodone." Investig Clin Urol, 2021

  9. Simon LV & Keenaghan M. "Serotonin Syndrome."Treasure Island (FL): StatPearls Publishing, 2023.

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