Nefazodone Side Effects

Medically reviewed by Drugs.com. Last updated on Mar 17, 2025.

Applies to nefazodone: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies with major depressive disorder (MDD) and other psychiatric disorders.

Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older.

This risk must be balanced with the clinical need.

Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior.

Families and caregivers should be advised of the need for close observation and communication with the prescriber.

Not approved for use in pediatric patients.

Cases of life-threatening hepatic failure have been reported.

Treatment should not be initiated in individuals with active liver disease or with elevated baseline serum transaminases.

Patients should be advised to be alert for signs and symptoms of liver dysfunction and to report them to their doctor immediately if they occur.

Patients who develop evidence of hepatocellular injury should be withdrawn from the drug .

Serious side effects of nefazodone

Along with its needed effects, nefazodone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur while taking nefazodone:

More common side effects

• blurred vision or other changes in vision
• clumsiness or unsteadiness
• lightheadedness or fainting
• ringing in the ears
• skin rash or itching

Less common side effects

• bladder pain
• bloody or cloudy
• cough or hoarseness
• diarrhea
• excessive muscle tone
• eye pain
• feeling dizzy
• frequent urge to urinate
• itching of the vagina or genital area
• muscle stiffness
• muscle tension or tightness
• nausea
• pain during sexual intercourse
• painful, burning, or difficult urination
• shortness of breath, tightness in chest, or wheezing
• stomach pain
• thick, white vaginal discharge with no odor or with a mild odor
• troubled breathing

Rare side effects

• asthma
• bleeding from the rectum
• bloody or black, tarry stools
• change in sexual desire or performance
• chest pain
• double vision
• dryness of eye
• ear pain
• fainting
• fast heartbeat
• fever, chills, or sore throat
• hallucinations (seeing, hearing, or feeling things that are not there)
• hives
• increased sense of hearing
• increased sensitivity to sun
• irritation or soreness of mouth
• joint or muscle pain or stiffness
• kidney stones
• large pupils of eyes
• lower back, side, or stomach pain
• menstrual changes
• mood or mental changes
• nerve pain or twitching
• pelvic pain
• problems in speaking
• problems with urination
• prolonged, painful, inappropriate penile erection
• red or irritated eyes
• sensitivity of eyes to light
• swelling of face
• swollen glands
• talking, feeling, and acting with excitement and activity you cannot control
• unusual bleeding or bruising
• unusual feeling of well-being
• unusual tiredness or weakness
• vomiting of blood or material that looks like coffee grounds

Incidence not known

• blistering, peeling, or loosening of skin
• light-colored stools
• confusion
• dark urine
• decreased urine output
• fever
• increased thirst
• itching
• lack of appetite
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• muscle pain or cramps
• muscle spasm or jerking of all extremities
• muscle stiffness
• pain, warmth, or burning in fingers, toes, and legs
• red skin lesions, often with a purple center
• sore throat
• sudden loss of consciousness
• sweating
• vomiting

Other side effects of nefazodone

Some side effects of nefazodone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

• abnormal dreams
• agitation
• confusion
• constipation
• diarrhea
• dizziness
• drowsiness
• dryness of mouth
• flushing or feeling of warmth
• headache
• heartburn
• increased appetite
• increased cough
• memory problems
• nausea
• swelling of arms or legs
• tingling, burning, or prickly sensations
• tremor
• trouble in sleeping
• vomiting

Less common or rare side effects

• breast pain
• generalized slowing of mental and physical activity
• increased thirst
• loss of strength or energy
• muscle weakness

Incidence not known

• unexpected or excess milk flow from breasts
• swelling of the breasts or breast soreness in males

For healthcare professionals

Applies to nefazodone: oral tablet.

General adverse events

The most commonly reported side effects were headache, somnolence, dry mouth, and nausea.^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 36%), somnolence (up to 28%), dizziness (up to 22%), lightheadedness (up to 10%)
• Common (1% to 10%): Ataxia, decreased concentration, hypertonia, incoordination, memory impairment, paresthesia, taste perversion, tremor
• Uncommon (0.1% to 1%): Abnormal gait, decreased attention, dysarthria, hangover effect, myoclonus, neuralgia, twitching, vertigo
• Rare (less than 0.1%): Cerebrovascular accident, hyperesthesia, hyperkinesia, hypotonia, neuroleptic malignant syndrome, taste loss
• Frequency not reported: Central nervous system stimulation, hypesthesia, migraine
• Postmarketing reports: Convulsions, grand mal seizures, serotonin syndrome^[Ref]

Gastrointestinal

• Very common (10% or more): Dry mouth (up to 25%), nausea (up to 23%), constipation (up to 17%)
• Common (1% to 10%): Diarrhea, dyspepsia, gastroenteritis, vomiting
• Uncommon (0.1% to 1%): Colitis, enlarged abdomen, eructation, esophagitis, gastritis, gingivitis, halitosis, mouth ulceration, peptic ulcer, periodontal abscess, rectal hemorrhage, stomatitis
• Rare (less than 0.1%): Dysphagia, gastrointestinal hemorrhage, glossitis, increased salivation, oral moniliasis, ulcerative colitis
• Frequency not reported: Abdominal pain, flatulence, tooth disorder^[Ref]

Other

• Very common (10% or more): Asthenia (up to 11%)
• Common (1% to 10%): Chills, fever, tinnitus
• Uncommon (0.1% to 1%): Ear pain, hernia, malaise
• Rare (less than 0.1%): Deafness
• Frequency not reported: Accidental injury, pain^[Ref]

Psychiatric

• Very common (10% or more): Insomnia (up to 11%)
• Common (1% to 10%): Abnormal dreams, agitation, confusion, decreased libido, psychomotor retardation
• Uncommon (0.1% to 1%): Abnormal thinking, apathy, depersonalization, derealization, euphoria, hallucinations, hostility, increased libido, paranoid reaction, suicidal thoughts, suicide, suicide attempt
• Rare (less than 0.1%): Anorgasmia
• Frequency not reported: Anxiety, depression, dysphoria, emotional lability^[Ref]

Ocular

• Very common (10% or more): Abnormal vision (up to 10%)
• Common (1% to 10%): Blurred vision, eye pain, scotoma, visual field defect, visual trails
• Uncommon (0.1% to 1%): Abnormality of accommodation, conjunctivitis, diplopia, dry eye, hyperacusis, keratoconjunctivitis, mydriasis, photophobia
• Rare (less than 0.1%): Angle-closure glaucoma, night blindness, ptosis^[Ref]

In clinical trials, scotomata and visual trails did not occur in patients given doses below 300 mg/day; however, these events were reported at doses below 300 mg/day in postmarketing experience.^[Ref]

Cardiovascular

• Common (1% to 10%): Feeling warm, flushing, hypotension, peripheral edema, postural hypotension, sinus bradycardia, vasodilatation
• Uncommon (0.1% to 1%): Angina pectoris, hypertension, syncope, tachycardia, ventricular extrasystoles
• Rare (less than 0.1%): Atrioventricular (AV) block, congestive heart failure, hemorrhage, pallor, varicose veins
• Frequency not reported: Chest pain, edema, palpitation^[Ref]

Genitourinary

• Common (1% to 10%): Breast pain, impotence, urinary frequency, urinary retention, urinary tract infection, vaginitis
• Uncommon (0.1% to 1%): Abnormal ejaculation, amenorrhea, breast enlargement, hematuria, menorrhagia, metrorrhagia, nocturia, pelvic pain, polyuria, urinary incontinence, urinary urgency, vaginal hemorrhage
• Rare (less than 0.1%): Enlarged uterine fibroids, oliguria, uterine hemorrhage
• Frequency not reported: Dysmenorrhea, dysuria
• Postmarketing reports: Galactorrhea, priapism^[Ref]

Respiratory

• Common (1% to 10%): Bronchitis, dyspnea, increased cough, pharyngitis
• Uncommon (0.1% to 1%): Asthma, epistaxis, hiccup, laryngitis, pneumonia, voice alteration
• Rare (less than 0.1%): Hyperventilation, yawn
• Frequency not reported: Rhinitis, sinusitis^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, rash
• Uncommon (0.1% to 1%): Acne, alopecia, dry skin, ecchymosis, eczema, face edema, maculopapular rash, photosensitivity reaction, urticaria, vesiculobullous rash
• Rare (less than 0.1%): Cellulitis
• Frequency not reported: Sweating
• Postmarketing reports: Stevens-Johnson syndrome^[Ref]

Metabolic

• Common (1% to 10%): Increased appetite, thirst
• Uncommon (0.1% to 1%): Dehydration, gout, increased lactic dehydrogenase, weight loss
• Rare (less than 0.1%): Hypercholesteremia, hypoglycemia
• Frequency not reported: Anorexia, weight gain
• Postmarketing reports: Hyponatremia^[Ref]

Musculoskeletal

• Common (1% to 10%): Arthralgia, neck rigidity
• Uncommon (0.1% to 1%): Arthritis, bursitis, muscle stiffness, tenosynovitis
• Rare (less than 0.1%): Tendinous contracture
• Frequency not reported: Back pain, cramp, myalgia, neck pain
• Postmarketing reports: Rhabdomyolysis^[Ref]

Rhabdomyolysis occurred in patients receiving this drug with lovastatin or simvastatin.^[Ref]

Immunologic

• Common (1% to 10%): Flu syndrome, infection^[Ref]

Hematologic

• Common (1% to 10%): Decreased hematocrit
• Uncommon (0.1 to 1%): Anemia, leukopenia, lymphadenopathy
• Postmarketing reports: Thrombocytopenia^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Abnormal liver function tests, increased ALT, increased AST
• Rare (less than 0.1%): Hepatitis
• Postmarketing reports: Liver failure (in some cases leading to liver transplantation and/or death), liver necrosis^[Ref]

Renal

• Uncommon (0.1% to 1%): Cystitis, kidney calculus^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Allergic reaction
• Postmarketing reports: Anaphylactic reactions, angioedema^[Ref]

Endocrine

• Postmarketing reports: Gynecomastia, increased prolactin^[Ref]

Further information

Nefazodone side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer