Trazodone undergoes hepatic (liver) metabolism, primarily via CYP3A4, as part of first-pass metabolism, which is part of why liver function and interacting medications that affect CYP3A4 can meaningfully change trazodone's effects.
First-pass metabolism
The process by which a drug taken by mouth is partly broken down by the liver before reaching the rest of the body, reducing the amount that becomes active in the bloodstream.