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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.

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.