Cyclobenzaprine oral tablet interactions: Alcohol, medications, and other factors

Cyclobenzaprine interactions with other drugs

Before you start treatment with cyclobenzaprine oral tablet, tell your doctor and pharmacist about any prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

To learn whether cyclobenzaprine interacts with supplements, herbs, or vitamins, see the “Cyclobenzaprine and other interactions” section.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with cyclobenzaprine. Keep in mind this table doesn’t include all drugs that may interact with cyclobenzaprine. Some of these interactions are described in detail in “Drug interactions in depth.”

When to avoid cyclobenzaprine  

In some cases, certain factors or conditions could prevent your doctor from prescribing cyclobenzaprine due to the risk of harm. These are known as contraindications. Below are the contraindications of cyclobenzaprine.

Note: Before you start treatment with cyclobenzaprine, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe cyclobenzaprine.

Having certain heart conditions

Doctors typically will not prescribe cyclobenzaprine for people with the following heart conditions:

• recent heart attack
• arrhythmia (irregular heartbeat)
• heart block or problems with electrical signals in the heart
• congestive heart failure

Cyclobenzaprine can cause a fast or irregular heartbeat, which can be dangerous for people with these heart conditions.

If you have one of these heart conditions, talk with your doctor before taking cyclobenzaprine. They’ll likely prescribe a treatment other than cyclobenzaprine for your condition.

Having hyperthyroidism

Doctors typically will not prescribe cyclobenzaprine for people with hyperthyroidism. This is because hyperthyroidism can cause a fast or irregular heartbeat, and cyclobenzaprine can make this worse.

If you have hyperthyroidism, talk with your doctor before taking cyclobenzaprine. They’ll likely prescribe a treatment other than cyclobenzaprine for your condition.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe cyclobenzaprine in combination with a type of drug called a monoamine oxidase inhibitor (MAOI) or drugs that have a similar mechanism of action to MAOIs.

Taking cyclobenzaprine with an MAOI can increase your risk of serious side effects, including seizures and serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, and vomiting. Serotonin syndrome can be life threatening for some people.

MAOIs that can interact with cyclobenzaprine include:

• phenelzine (Nardil)
• selegiline (Emsam, Zelapar)
• isocarboxazid (Marplan)

Before you start treatment with cyclobenzaprine, it’s important to tell your doctor if you take an MAOI. They’ll likely not prescribe cyclobenzaprine. You can talk with them about other treatment options for your condition. Likewise, after you stop taking cyclobenzaprine, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Having had an allergic reaction to cyclobenzaprine or any of its ingredients

If you have had an allergic reaction to cyclobenzaprine or any of its ingredients, your doctor will likely not prescribe cyclobenzaprine. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

For warnings about other health factors that may interact with cyclobenzaprine, see “Cyclobenzaprine and health-related interactions.” If you have questions about what to avoid when taking muscle relaxers such as cyclobenzaprine, talk with your doctor or pharmacist.

Cyclobenzaprine interaction with alcohol 

If you drink alcohol, your doctor will likely recommend that you do not drink it while taking cyclobenzaprine.

Consuming alcohol and taking cyclobenzaprine may cause serious side effects, including:

• drowsiness
• dizziness
• difficulty with balance and coordination
• slowed reactions
• decreased awareness
• slow or weak breathing
• coma

The combination of alcohol and cyclobenzaprine may also, in some cases, lead to death. If you drink alcohol and have concerns about avoiding it while you’re taking cyclobenzaprine, talk with your doctor before starting treatment.

Drug interactions in depth 

Here’s a closer look at certain drug interactions of cyclobenzaprine.

Opioids

Opioids are strong pain-relieving medications. Taking cyclobenzaprine with opioids can cause serious side effects.

Cyclobenzaprine and opioids are both CNS depressants. This means they slow activity in your brain and spinal cord. Taking cyclobenzaprine with opioids can raise your risk of CNS depression. CNS depression can cause symptoms such as:

• drowsiness
• dizziness
• slurred speech
• confusion
• difficulty with balance and coordination

In severe cases, CNS depression may lead to slow, weak breathing, loss of consciousness, coma, or death.

Cyclobenzaprine and certain opioids can both cause a serious side effect called serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. Taking cyclobenzaprine with certain opioids can raise your risk of serotonin syndrome. Serotonin syndrome can cause symptoms such as blood pressure changes, excessive sweating, and nausea and vomiting. This syndrome can be life threatening for some people.

Taking cyclobenzaprine with opioids can also raise your risk of severe constipation. Constipation is a side effect of both drugs.

Here are some opioids that may interact with cyclobenzaprine:

• hydrocodone (Hysingla ER)
• oxycodone (OxyContin)
• tramadol (ConZip)

Steps you or your doctor may take

Your doctor will usually avoid prescribing cyclobenzaprine with opioids. If they do prescribe these medications together, they may prescribe a lower than usual dosage of one or both medications.

If you take cyclobenzaprine with an opioid, tell your doctor right away if you have symptoms of CNS depression or serotonin syndrome.

If you have questions about taking cyclobenzaprine with opioids, talk with your doctor or pharmacist.

Antidepressants

Taking cyclobenzaprine with antidepressants can raise your risk of serious side effects.

Cyclobenzaprine and antidepressants can both cause serotonin syndrome as a side effect. Taking cyclobenzaprine with antidepressants can raise your risk of this potentially life threatening side effect.

Some antidepressants, such as tricyclics, are CNS depressants. Taking cyclobenzaprine (a CNS depressant) with these antidepressants can raise your risk of CNS depression.

You can find details about serotonin syndrome and CNS depression in the “Opioids” section.

Taking cyclobenzaprine with tricyclic antidepressants can also raise your risk of urination problems and severe constipation. These are possible side effects of both drugs.

Here are some antidepressants that may interact with cyclobenzaprine:

• selective serotonin reuptake inhibitor (SSRI) antidepressants, such as sertraline (Zoloft) and citalopram (Celexa)
• serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants, such as duloxetine (Cymbalta) and venlafaxine (Effexor XR)
• tricyclic antidepressants, such as amitriptyline and imipramine (Tofranil)
• MAOIs, such as phenelzine (Nardil) and isocarboxazid (Marplan)*
• bupropion (Wellbutrin)
• mirtazapine (Remeron)

* Your doctor likely will not prescribe cyclobenzaprine with MAOIs. For more information, see “When to avoid cyclobenzaprine.”

Steps you or your doctor may take

If you take an antidepressant, talk with your doctor before taking cyclobenzaprine. In some cases, your doctor may avoid prescribing cyclobenzaprine. You can talk with them about alternatives that may be safer for you.

If your doctor prescribes cyclobenzaprine with your antidepressant, they may prescribe a dosage of either medication that’s lower than usual. Talk with your doctor about what side effects to look out for and what to do if you get them. If you have symptoms of serotonin syndrome, you should talk with your doctor right away.

If you have questions about taking cyclobenzaprine with antidepressants, talk with your doctor or pharmacist.

Certain blood pressure medications

Cyclobenzaprine has interactions with certain blood pressure medications.

Here are some blood pressure medications that may interact with cyclobenzaprine:

• clonidine (Catapres)
• verapamil (Verelan)

Taking cyclobenzaprine with clonidine can make clonidine less effective at lowering your blood pressure. It can also raise your risk of drowsiness, as both medications can cause drowsiness.

Taking cyclobenzaprine with verapamil can raise your risk of serotonin syndrome. This is a serious side effect that can be life threatening for some people. You can find details about serotonin syndrome in the “Opioids” section.

Taking cyclobenzaprine with other blood pressure medications doesn’t usually cause an interaction. However, cyclobenzaprine and blood pressure medications can both cause dizziness. So you may have a higher risk of this side effect if you take these medications together.

Steps you or your doctor may take

If you take blood pressure medication, talk with your doctor before taking cyclobenzaprine. In some cases, your doctor may avoid prescribing cyclobenzaprine. You can talk with them about alternatives that may be safer for you.

If your doctor prescribes cyclobenzaprine with your blood pressure medication, they may prescribe a dosage of cyclobenzaprine that’s lower than usual. Tell your doctor if you have new or increased dizziness or drowsiness.

If you take cyclobenzaprine with clonidine, your doctor may monitor your blood pressure more closely. If you take cyclobenzaprine with verapamil, talk with your doctor right away if you have symptoms of serotonin syndrome.

If you have questions about taking cyclobenzaprine with blood pressure medications, talk with your doctor or pharmacist.

Cyclobenzaprine and other interactions

Cyclobenzaprine may have other interactions, such as with supplements, foods, vaccines, or lab tests.

Here are some potential interactions with cyclobenzaprine. Keep in mind that the following information does not include all other possible cyclobenzaprine interactions.

Cyclobenzaprine interactions with supplements

Before you start treatment with cyclobenzaprine, tell your doctor and pharmacist about any supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Cyclobenzaprine interactions with herbs

Cyclobenzaprine can interact with certain herbs.

Valerian: It’s possible for cyclobenzaprine to interact with herbs that can cause drowsiness, such as valerian. Some people use this herb to aid sleep. If you take valerian during cyclobenzaprine treatment, it may increase drowsiness.

If you take any valerian supplements, talk with your doctor before starting cyclobenzaprine treatment. They may advise you to stop taking the supplements while you’re taking cyclobenzaprine. Or they may recommend taking a lower dosage of valerian or cyclobenzaprine.

St. John’s wort: Doctors will typically recommend you avoid taking St. John’s wort with cyclobenzaprine. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

Taking St. John’s wort with cyclobenzaprine may raise your risk of a serious side effect called serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, diarrhea, nausea, and vomiting. Serotonin syndrome can be life threatening for some people.

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Cyclobenzaprine interactions with vitamins

There are no specific reports of vitamins interacting with cyclobenzaprine. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with cyclobenzaprine.

Cyclobenzaprine interactions with food

There were no reports of food interactions with cyclobenzaprine. If you’d like to learn more about eating certain foods during treatment with cyclobenzaprine, talk with your doctor.

Cyclobenzaprine interactions with vaccines

There aren’t any known interactions between cyclobenzaprine and vaccines. Talk with your doctor or pharmacist to check whether you’re due for any vaccines.

Cyclobenzaprine interactions with lab tests

Cyclobenzaprine isn’t known to interact with lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

CYCLOBENZAPRINE INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Amrix (a brand-name version of cyclobenzaprine).

Cyclobenzaprine and cannabis are both CNS depressants. This means that they slow activity in your brain and spinal cord. Taking cyclobenzaprine with cannabis or cannabis products can raise your risk of CNS depression. CNS depression can cause symptoms such as drowsiness, dizziness, and confusion.

Taking cyclobenzaprine with cannabis or cannabis products can make cyclobenzaprine build up in your body. This can raise your risk of side effects from cyclobenzaprine.

Before you start treatment with cyclobenzaprine, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Cyclobenzaprine and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with cyclobenzaprine. Before you take this drug, be sure to talk with your doctor about your health history. Cyclobenzaprine may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with cyclobenzaprine include:

• Certain heart conditions: If you have certain heart conditions, your doctor will likely not prescribe cyclobenzaprine. For more information, see “When to avoid cyclobenzaprine.”
• Hyperthyroidism: If you have hyperthyroidism (high thyroid hormone levels), your doctor will likely not prescribe cyclobenzaprine. For more information, see “When to avoid cyclobenzaprine.”
• Allergic reaction: If you’ve had an allergic reaction to cyclobenzaprine or any of its ingredients, your doctor will likely not prescribe cyclobenzaprine. For more information, see “When to avoid cyclobenzaprine.”
• Liver problems: If you have a liver problem, cyclobenzaprine can build up in your body. This can raise your risk of side effects of cyclobenzaprine, such as drowsiness and dizziness. To avoid this problem, your doctor may prescribe a dose of cyclobenzaprine that’s lower than usual or may extend the time between doses.
• Difficulty urinating: If you have difficulty urinating or emptying your bladder, taking cyclobenzaprine can make this worse. Talk with your doctor about whether cyclobenzaprine is right for you.
• Glaucoma: If you have glaucoma or raised pressure in your eye, taking cyclobenzaprine can make this worse. Talk with your doctor about whether cyclobenzaprine is right for you.
• Older age: If you’re age 65 years or older, you may have a raised risk of cyclobenzaprine side effects, such as drowsiness and dizziness. Because of this, your doctor may prescribe a dosage of cyclobenzaprine that’s lower than usual.
• Breastfeeding: It’s not known whether it’s safe to take cyclobenzaprine while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects cyclobenzaprine may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking cyclobenzaprine. They can talk with you about treatment options and ways to feed a child other than breastfeeding.
• Pregnancy: There haven’t been enough clinical trials to determine whether cyclobenzaprine is safe to use while pregnant. In animal studies, the drug didn’t cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting cyclobenzaprine. They can advise you on the right treatment plan for you.

FAQ about cyclobenzaprine and interactions 

Here are some frequently asked questions about cyclobenzaprine and possible interactions.

Does cyclobenzaprine have interactions with ibuprofen?

No, cyclobenzaprine is not known to interact with ibuprofen (Advil, Motrin). It’s generally considered safe to take these medications together.

Your doctor may recommend taking cyclobenzaprine with ibuprofen if you have a painful muscle strain or injury. Cyclobenzaprine helps relax the injured muscle and relieve the pain, while ibuprofen reduces inflammation (swelling) related to the injury. This can also help relieve the pain.

If you have questions about taking cyclobenzaprine with ibuprofen, talk with your doctor.

Can you drink coffee while taking cyclobenzaprine?

Yes, it’s usually safe to drink coffee while you’re taking cyclobenzaprine. Coffee contains caffeine, which is a CNS stimulant that can help counteract drowsiness that you may have with cyclobenzaprine.

Note that on rare occasions, cyclobenzaprine may cause increased heart rate, heart palpitations, agitation, or anxiety. If you have these side effects, drinking coffee could make them worse, as caffeinated coffee can also cause these side effects.

If you have questions about drinking coffee with cyclobenzaprine, talk with your doctor or pharmacist.

Preventing interactions  

You can take certain steps to help prevent interactions with cyclobenzaprine. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the cyclobenzaprine label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. The paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If cyclobenzaprine doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with cyclobenzaprine by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.