{"id":628609,"date":"2024-06-17T08:59:23","date_gmt":"2024-06-17T12:59:23","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=628609"},"modified":"2024-10-25T09:54:32","modified_gmt":"2024-10-25T13:54:32","slug":"cyclobenzaprine-and-tramadol","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/cyclobenzaprine-and-tramadol\/","title":{"rendered":"Can you take cyclobenzaprine with tramadol?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/cyclobenzaprine-hcl\/what-is\"><span style=\"font-weight: 400;\">Cyclobenzaprine<\/span><\/a><span style=\"font-weight: 400;\">, known by the brand name Flexeril, is a muscle relaxant that can treat spasms, discomfort, and stiffness throughout the body, often from injuries. <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/tramadol-hcl\/what-is\"><span style=\"font-weight: 400;\">Tramadol<\/span><\/a><span style=\"font-weight: 400;\"> is an opioid pain reliever used for treating severe pain. These two prescription drugs might seem like they&rsquo;d go hand-in-hand, but taking them together can have a significant effect on the central nervous system, potentially leading to some serious side effects. Before combining medications, please continue reading for important information.<\/span><\/p>\n<h2 id=\"can-you-take-tramadol-and-cyclobenzaprine-together\"><span style=\"font-weight: 400;\">Can you take tramadol and cyclobenzaprine together?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In certain situations, it could be dangerous to take tramadol and cyclobenzaprine at the same time, so doctors often use them carefully, particularly for older adults. Because both drugs affect the central nervous system, they can have an additive effect when used together, according to <\/span><a href=\"https:\/\/www.linkedin.com\/in\/paul-daidone-md-fasam-24556b72\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Dr. Paul Daidone, MD, FASAM<\/span><\/a><span style=\"font-weight: 400;\">, medical director of <\/span><a href=\"https:\/\/trueselfrecovery.com\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">True Self Recovery<\/span><\/a><span style=\"font-weight: 400;\">. &ldquo;The concurrent use of tramadol and cyclobenzaprine is not outright contraindicated,&rdquo; he says. &ldquo;But it requires a cautious approach.&rdquo;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. John Lowe, MD of <\/span><a href=\"https:\/\/www.restorecare.org\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Restore Care Wellness Clinic<\/span><\/a><span style=\"font-weight: 400;\"> agrees, stating, &ldquo;Combining the synthetic opioid analgesic tramadol and cyclobenzaprine, a muscle relaxant, raises legitimate concerns due to possible additive central nervous system depression.&rdquo; Central nervous system depression is when the body&rsquo;s neurological processes slow down, affecting breathing, heart rate, blood pressure, and more.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Higher doses often pose a higher risk, so &ldquo;generally, doctors aim to start with the lowest effective dose for each medication to minimize the risk of adverse effects while still achieving therapeutic benefit,&rdquo; Dr. Lowe says. However, &ldquo;the specific dosage regimen can vary widely among patients, and it&#8217;s essential for healthcare providers to carefully assess and monitor each patient&#8217;s response to treatment to adjust the dosage as needed.&rdquo;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The United States Drug Enforcement Agency has classified tramadol as a <\/span><a href=\"https:\/\/www.dea.gov\/drug-information\/drug-scheduling\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">class IV controlled substance<\/span><\/a><span style=\"font-weight: 400;\">, which means it also has a risk (albeit a relatively low one) of abuse, dependence, and withdrawal symptoms. That&rsquo;s why it&rsquo;s most often used for the short-term treatment of acute pain. It&rsquo;s not typically recommended for chronic pain, but healthcare professionals might still prescribe it for a longer duration of use in rare situations.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">So yes, technically, you can take them together, but only when a health care professional prescribes it. And you have to follow their instructions exactly.&nbsp;<\/span><\/p>\n<h2 id=\"what-happens-if-you-take-tramadol-and-cyclobenzaprine-together\"><span style=\"font-weight: 400;\">What happens if you take tramadol and cyclobenzaprine together?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">As CNS depressants, both drugs significantly slow down certain central nervous system functions. Unlike many muscle relaxants, cyclobenzaprine acts directly on the brain stem rather than the muscles. Similar to some tricyclic antidepressants, it <\/span><a href=\"https:\/\/www.sciencedirect.com\/topics\/neuroscience\/cyclobenzaprine\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">blocks certain motor neurons<\/span><\/a><span style=\"font-weight: 400;\"> to help relieve muscle spasms. On the other hand, tramadol inhibits<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15509185\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\"> norepinephrine and serotonin reuptake<\/span><\/a><span style=\"font-weight: 400;\"> while blocking certain opioid receptors to influence the body&rsquo;s pain response.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Together, those effects can produce some concerning adverse reactions. &ldquo;The two drugs are both sedative agents, and, when taken concurrently, they will increase sedation, dizziness, weakness, or lack of balance,&rdquo; says Dr. Lowe. &ldquo;This can lead to more accidents occurring, especially among those groups who are vulnerable, such as older populations or those with other conditions.&rdquo;&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other <\/span><a href=\"https:\/\/www.sciencedirect.com\/topics\/medicine-and-dentistry\/central-nervous-system-depression\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">central nervous system side effects<\/span><\/a><span style=\"font-weight: 400;\"> may include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Slurred speech<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulty breathing&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drowsiness&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Reduced mental alertness&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mood changes&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Slower heart rate<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dry mouth&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Constipation&nbsp;<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blurred or altered vision<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Allergic reaction&nbsp;<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">For people who experience one or more of these reactions, the healthcare provider might recommend a dose adjustment or alternative medications.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But there is another risk of taking cyclobenzaprine and tramadol together. Dr. Daidone adds, &ldquo;Concurrent use can also increase the risk of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/serotonin-syndrome-symptoms\/\"><span style=\"font-weight: 400;\">serotonin syndrome<\/span><\/a><span style=\"font-weight: 400;\">, a potentially life-threatening medical condition characterized by symptoms such as confusion, rapid heart rate, dilated pupils, fever, ataxia, stiff muscles, and more.&rdquo; In certain rare cases, severe central nervous system depression from taking these drugs together may cause seizures, respiratory distress, coma, and even death.&nbsp;<\/span><\/p>\n<h3 id=\"precautions\"><span style=\"font-weight: 400;\">Precautions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Each drug has certain precautions that every patient and their healthcare provider should assess. It&rsquo;s crucial for your healthcare provider to know your medical history, so before beginning<\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a682514.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\"> cyclobenzaprine treatment<\/span><\/a><span style=\"font-weight: 400;\">, inform your care team if you&rsquo;ve had:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cardiac issues like heart failure, irregular heartbeat, or heart block<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Overactive thyroid<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Glaucoma<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulty urinating<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Because tramadol is a controlled substance, its list of <\/span><a href=\"https:\/\/medlineplus.gov\/druginfo\/meds\/a695011.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">precautions and warnings<\/span><\/a><span style=\"font-weight: 400;\"> is even longer. Inform the healthcare provider if you currently have or have had:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">COPD (since it can cause serious breathing issues)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Head injuries or brain tumors<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Seizures<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Recent heart attack or other heart problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mental health conditions, including depression and addiction<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Blocking or narrowing of stomach\/intestines or paralytic ileus<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Brain or spine infection<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Difficulty urinating<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low sodium<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diabetes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pancreas, gallbladder, or thyroid issues<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Kidney or liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Upcoming surgery<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">On top of all that, anyone taking these drugs should cut out the use of alcohol. Alcoholic beverages are also depressants. Avoid driving or operating hazardous machinery while taking these medications. People who are pregnant, breastfeeding, or planning on getting pregnant should inform their healthcare provider since the drugs might affect unborn children.&nbsp;<\/span><\/p>\n<h3 id=\"drug-interactions\"><span style=\"font-weight: 400;\">Drug interactions<\/span><\/h3>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/cyclobenzaprine-interactions\/\"><span style=\"font-weight: 400;\">Cyclobenzaprine<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/tramadol-interactions\/\"><span style=\"font-weight: 400;\">tramadol<\/span><\/a><span style=\"font-weight: 400;\"> both have major drug interaction warnings as well, most significantly with monoamine oxidase inhibitors (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/maois\"><span style=\"font-weight: 400;\">MAOIs<\/span><\/a><span style=\"font-weight: 400;\">) like Marplan and Nardil. Due to the seriousness of these interactions, cyclobenzaprine or tramadol should not be used within 14 days of taking MAO inhibitors. They may also interact with the following medicines:&nbsp;<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other muscle relaxants<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other narcotic pain medicines<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain selective serotonin reuptake inhibitors (<\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/ssris\"><span style=\"font-weight: 400;\">SSRIs<\/span><\/a><span style=\"font-weight: 400;\">)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Other drugs that affect serotonin levels<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medications for sleep or anxiety<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antifungals\"><span style=\"font-weight: 400;\">Azole antifungals<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/macrolides\"><span style=\"font-weight: 400;\">Macrolide antibiotics<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticonvulsants\"><span style=\"font-weight: 400;\">Seizure drugs<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Certain nonprescription drugs like cough relievers or allergy medicines<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Some dietary supplements, natural products, or herbal products like St. John&rsquo;s wort.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Inform your healthcare provider about all medicines and supplements you&rsquo;re taking before beginning treatment.&nbsp;<\/span><\/p>\n<h2 id=\"when-would-you-need-to-take-cyclobenzaprine-and-tramadol\"><span style=\"font-weight: 400;\">When would you need to take cyclobenzaprine and tramadol?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Despite the long list of possible interactions, cyclobenzaprine and tramadol aren&rsquo;t totally incompatible. There are some specific situations where taking them together might be necessary.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Dr. Lowe, those situations include &ldquo;the management of musculoskeletal pain conditions such as muscle spasms and certain types of chronic pain. Additionally, this combination might be utilized in postoperative settings, particularly for surgeries associated with significant musculoskeletal pain or muscle spasm.&rdquo;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">That&rsquo;s usually when someone hasn&rsquo;t had adequate pain relief with one drug alone or other drugs have already been tried, adds Dr. Daidone. &ldquo;The goal would be to use the lowest effective doses for the shortest duration possible, with careful monitoring for adverse effects,&rdquo; he says.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Each person is different, so &ldquo;the decision to co-administer these medications should be made on a case-by-case basis,&rdquo; according to Dr. Daidone. &ldquo;Doctors should evaluate the benefits against the risks and consider the individual patient&#8217;s health status and concurrent medications.&rdquo;<\/span><\/p>\n<h2 id=\"is-it-safe-to-take-tramadol-and-cyclobenzaprine\"><span style=\"font-weight: 400;\">Is it safe to take tramadol and cyclobenzaprine?&nbsp;<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It can be, but only in specific circumstances under the close supervision of the prescribing healthcare provider. Both drugs depress the central nervous system, and even though they have different functions, they can cause some serious&mdash;even life-threatening&mdash;issues when taken together. That&rsquo;s why it&rsquo;s crucial never to self-medicate. Instead, follow the exact instructions of your healthcare provider and pharmacist and seek medical help if anything seems off.&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cyclobenzaprine, known by the brand name Flexeril, is a muscle relaxant that can treat spasms, discomfort, and stiffness throughout the body, often from injuries. Tramadol is an opioid pain reliever used for treating severe pain. These two prescription drugs might seem like they&rsquo;d go hand-in-hand, but taking them together can have a significant effect on [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":628610,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[788,808],"coauthors":[8861],"class_list":["post-628609","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-drug-safety","tag-pain-management","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Can you take cyclobenzaprine with tramadol?<\/title>\n<meta name=\"description\" content=\"It is generally recommended that you avoid mixing cyclobenzaprine and tramadol, as the combination may cause serious side effects. 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