Drug interactions
Cyclobenzaprine + Paroxetine
Severity: Major
Cyclobenzaprine and Paroxetine: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs enhance serotonergic activity, so serotonin syndrome is a concern. Paroxetine also strongly inhibits CYP2D6 and has anticholinergic effects, which may add to cyclobenzaprine's anticholinergic and sedative burden.
What this interaction means in plain words
Cyclobenzaprine and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cyclobenzaprine belongs to Musculoskeletal; Paroxetine belongs to Central Nervous System.
Why it happens
Additive serotonin reuptake inhibition and additive anticholinergic effects, with paroxetine inhibiting CYP2D6.
What to do
Avoid if an alternative muscle relaxant is suitable. If used, give the lowest cyclobenzaprine dose for a short period and monitor for serotonin toxicity and anticholinergic effects.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Cyclobenzaprine
- Cyclobenzaprine + Isocarboxazid Contraindicated
- Cyclobenzaprine + Linezolid Contraindicated
- Cyclobenzaprine + Phenelzine Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Cyclobenzaprine + Selegiline Contraindicated
- Cyclobenzaprine + Selegiline transdermal Contraindicated
Other interactions of Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Cyclobenzaprine with Paroxetine?
MediHelp rates the interaction as major. Cyclobenzaprine and Paroxetine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs enhance serotonergic activity, so serotonin syndrome is a concern. Paroxetine also strongly inhibits CYP2D6 and has anticholinergic effects, which may add to cyclobenzaprine's anticholinergic and sedative burden.
How serious is the interaction between Cyclobenzaprine and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid if an alternative muscle relaxant is suitable. If used, give the lowest cyclobenzaprine dose for a short period and monitor for serotonin toxicity and anticholinergic effects.
What other medicines interact with Cyclobenzaprine?
MediHelp also lists interactions of Cyclobenzaprine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Cyclobenzaprine page.
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