Drug interactions
Fentanyl + Tizanidine
Severity: Moderate
Fentanyl and Tizanidine: moderate interaction.
Last updated
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
Tizanidine is a sedating alpha-2 agonist that causes drowsiness and hypotension, and combined with fentanyl the sedative and hypotensive effects are additive. Respiratory depression and falls are possible.
What this interaction means in plain words
Fentanyl and Tizanidine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Fentanyl belongs to Musculoskeletal; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive CNS depression and hypotension from alpha-2 agonism and opioid receptor agonism.
What to do
Start with low doses and titrate slowly while monitoring sedation and blood pressure. Counsel patients to avoid driving and other CNS depressants.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fentanyl
- Alvimopan + Fentanyl Contraindicated
- Fentanyl + Isocarboxazid Contraindicated
- Fentanyl + Olanzapine / samidorphan Contraindicated
- Fentanyl + Phenelzine Contraindicated
- Fentanyl + Tranylcypromine Contraindicated
- Alfentanil + Fentanyl Major
Other interactions of Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Pipemidic acid + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
Frequently asked questions
Can I take Fentanyl with Tizanidine?
MediHelp rates the interaction as moderate. Fentanyl and Tizanidine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Tizanidine is a sedating alpha-2 agonist that causes drowsiness and hypotension, and combined with fentanyl the sedative and hypotensive effects are additive. Respiratory depression and falls are possible.
How serious is the interaction between Fentanyl and Tizanidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate slowly while monitoring sedation and blood pressure. Counsel patients to avoid driving and other CNS depressants.
What other medicines interact with Fentanyl?
MediHelp also lists interactions of Fentanyl with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Fentanyl page.
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