Drug interactions
Fentanyl intranasal + Tizanidine
Severity: Major
Fentanyl intranasal and Tizanidine: major 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 and intranasal fentanyl together can cause additive sedation, hypotension and respiratory depression. Fentanyl's rapid onset can make the effects abrupt.
What this interaction means in plain words
Fentanyl intranasal and Tizanidine 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.
Why it happens
Additive CNS depression from alpha-2 agonism and mu-opioid agonism.
What to do
Reserve for patients without alternatives, using the lowest doses. Monitor sedation, respiratory rate and blood pressure.
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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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 intranasal with Tizanidine?
MediHelp rates the interaction as major. Fentanyl intranasal and Tizanidine 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. Tizanidine and intranasal fentanyl together can cause additive sedation, hypotension and respiratory depression. Fentanyl's rapid onset can make the effects abrupt.
How serious is the interaction between Fentanyl intranasal and Tizanidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients without alternatives, using the lowest doses. Monitor sedation, respiratory rate and blood pressure.
What other medicines interact with Tizanidine?
MediHelp also lists interactions of Tizanidine with, for example, Ciprofloxacin, Fluvoxamine, Pefloxacin. The full list is on the Tizanidine page.
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