Drug interactions
Fentanyl transdermal + Tizanidine
Severity: Major
Fentanyl transdermal 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 is a centrally acting alpha-2 agonist that causes drowsiness and hypotension, and fentanyl is a potent opioid. Together they can produce additive sedation, respiratory depression and hypotension. Risk is greatest at initiation and with dose increases.
What this interaction means in plain words
Fentanyl transdermal 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 central nervous system depression through different pharmacodynamic pathways.
What to do
Reserve the combination for patients in whom alternatives are inadequate, using the lowest effective doses and shortest duration. Monitor for sedation, respiratory depression and low 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 transdermal with Tizanidine?
MediHelp rates the interaction as major. Fentanyl transdermal 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 is a centrally acting alpha-2 agonist that causes drowsiness and hypotension, and fentanyl is a potent opioid. Together they can produce additive sedation, respiratory depression and hypotension. Risk is greatest at initiation and with dose increases.
How serious is the interaction between Fentanyl transdermal 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 the combination for patients in whom alternatives are inadequate, using the lowest effective doses and shortest duration. Monitor for sedation, respiratory depression and low 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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