Drug interactions
Pipemidic acid + Tizanidine
Severity: Contraindicated
Pipemidic acid and Tizanidine: contraindicated 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
Pipemidic acid is a CYP1A2 inhibitor and can markedly raise tizanidine exposure. This may cause profound hypotension, bradycardia and sedation. Related fluoroquinolone CYP1A2 inhibitors are contraindicated with tizanidine.
What this interaction means in plain words
Pipemidic acid and Tizanidine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Inhibition of CYP1A2-mediated tizanidine metabolism increases plasma concentrations.
What to do
Avoid the combination and choose an antibiotic that does not inhibit CYP1A2. If it cannot be avoided, use an alternative muscle relaxant.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Tizanidine
- Ciprofloxacin + Tizanidine Contraindicated
- Fluvoxamine + Tizanidine Contraindicated
- Pefloxacin + Tizanidine Contraindicated
- Benzhydrocodone / acetaminophen + Tizanidine Major
- Brexanolone + Tizanidine Major
- Buprenorphine long-acting + Tizanidine Major
Frequently asked questions
Can I take Pipemidic acid with Tizanidine?
MediHelp rates the interaction as contraindicated. Pipemidic acid and Tizanidine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Pipemidic acid is a CYP1A2 inhibitor and can markedly raise tizanidine exposure. This may cause profound hypotension, bradycardia and sedation. Related fluoroquinolone CYP1A2 inhibitors are contraindicated with tizanidine.
How serious is the interaction between Pipemidic acid and Tizanidine?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and choose an antibiotic that does not inhibit CYP1A2. If it cannot be avoided, use an alternative muscle relaxant.
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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