Drug interactions
Sacubitril-valsartan + Tizanidine
Severity: Moderate
Sacubitril-valsartan 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 centrally acting alpha-2 agonist with significant blood pressure lowering effect. Combined with sacubitril-valsartan it can cause additive hypotension, dizziness and syncope.
What this interaction means in plain words
Sacubitril-valsartan 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.
Sacubitril-valsartan belongs to Cardiovascular; Tizanidine belongs to Musculoskeletal.
Why it happens
Additive hypotension from central alpha-2 agonism and RAAS/neprilysin-related vasodilation.
What to do
Monitor blood pressure and orthostatic symptoms, and start tizanidine at a low dose with slow titration.
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 Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
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 Sacubitril-valsartan with Tizanidine?
MediHelp rates the interaction as moderate. Sacubitril-valsartan 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 centrally acting alpha-2 agonist with significant blood pressure lowering effect. Combined with sacubitril-valsartan it can cause additive hypotension, dizziness and syncope.
How serious is the interaction between Sacubitril-valsartan 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: Monitor blood pressure and orthostatic symptoms, and start tizanidine at a low dose with slow titration.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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