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Can You Take Muscle Relaxers And Ibuprofen Together? Risks Of Mixing Drugs

Last Updated: June 20, 2022

Authored by Olivier George, Ph.D.

Muscle relaxers are medications patients use to treat acute and chronic pain conditions. Usually, the OTC muscle relaxants are used for the treatment of short-term pain and the prescription muscle relaxers are used for the treatment of long-term pain. Sometimes, patients take ibuprofen, an NSAID medication that can also be used for pain conditions, to speed up their recovery. But the question is, can you take ibuprofen with muscle relaxers? It is important to mention that patients should avoid taking these drugs with ibuprofen as this may cause a dangerous drug interaction. In a report by medical doctors from Pennsylvania, the CNS side effects of these drugs can be increased by 45% if used with ibuprofen. Eventually, this could lead to severe sedation and fatality. 

To understand more about this, information about drug interactions, mixing these drugs with painkillers, benzodiazepines, other drugs, and substances, the effects of taking two muscle relaxers together, and how to treat and manage drug muscle relaxers interactions will be discussed in this article.

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What You Should Know About Drug Interactions

According to the US Food and Drug Administration, drug interactions occur when two or more drugs are taken together. Drug interactions may be beneficial and harmful. A medical doctor may prescribe two drugs that are supposed to be taken together to achieve optimal results. These beneficial drug interactions are called additive and synergistic. However, drug interactions become harmful when unexpected side effects occur. These harmful drug interactions are usually antagonism and potentiation.

Furthermore, drug interactions may be divided into three: drug-drug interactions, drug-food interactions, and drug-condition interactions. In terms of muscle relaxers, some drugs that interact with these medications include painkillers, benzodiazepines, antidepressants, anesthetic agents, alcohol, cocaine, and weed.

Mixing Muscle Relaxers And Painkillers

One of the most common drugs that interact with muscle relaxers or spasmolytic agents includes painkillers. The former works by inhibiting the afferent nerves from releasing excitatory neurotransmitters, thereby producing sedative effects. Likewise, based on a study by a medical doctor from England, painkillers work by inhibiting excitatory neurotransmitters. Since these drugs both slow down the CNS, they both induce depression. Eventually, when taken together, they can cause difficulty of breathing and loss of consciousness. 

Some of the painkillers that one should avoid are the following:

In case a patient mixes these drugs and experiences some of the symptoms of drug interactions, such as constricted pupils, it is highly recommended to call 911 or bring the patient to the nearest hospital for proper management of the health condition. 

Can You Take Muscle Relaxers and Ibuprofen Together?

In real-world data from 2000 to 2019, it was reported that 74,657 people who used spasmolytic agents experienced unintentional traumatic injuries due to drug interactions, and one of the most common muscle relaxers interactions that caused these injuries is associated with ibuprofen. It is believed that this occurred because both drugs are available prescription and OTC and the patients’ lack of knowledge about these muscle relaxers interactions can increase the risk of dangerous events. To prevent this, pharmacists are highly advised to make a policy about proper patient counseling. A policy about proper drug-drug interactions can also be made.

If someone is trying to find out whether one can take these drugs and ibuprofen together, it is not recommended to mix both of them. If both are consumed in large doses, they may slow down breathing and leave the person sedated. Other side effects include headache, nausea, tiredness, nervousness, heartburn, constipation, stomach ache, and more.

Can you take Tylenol with Muscle Relaxers?

Some patients may wonder, can you take Tylenol with muscle relaxers? Generally, it is safe to take Tylenol with these drugs as long as patients follow the recommended dosages. As of today, there are no known reports about this drug interaction. If there is, the interaction is very rare. In fact, Carisoprodol is even formulated with acetaminophen and caffeine. However, this does not necessarily mean that no muscle relaxers interactions could exist at all. In a report from Pennsylvania, at larger doses, this can induce seizures and fatality. For safer use, it is highly recommended to speak with a medical doctor or ask for counseling from a pharmacist.

Combining Tramadol and Muscle Relaxers

Mixing Tramadol and these drugs is not a good idea as both medicines are known to depress the central nervous system. The interaction also leads to other effects such as coma and respiratory distress. For example, Tizanidine when combined with Tramadol, can cause increased severity of CNS depression. If one experiences any one of the effects of this combination, the patient should seek medical attention immediately.

When taking these drugs, It is also important to answer the question: do muscle relaxers affect the heart? Vecuronium and rocuronium are the drugs that affect the heart rate of the patient, especially when taken with pain-relieving medication. The risk of muscle relaxers overdose is also higher if one is mixing painkillers like Tramadol with these drugs.

Mixing Muscle Relaxers And Painkillers

Taking Two Muscle Relaxers

Some patients may wonder, can one take two muscle relaxers? Generally, it is not safe to take two muscle relaxers together. However, this may change depending on the instruction of a medical doctor. One must intake pills as prescribed, and if there is no specific “signa” that two of these drugs should be taken, one should not take two of them together.

According to a publication on Anesthesiology, ASA publications, it was demonstrated that if a shorter-acting pill is taken after a longer-acting one, it takes on the characteristic of the first drug. It also increases the plasma concentration in the patient. The combination also leads to interaction effects such as fatigue, abnormally rapid heart rate, dry mouth, dizziness, drowsiness, and upset stomach.

Mixing Muscle Relaxers And Benzodiazepines

Like spasmolytic agents, benzodiazepines work by inhibiting the excitatory neurotransmitters in the brain. According to medical doctors from the USA, these drugs are used for the treatment of anxiety disorders, insomnia, epilepsy, seizure disorders, and agitation. In rare cases, benzodiazepines are used to relieve spasticity and pain due to various neurological disorders such as spinal cord injury and strokes. But if someone mixes them with muscle relaxers, the individual becomes prone to face many muscle relaxers interactions. One of the dangerous interactions includes the increase in the severity of CNS depression. In this section, information about some of these benzodiazepines that may interact with these drugs will be discussed.

Valium And Muscle Relaxers Combination

There is a moderate interaction between Valium and spasmolytic drugs. At high doses, the combination of these drugs leads to an increase in various adverse effects such as confusion, dizziness, and drowsiness. Elderly individuals may experience impairment in thinking, motor coordination, and judgment. In one study published in the British Medical Journal, Valium increases the effects of spasmolytic agents. When combined, these drugs can increase the severity of CNS side effects.

Xanax And Muscle Relaxants Combination

In a report by medical professionals from North Carolina, it was stated that Xanax is affected by both CYP3A4 drug inhibitors and inducers. Having said this, muscle relaxants are potent inhibitors of CYP3A4 that can increase the plasma concentrations of Xanax. Eventually, this combination leads to numerous increases in the severity of CNS side effects, including confusion, drowsiness, dizziness, and difficulty in concentrating.

Combining Muscle Relaxers With Other Drugs

Apart from those drugs stated above, other medications may interact with these drugs. For example, for cyclobenzaprine, there are 717 approved drug interactions. For methocarbamol, there are 442 approved drug interactions. In this section, information about some of these other drugs that may interact with muscle relaxers will be discussed.

Zoloft And Muscle Relaxers

Zoloft is one of the selective serotonin reuptake inhibitors (SSRIs) and it is mainly used for the treatment of major depressive disorder. As of 2019, there are around 1,000 drug interactions with this medication and these include muscle relaxants. Zoloft interactions with these drugs increase the risk of quite a health condition known as Serotonin Syndrome. The symptoms of this syndrome include seizures, hallucinations, increased heart rate, fever, spasms, nausea, cramps, in-coordination, and diarrhea.

Cymbalta And Muscle Relaxers

Cymbalta belongs to the drug class called selective norepinephrine reuptake inhibitors (SNRIs). This drug is mainly used to treat depression, anxiety, and nerve pain in patients with diabetes and other related conditions. The drug interactions with Cymbalta and these drugs may also lead to serotonin syndrome. Consistent with a case report from Minnesota, the symptoms of this serotonin syndrome due to this drug combination include autonomic instability and severe agitation. One should seek immediate help if these symptoms come up. 

Novocaine And Muscle Relaxers Interaction

Novocaine is a medication that belongs to the drug class local anesthetics. Generally, doctors use this drug to numb a particular part of the body. The drug interactions between novocaine and muscle relaxers only show the effect at the neuromuscular junction. According to a study by the US National Library of Medicine National Institutes of Health, an individual who is receiving high enough doses of both agents can suffer from NM block.

Mixing Aleve and Muscle Relaxers

Aleve or Naproxen is a non-steroidal anti-inflammatory drug and patients use it to manage pain caused by headaches, muscle aches, tendonitis, dental pain, and menstrual cramps. Although useful for patients with pain conditions, it is important to understand that one can go for this combination as Aleve does not have any muscle relaxers interactions. According to a study published in the US National Library of Medicine National Institutes of Health, the combination therapy consisting of naproxen and muscle relaxant benefits patients with acute low strain than this drug alone.

Although OTC painkillers are recommended as first-line therapy for spasms over prescription ones, one can take OTC NSAIDs rather than over-the-counter muscle relaxants, which are topical solutions mostly. If someone has combined muscle relaxers for TMJ with other drugs, it is better to seek help.

Can you take gabapentin and muscle relaxers together?

Gabapentin is an anticonvulsant medication that works by decreasing abnormal excitement in the brain. Many patients use this drug to control seizures and relieve nerve pain. But, can you take gabapentin and muscle relaxers together? When combined with muscle relaxers, this can lead to an increase in the severity of CNS side effects. Eventually, this could cause severe dizziness and drowsiness.

Can you take muscle relaxers with blood thinners?

Blood thinners such as anticoagulants and antiplatelets are medications used to promote proper blood flow in blood vessels. These drugs can prevent heart attack and stroke. But, can you take muscle relaxers with blood thinners? However, when used with muscle relaxants, these can increase the risk of thromboembolism and neurologic disorders.

Combining Muscle Relaxers With Other Drugs

Muscle Relaxers And Substances Interactions

These drugs are known to enhance the effects of central nervous system depressants such as alcohol and or cannabis. Individuals who combine these drugs with the following substances do it to experience enhanced euphoria, relaxation, and psychoactive effects. However, there are some interactions associated with these combinations that one should be aware of. In this section, information about the substances that may interact with these drugs will be provided.

Taking Muscle Relaxers And Alcohol Together

Alcohol is known to produce some pain-relieving effects, but taking these drugs at the same time with antispasmodics is not advised as this combination can increase CNS depression. How long it takes for muscle relaxers to work should also be considered. Some of the muscle relaxers and alcohol side effects also include fatigue, drowsiness, dry mouth, nausea, and confusion. Severe effects include the risk of overdose and co-occurring addiction. If one has overdosed on the combination, immediate medical detox is required.

Cocaine And Muscle Relaxers Together

Mixing cocaine and muscle relaxants come with dangerous interactions and side effects. When combined, the CNS depressant effects of cocaine can be increased. Aside from this, the results include an increased risk of development of addiction or polysubstance dependence. In case of muscle relaxers addiction, getting help from rehab centers would be a great choice.

Mixing Weed And Muscle Relaxers

In a study of healthcare professionals from New York, it was reported that weed is an effective substance to treat lower back pain. Sometimes, cyclobenzaprine is often added to the regimen. However, when abused, using these drugs together with cannabis increases side effects such as drowsiness, confusion, dizziness, and difficulty in concentrating. Due to harmful muscle relaxers interactions with CBD, an individual can experience impairment in thinking and judgment.

Valerian And Muscle Relaxers Interaction

Valerian is an herbal substance that is used to support neck and shoulder tension. Although it mimics the uses of muscle relaxers, one should also avoid valerian and muscle relaxant combination as it makes the patient sleepy and can lead to increased tiredness and drowsiness. Valerian can be used as an effective herbal muscle relaxer, but not in combination with other pills.

Drug Interactions Treatment

Indeed, muscle relaxers are effective drugs that can be used to manage acute and chronic pain. Since they can also be bought over-the-counter, users of these medications should know that some drugs and substances can interact with them. When abused, dangerous muscle relaxer side effects can arise. Whether an individual is suffering from lower back pain or spasticity, it is essential to get them treated. They are quite likely to be treated with physical therapy, relaxants, and rest, but it is important to set an appointment with a doctor for the best results. To avoid dangerous drug interactions, healthcare workers, especially pharmacists, are highly recommended to make a policy about proper drug labeling.

Additionally, prescription muscle relaxers are not entirely safe and can cause addiction. Professional addiction treatment should be sought if drug abuse took place. In any case, drug misuse and co-occurring addictions are advised to treat in substance abuse rehabs. There are inpatient rehab centers and outpatient rehab centers that patients can consider for a successful recovery. There are addiction specialists in these resources that can formulate a relapse prevention plan.

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Page Sources

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Published on: August 14th, 2019

Updated on: June 20th, 2022

About Author

Olivier George, Ph.D.

Olivier George is a medical writer and head manager of the rehab center in California. He spends a lot of time in collecting and analyzing the traditional approaches for substance abuse treatment and assessing their efficiency.