Sage + Cyclobenzaprine
Cyclobenzaprine brand names: Cyclobenzaprine, Flexeril, Cycloprine.
Cyclobenzaprine falls into 2 drug categories that Sage can interact with; the most serious is rated moderate. Theoretically, sage might increase the levels and clinical effects of drugs metabolized by CYP2D6.
Read the full interaction reportSage and Cyclobenzaprine
These two interact in 2 distinct ways. Each one is explained separately below.
Why Are There 2 Interactions?
Sage interacts with whole categories of medication. Cyclobenzaprine falls into 2 of those categories, so it can interact with Sage in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
1 of 2Why this applies to Cyclobenzaprine
Cyclobenzaprine falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Sage interacts with.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP2D6. So far, this interaction has not been reported in humans.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the gist with sage and cyclobenzaprine. Your body partly relies on a liver enzyme called CYP2D6 to break this muscle relaxer down. In lab dishes, concentrated sage extracts seemed to slow that enzyme. If that happened in real life, cyclobenzaprine could clear a little more slowly and build up, which might leave you feeling extra drowsy, dizzy, dry-mouthed, or foggy.
I'll be honest, though: this is theoretical and has only been seen in lab studies, never in actual people. A bit of sage in your cooking is very unlikely to cause trouble. Concentrated sage supplements or the essential oil are the bigger question mark. If you take those regularly, just run it by your pharmacist or doctor first.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum BH, Nilsen OG. The in vitro inhibitory potential of trade herbal products on human CYP2D6-mediated metabolism and the influence of ethanol. Basic Clin Pharmacol Toxicol. 2007 Nov;101:350-8.
CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES
2 of 2Cyclobenzaprine also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.
In vitro evidence suggests that aqueous extracts of sage can inhibit CYP3A4. So far, this interaction has not been reported in humans.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the simple version: your body uses an enzyme called CYP3A4 to help clear cyclobenzaprine out of your system. In lab dish studies, sage extracts seemed to slow that enzyme down a bit. If that happened in a real person, cyclobenzaprine could hang around longer and feel stronger, which might mean more drowsiness, dry mouth, dizziness, or grogginess than usual.
I want to be honest about how shaky this evidence is. It comes only from test-tube work, and it has never actually been reported in people. A little sage in your cooking is nothing to worry about. The bigger question is concentrated sage capsules or essential oil taken daily. If you use those, just mention it to your pharmacist or doctor before mixing them with cyclobenzaprine.
- Foster BC, Vandenhoek S, Hana J, et al. In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 2003;10:334-42.. PubMed
- Hellum, B. H. and Nilsen, O. G. In vitro inhibition of CYP3A4 metabolism and P-glycoprotein-mediated transport by trade herbal products. Basic Clin Pharmacol Toxicol. 2008;102(5):466-475.
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Sage Also Interacts With Other Medications
Sage has 1,296 moderate known drug interactions in our database — the Cyclobenzaprine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Sage
We haven’t checked that one against Sage yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Sage. Pick one to open its full report.
Questions About Sage or Cyclobenzaprine
These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Sage or Cyclobenzaprine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:
- Concern With Taking Flexeril And Gabapentin Together ›
- Can You Take Lyrica And Flexeril Together? ›
- Prednisone With Flexeril - Interaction Details ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Cyclobenzaprine
This page covers Sage only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Cyclobenzaprine page lists 197 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: Activated Charcoal (major), Grapefruit (major), Lithium (major), Procaine (major) and St. John's Wort (major).
By severity: 5 major · 146 moderate · 46 minor.
Taking Sage as Part of a Dietary Supplement Product? Check It for Interactions
We hold 718 real supplement products containing Sage, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Sage. Your product may carry other ingredients that interact with Cyclobenzaprine too, on top of Sage — and those would not show on this page. Find your product and we’ll check every ingredient on its label:
Where Sage and Cyclobenzaprine Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#223 of 1,452 supplements looked up here in the last 7 days
#897 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
About Sage
What is Sage?
- Sore throat and mouth irritation
- Digestive upset
- Excessive sweating
- Memory and thinking
- Menopause symptoms (hot flashes)
- General antioxidant support
Sage is a common kitchen herb that is generally safe in food amounts and is traditionally used for sore throats, digestion, sweating, and memory. Some early research is encouraging for sore throat and menopausal hot flashes, but most uses are not well proven. Concentrated extracts and the essential oil should be used carefully because high doses contain a compound called thujone, which can be harmful.
About Cyclobenzaprine
What Is Cyclobenzaprine Used For?
Brand names: Cyclobenzaprine, Flexeril, Cycloprine
Cyclobenzaprine tablets and extended-release capsules (including Fexmid and Amrix) are used along with rest and physical therapy. They relieve muscle spasm from acute, painful muscle and joint conditions. That means easing pain, tenderness and limited movement.
Tonmya, a sublingual (under-the-tongue) tablet, is used to treat fibromyalgia in adults. Cyclobenzaprine has not been found effective for spasticity from brain or spinal cord disease, or in children with cerebral palsy.
Other Drugs & Sage
Browse every other medication we’ve checked against Sage — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,296 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Nifedipine ›
- Ibuprofen ›
- Diphenhydramine ›
- Hydrocortisone ›
- Insulin (rdna) ›
- Naproxen ›
- Doxycycline ›
- Erythromycin ›
- Estradiol ›
- Minocycline ›
- Propranolol ›
- Tetracycline ›
- Lidocaine ›
- Ranitidine ›
- Hydrochlorothiazide ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Glycopyrrolate ›
- Insulin (pork) ›
- Triazolam ›
- Zopiclone ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Triamcinolone ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Hydralazine ›
- Indomethacin ›
- Insulin (human) ›
- Ipratropium ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Procainamide ›
- Trimipramine ›
- Acetaminophen ›
Showing 60 of 1,296 moderate interactions — see all 1,296 on the Sage page.
No interaction 1,533 drugs checked — show the list
We also checked Sage against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Rosuvastatin ›
- Aspirin ›
- Isotretinoin ›
- Levothyroxine, Liothyronine ›
- Docusate ›
- Sumatriptan ›
- Valacyclovir ›
- Hydroxyurea ›
- Amoxicillin ›
- Methotrexate ›
- Bupropion ›
- Azithromycin ›
- Acyclovir ›
- Bendamustine ›
- Methylene Blue ›
- Ciprofloxacin ›
- Amoxicillin, Clavulanate Potassium ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Acetylsalicylic Acid ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aspirin, Butalbital ›
- Ezetimibe ›
- Bismuth Subcarbonate, Calcium Carbonate, Opium ›
- Cephalexin ›
- Cyclopentolate ›
- Levodopa ›
- Isoniazid, Pyrazinamide, Rifampin ›
- Daunorubicin, Cytarabine ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Carbidopa, Levodopa ›
- Sodium Bicarbonate (otc Drug) ›
- Efgartigimod Alfa-fcab ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Cytomegalovirus Immune Globulin ›
- Thyroid Hormone ›
- Alginic Acid, Aluminum Hydroxide ›
- Measles, Mumps, Rubella Virus Live ›
- Aminolevulinic Acid Hydrochloride ›
- Peginterferon Alfa-2a, Ribavirin ›
- Vestronidase Alfa-vjbk ›
- Glycerol Phenylbutyrate ›
- Psyllium , Senna (otc Drug) ›
- Sulfadiazine, Trimethoprim ›
- Neomycin, Polymyxin B, Gramicidin ›
- Lonapegsomatropin-tcgd ›
- Tubocurarine ›
- Levothyroxine Sodium ›
- Charcoal (otc Drug) ›
- Human Papillomavirus Vaccine ›
- Daxibotulinumtoxina-lanm ›
- Imipenem, Cilastatin, Relebactam ›
- Delafloxacin (oral) ›
- Alpha-1 Proteinase Inhibitor ›
- Cefaclor ›
- Magnesium Hydroxide (otc Drug) ›
- Articaine, Epinephrine ›
- Dexmethylphenidate ›
- Dihydroxyaluminum Sodium Carbonate ›
Showing the 60 most looked-up of 1,533 medications checked with no known interaction — see the full Sage list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Taking Sage and Cyclobenzaprine Together: Common Questions
Can you take Sage with Cyclobenzaprine?
Why are there 2 interactions listed for Sage and Cyclobenzaprine?
How serious is the Sage and Cyclobenzaprine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.