Can You Take Flexeril And Tramadol Together?
In our latest question and answer, our pharmacist discusses whether or not there is a drug interaction between tramadol and Flexeril (cyclobenzaprine).
Is it possible to take tramadol and Flexeril (cyclobenzaprine) together? I was prescribed both but by different doctors.
Jun 24, 2022- Avoid taking tramadol and Flexeril together unless your doctor specifically directs you to do so, as they can increase sedation and slow your breathing to dangerous levels. Both medications can affect your digestive system and increase the risk of bowel obstruction when combined. If your doctor determines these drugs must be used together, use the lowest dose possible and watch for side effects like excessive sleepiness, slow breathing, urinary retention, and constipation.
You should avoid taking tramadol and Flexeril together unless specifically directed by your doctor, as the drugs have a potentially significant interaction.
What Are Tramadol And Flexeril?
Tramadol (brand name Ultram) is a pain reliever, technically classified as an opioid medication that is stronger than Tylenol or ibuprofen but not as strong as morphine or oxycodone. It works on both opioid receptors and also increases serotonin levels.
Flexeril (cyclobenzaprine) is a muscle relaxant that is used for short-term (2-3 weeks) treatment of muscle spasms along with rest and physical therapy.
The Interaction
First and foremost, both tramadol and Flexeril are sedating, and combined use increases the severity of this side effect.
More importantly, the use of both together, especially at high doses, may increase your risk of respiratory depression, which is slow or shallow breathing.
This can cause a lower level of oxygen in your body which has potentially serious outcomes. Sedation or sleepiness is often the first sign/symptom that respiratory depression might be occurring. Taking these medications together can also cause CNS depression, or altered brain activity, which can cause:
- Slower rate of breathing
- Slower heart rate
A slower breathing rate is especially a concern when taking these two medications together because it can happen from two different mechanisms (respiratory depression and CNS depression).
Lastly, the combination of Tramadol and Flexeril can also increase your risk of bowel obstruction (a block in your digestive tract).
They both affect the muscles in your digestive tract that help in the digestion and defecation processes. Slowing this process can cause paralysis of your gut muscles and lead to blockage, which is a serious concern.
How To Manage
As both medications are relatively short-acting (~4-12 hours per dose), they could potentially be dosed on the same day, just not at the same time.
I also want to point out that there are clinical situations where these drugs can be used together.
If use together is necessary, it is prudent to use the lowest dose and shortest duration necessary to achieve treatment goals. Side effects, such as sedation, respiratory depression, urinary retention, and constipation should be monitored.
Final Words
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References & sources
Glossary — Terms in This Answer
- Opioid
- A type of pain-relieving medication that works by attaching to specific receptors in the brain and body to reduce the sensation of pain.
- Serotonin
- A chemical messenger in the brain that affects mood, sleep, and various other body functions.
- Muscle relaxant
- A medication that reduces muscle tension and spasms, typically used for short-term treatment of muscle problems.
- Respiratory depression
- A condition where breathing becomes abnormally slow or shallow, reducing the amount of oxygen that reaches the body.
- CNS depression
- A slowing down of brain and nervous system activity that can affect breathing, heart rate, and alertness.
- Bowel obstruction
- A blockage in the digestive tract that prevents food and waste from moving through normally.
- Urinary retention
- The inability to completely empty the bladder, causing urine to remain in the body.
- Constipation
- Difficulty having bowel movements, often resulting in infrequent or hard stools.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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