Cyclobenzaprine

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Aug 02, 2022

Warnings

Cyclobenzaprine Risks, Warnings, and Complications

Cyclobenzaprine can cause severe health problems, especially in certain high-risk patients. Some of the risks of cyclobenzaprine use include:

SEROTONIN SYNDROME: Serotonin syndrome is a rare but dangerous and potentially life-threatening condition that occurs due to the presence of too much serotonin in the central nervous system. Serotonin is a natural chemical that plays an important role in mood regulation. There is a greater risk of serotonin syndrome if you use cyclobenzaprine with other medications that can increase serotonin levels, such as antidepressants, triptans (medications used to treat migraines), lithium, and St. John's wort. Give your doctor and pharmacist a list of all your medications, including prescription and nonprescription drugs, before starting cyclobenzaprine so they can check for any possible drug interactions. Symptoms of excess serotonin may include a fast or irregular heartbeat, sweating, muscle spasms, muscle stiffness, fever, and confusion. Seek immediate medical help if you experience any of these symptoms.
EFFECTS ON CONCENTRATION: Cyclobenzaprine can make you drowsy and dizzy and affect your ability to concentrate and focus. The risk is higher in people over the age of 65 years and in those who take other medicines that can also cause drowsiness. Avoid drinking alcohol while on cyclobenzaprine as both can cause CNS depression. Do not drive, operate heavy machinery, or do anything that requires your full attention until you know how this medicine affects you.
DRYING UP OF SECRETIONS: Taking cyclobenzaprine can lead to dry mouth, dry eyes, and difficulty urinating because this medicine can cause drying up of bodily fluids like saliva and tears. Most people only experience mild side effects. But people who have glaucoma (increased eye pressure) or conditions that cause trouble urinating can experience worsening symptoms on cyclobenzaprine. These side effects are more likely to occur if you take anticholinergic drugs (other medicines that can cause dry eyes, dry mouth, etc.). Tell your healthcare provider about all your medical conditions and give them a complete list of medications before starting cyclobenzaprine. Let your doctor know if these side effects are bothersome.
HEPATIC IMPAIRMENT: Cyclobenzaprine should be used with caution in people with a liver disease history. This medicine should be avoided in those with severe liver problems. Cyclobenzaprine is metabolized (processed) by the liver. If the liver is not working properly, it can lead to excess cyclobenzaprine in the body, which can increase the risk of side effects.

Talk to your doctor or pharmacist for medical advice if you are at a high risk of complications or adverse effects from cyclobenzaprine use.

Precautions Before Starting Cyclobenzaprine

Tell your doctor if you have ever had an allergic reaction to cyclobenzaprine, any of the active or inactive ingredients in cyclobenzaprine tablets or capsules, or any other drugs. Your pharmacy can give you a list of ingredients.

Give your healthcare provider a complete medical history. Cyclobenzaprine may not be right for people with certain medical conditions, such as hyperthyroidism (overactive thyroid gland), recent heart attack, heart failure, heart block, ventricular arrhythmias, fast or irregular heartbeat, glaucoma, liver disease, or trouble urinating.

Give your doctor a complete list of all your medications, including prescription and nonprescription drugs, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between cyclobenzaprine and your other medications.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are feeding an infant breast milk.

Talk to your doctor for medical advice if you are an older adult (age 65 years or above). There may be other safer alternatives available to treat muscle spasms and muscle pain.

Precautions During Use of Cyclobenzaprine

Keep all your doctors’ appointments while on cyclobenzaprine.

Call your doctor if you become pregnant while on cyclobenzaprine.

Cyclobenzaprine can cause drowsiness and dizziness. Do not drive or operate machinery until you know how this medicine affects you.

Avoid drinking alcohol while on cyclobenzaprine.

Cyclobenzaprine Drug Interactions

Taking cyclobenzaprine with other drugs can affect how each of the medications works. Possible interactions between drugs can also increase the risk of serious side effects. Your healthcare professional may choose a different medication for you, change the dose or frequency of your medications, and/or closely monitor you for side effects if there are known interactions between cyclobenzaprine and your other drugs.

You should not take cyclobenzaprine if you are taking or have taken monoamine oxidase (MAO) inhibitors within the past two weeks. Examples of MAO inhibitors include phenelzine (Nardil), isocarboxazid (Marplan), rasagiline (Azilect), tranylcypromine (Parnate), methylene blue, and selegiline (Eldepryl, Emsam, Zelapar).

There can also be possible drug interactions between cyclobenzaprine and the following medications:

Medications used to treat allergies, colds, and coughs
Medications used to treat depression, anxiety, mood, and thought disorders
Barbiturates such as phenobarbital, butabarbital (Butisol), and secobarbital (Seconal)
Antidepressants like bupropion (Wellbutrin, Zyban, Forfivo XL, Aplenzin)
Antidepressants (selective serotonin reuptake inhibitors or SSRIs) like fluoxetine (Prozac, Selfemra, Sarafem, in Symbyax), citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), sertraline (Zoloft), and paroxetine (Paxil, Brisdelle, Pexeva)
Antidepressants (selective serotonin and norepinephrine reuptake inhibitors or SNRIs) like levomilnacipran (Fetzima), desvenlafaxine (Pristiq, Khedezla), duloxetine (Cymbalta), venlafaxine (Effexor), and milnacipran (Savella)
Tricyclic antidepressants (TCAs) like amitriptyline, clomipramine (Anafranil), amoxapine, desipramine (Norpramin), imipramine (Tofranil), doxepin (Silenor), protriptyline (Vivactil), nortriptyline (Pamelor), and trimipramine (Surmontil)
Opioid analgesics like meperidine (Demerol) and tramadol (Ultram, Conzip, in Ultracet)
Sleeping pills, sedatives, and tranquilizers
Calcium channel blockers like verapamil (Covera HS, Calan, Verelan, in Tarka)

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products.

Also, tell your doctor if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.

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