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Can you take Amrix with Felbamate?

1 drug interaction and 20 additional warnings found for the following 2 drugs:

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Drug interactions

Moderate drug interactions

Moderate:

cyclobenzaprine felbamate

Applies to: Amrix (cyclobenzaprine) and felbamate

Using cyclobenzaprine together with felbamate may increase side effects such as:

  • dizziness
  • drowsiness
  • confusion
  • difficulty concentrating

Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination.

What to do: You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you.

Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Food/lifestyle interactions

Moderate food/lifestyle interactions

Moderate:

cyclobenzaprine Food/Lifestyle

Applies to: Amrix (cyclobenzaprine)

Alcohol can increase the nervous system side effects of cyclobenzaprine such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with cyclobenzaprine.

Do not use more than the recommended dose of cyclobenzaprine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Moderate:

felbamate Food/Lifestyle

Applies to: felbamate

Alcohol can increase the nervous system side effects of felbamate such as:

  • dizziness
  • drowsiness
  • difficulty concentrating

Some people may also experience impairment in thinking and judgment.

You should avoid or limit the use of alcohol while being treated with felbamate.

Do not use more than the recommended dose of felbamate, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you.

Talk to your doctor or pharmacist if you have any questions or concerns.

Disease interactions

18 potential interactions Applies to: 18 conditions, including Depression, Heart Failure, Hypotension, Anemia, and Hyperthyroidism.

Anemia

Major:

felbamate

Felbamate has a major potential interaction with Anemia.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Bone Marrow Depression/Low Blood Counts

Major:

felbamate

Felbamate has a major potential interaction with Bone Marrow Depression/Low Blood Counts.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Cardiovascular Conditions and Disorders

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Cardiovascular Conditions and Disorders.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

Cerebrovascular Insufficiency

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Cerebrovascular Insufficiency.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

Dehydration

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Dehydration.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

Depression

Moderate:

felbamate

Felbamate has a moderate potential interaction with Depression.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Gastrointestinal Obstruction

Moderate:

Amrix

The cyclobenzaprine in Amrix has a moderate potential interaction with Gastrointestinal Obstruction.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.

Glaucoma/Intraocular Hypertension

Moderate:

Amrix

The cyclobenzaprine in Amrix has a moderate potential interaction with Glaucoma/Intraocular Hypertension.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.

Heart Failure

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Heart Failure.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

History - Cerebrovascular Disease

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with History - Cerebrovascular Disease.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

History - Myocardial Infarction

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with History - Myocardial Infarction.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

History of Blood Dyscrasias

Major:

felbamate

Felbamate has a major potential interaction with History of Blood Dyscrasias.

The use of felbamate is contraindicated in patients with bone marrow suppression or a current or prior history of blood dyscrasias. A marked increase in the incidence of aplastic anemia has been associated with the use of felbamate, reportedly exceeding 100 times the incidence observed in the general population (2 to 5 per million persons per year). In the few cases that have been reported in felbamate patients, the onset of clinical manifestations of aplastic anemia ranged from 5 to 30 weeks. However, the injury to bone marrow stem cells that is believed to be ultimately responsible for the anemia may occur much earlier. Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or myelotoxic drugs. Expert hematologic consultation should be available for all patients treated with felbamate. Since aplastic anemia typically develops without premonitory clinical or laboratory signs, it should be borne in mind that routine blood testing may not be reliably used to prevent development of the syndrome. However, in some cases, it may allow the detection of hematologic changes before the condition is full-blown. Felbamate therapy should be withdrawn if evidence of bone marrow depression is observed. Patients who are discontinued from the drug may remain at risk for developing anemia for a variable and unknown period afterwards and should be monitored accordingly.

Hyperthyroidism

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Hyperthyroidism.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

Hypotension

Major:

Amrix

The cyclobenzaprine in Amrix has a major potential interaction with Hypotension.

The manufacturers consider the use of cyclobenzaprine to be contraindicated in the acute recovery phase following myocardial infarction and in patients with hyperthyroidism, congestive heart failure, arrhythmias, heart block, and/or conduction disturbances. Cyclobenzaprine is structurally related to the tricyclic antidepressants, which have been reported to cause tachycardia, arrhythmias, heart block, hypertension, hypotension (particularly orthostatic hypotension), thrombosis, thrombophlebitis, myocardial infarction, strokes, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation. Therapy with cyclobenzaprine should be administered cautiously in patients with a history of cardiovascular or cerebrovascular disease or a predisposition to hypotension, particularly if the intended dosage exceeds those normally used for musculoskeletal conditions. Tachycardia, arrhythmia, palpitation, and hypotension have been reported with the use of cyclobenzaprine in less than 1% of patients.

Liver Disease

Major:

felbamate

Felbamate has a major potential interaction with Liver Disease.

The use of felbamate is contraindicated in patients with a history of hepatic impairment. A marked increase in the incidence of hepatic failure, some resulting in fatality, has been associated with the use of felbamate relative to that expected in the general population (approximately 2000 cases per year). Currently, it is not known whether the risk is related to dose, duration of exposure, and/or concomitant use of other antiepileptic or hepatotoxic drugs. All patients treated with felbamate should have serum transaminase and bilirubin levels checked prior to initiating therapy and at 1- to 2-week intervals while treatment continues. Felbamate therapy should be withdrawn if abnormal liver function tests occur.

Psychosis

Moderate:

felbamate

Felbamate has a moderate potential interaction with Psychosis.

Antiepileptic drugs (AEDs) have been associated with an increased risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Pooled analyses of 199 placebo-controlled clinical studies involving the use of 11 different AEDs showed that patients receiving AEDs had approximately twice the risk of suicidal thinking or behavior compared to patients receiving placebo. AEDs should be administered cautiously in patients with depression or other psychiatric disorders; phentermine-topiramate should be avoided in patients with history of suicidal attempts or active suicidal ideation. The risk of suicidal thoughts and behavior should be carefully assessed against the risk of untreated illness, bearing in mind that epilepsy and many other conditions for which AEDs are prescribed are themselves associated with morbidity and mortality and an increased risk of suicidal thoughts and behavior. Patients, caregivers, and families should be alert to the emergence or worsening of signs and symptoms of depression, any unusual changes in mood or behavior, or the emergence of suicidal thoughts or behavior. If patients have symptoms of suicidal ideation or behavior, a dosage reduction or treatment discontinuation should be considered.

Renal Dysfunction

Major:

felbamate

Felbamate has a major potential interaction with Renal Dysfunction.

Felbamate is partially eliminated by the kidney as unchanged drug (approximately 40% to 50% of absorbed dose). The plasma clearance of felbamate may be decreased and the half-life prolonged in patients with impaired renal function. Therapy with felbamate should be administered cautiously in patients with renal impairment.

Urinary Retention

Moderate:

Amrix

The cyclobenzaprine in Amrix has a moderate potential interaction with Urinary Retention.

Cyclobenzaprine has anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with cyclobenzaprine should be administered cautiously in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Glaucoma should be treated and under control prior to initiation of cyclobenzaprine therapy, and intraocular pressure monitored during therapy.

More resources

Amrix

A total of 466 drugs are known to interact with Amrix.

felbamate

A total of 554 drugs are known to interact with felbamate.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.