Can you take Clobazam with Tizanidine?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- clobazam
- tizanidine
Drug interactions
Moderate drug interactions
Moderate:
tiZANidine cloBAZam
Applies to: tizanidine and clobazam
Using tiZANidine together with cloBAZam may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol during treatment. In addition, these medications may also have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. These side effects are most likely to be seen at the beginning of treatment, following a dose increase, or when treatment is restarted after an interruption. Let your doctor know if you develop these symptoms and they do not go away after a few days or they become troublesome. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. 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:
cloBAZam Food/Lifestyle
Applies to: clobazam
Alcohol can increase the nervous system side effects of cloBAZam such as dizziness, drowsiness, and 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 cloBAZam. Do not use more than the recommended dose of cloBAZam, 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
11 potential interactions Applies to: 9 conditions, including Depression, Hypotension, Psychosis, Liver Disease, and Drug Dependence.
Acute Alcohol Intoxication
Major:
clobazam
cloBAZam has a major potential interaction with Acute Alcohol Intoxication.
The use of benzodiazepines with alcohol is not recommended. Patients with acute alcohol intoxication exhibit depressed vital signs. The central nervous system depressant effects of benzodiazepines may be additive with those of alcohol, and severe respiratory depression and death may occur. Therapy with benzodiazepines should be administered cautiously in patients who might be prone to acute alcohol intake.
Dehydration
Major:
tizanidine
tiZANidine has a major potential interaction with Dehydration.
Tizanidine is a centrally-acting alpha-2 adrenergic agonist with 1/10 to 1/50 the potency of clonidine in lowering blood pressure. According to the manufacturer, two-thirds of patients in a study given single 8 mg doses of tizanidine had a 20% reduction in either the diastolic or systolic blood pressure. The effect was seen one hour after dosing and peaked at 2 to 3 hours post-dose. Bradycardia, orthostatic hypotension, lightheadedness, dizziness and, rarely, syncope have occurred. Therapy with tizanidine should be administered cautiously in patients with or predisposed to hypotension. The risk of significant hypotension may be minimized by gradual dosage titration. Patients should be advised not to rise abruptly from a supine position.
Depression
Moderate:
clobazam
cloBAZam has a moderate potential interaction with Depression.
Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Drug Dependence
Major:
clobazam
cloBAZam has a major potential interaction with Drug Dependence.
Benzodiazepines have the potential to cause dependence and abuse. Tolerance as well as physical and psychological dependence can develop, particularly after prolonged use and/or excessive dosages. However, abrupt cessation following continual use of as few as 6 weeks at therapeutic levels has occasionally precipitated withdrawal symptoms. Addiction- prone individuals, such as those with a history of alcohol or substance abuse, should be under careful surveillance when treated with benzodiazepines. It may be prudent to refrain from dispensing large quantities of medication to these patients. After prolonged use or if dependency is suspected, withdrawal of benzodiazepine therapy should be undertaken gradually using a dosage- tapering schedule. If withdrawal symptoms occur, temporary reinstitution of benzodiazepines may be necessary.
Hypotension
Major:
tizanidine
tiZANidine has a major potential interaction with Hypotension.
Tizanidine is a centrally-acting alpha-2 adrenergic agonist with 1/10 to 1/50 the potency of clonidine in lowering blood pressure. According to the manufacturer, two-thirds of patients in a study given single 8 mg doses of tizanidine had a 20% reduction in either the diastolic or systolic blood pressure. The effect was seen one hour after dosing and peaked at 2 to 3 hours post-dose. Bradycardia, orthostatic hypotension, lightheadedness, dizziness and, rarely, syncope have occurred. Therapy with tizanidine should be administered cautiously in patients with or predisposed to hypotension. The risk of significant hypotension may be minimized by gradual dosage titration. Patients should be advised not to rise abruptly from a supine position.
Liver Disease
Major:
tizanidine
tiZANidine has a major potential interaction with Liver Disease.
Tizanidine may cause hepatocellular injury. According to the manufacturer, approximately 5% of patients treated with tizanidine in clinical studies had elevations in serum transaminases greater than 3 times the upper limit of normal (or 2 times if baseline levels were elevated), compared to 0.4% in control patients. Most cases were asymptomatic and resolved rapidly following withdrawal of the drug. However, liver failure resulting in death has been reported in postmarketing use. In three cases cited by the package labeling, two involved concomitant use of hepatotoxic agents in addition to tizanidine, while the third had no other known risk factors. Because of potential hepatotoxicity, therapy with tizanidine should be administered cautiously in patients with impaired hepatic function. All patients treated with tizanidine should have liver function tests performed at baseline, 1, 3 and 6 months, and periodically thereafter. In addition, they should be instructed to immediately report any signs and symptoms of hepatic injury such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine and jaundice.
Psychiatric Disorders
Moderate:
tizanidine
tiZANidine has a moderate potential interaction with Psychiatric Disorders.
Formed, visual hallucinations or delusions have been reported in 3% of patients treated with tizanidine in two North American controlled clinical studies. Therapy with tizanidine should be administered cautiously in patients with a history of psychiatric disorders.
Psychosis
Moderate:
clobazam
cloBAZam has a moderate potential interaction with Psychosis.
Benzodiazepines depress the central nervous system and may cause or exacerbate mental depression and cause suicidal behavior and ideation. Episodes of mania and hypomania have also been reported in depressed patients treated with some of these agents. Therapy with benzodiazepines should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.
Moderate:
tizanidine
tiZANidine has a moderate potential interaction with Psychosis.
Formed, visual hallucinations or delusions have been reported in 3% of patients treated with tizanidine in two North American controlled clinical studies. Therapy with tizanidine should be administered cautiously in patients with a history of psychiatric disorders.
Renal Dysfunction
Major:
tizanidine
tiZANidine has a major potential interaction with Renal Dysfunction.
The clearance of tizanidine has been shown to reduce by more than 50% in elderly patients with renal impairment (creatinine clearance < 25 mL/min) compared to healthy elderly patients. Prolonged pharmacologic effects of tizanidine may occur due to drug accumulation. Therapy with tizanidine should be administered cautiously and initiated at reduced dosages in patients with impaired renal function. During titration, individual doses rather than the dosing frequency should be increased.
Moderate:
clobazam
cloBAZam has a moderate potential interaction with Renal Dysfunction.
Benzodiazepines are excreted by the kidneys and should be used with caution in patients with impaired renal function and end-stage kidney disease.
More resources
clobazam
A total of 537 drugs are known to interact with clobazam.
- Clobazam is in the following drug classes: benzodiazepine anticonvulsants, benzodiazepines.
- Clobazam is used to treat the following conditions:
tizanidine
A total of 676 drugs are known to interact with tizanidine.
- Tizanidine is in the drug class skeletal muscle relaxants.
-
Tizanidine is used to treat the following conditions:
- Cluster Headaches (off-label)
- Muscle Spasm
- Spasticity
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.