Can I take Pregabalin and Tizanidine together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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Taking pregabalin and tizanidine together can significantly increase the risk of side effects such as extreme drowsiness, dizziness, and confusion. You may find it very difficult to concentrate or stay awake. There is also an increased risk of physical coordination problems, which can lead to falls, and a risk of slowed or shallow breathing.
Why this happens
Both medicines act as central nervous system (CNS) depressants. While they work in different ways, they both slow down brain activity. When taken together, their effects add up (a 'synergistic' effect), making the sedative impact much stronger than if either were taken alone.
What you should do
Use this combination with caution and only under strict medical supervision. Do not drive, operate heavy machinery, or perform dangerous tasks until you know how this combination affects you. Avoid alcohol, as it will make these side effects much worse. If you experience extreme sleepiness or difficulty breathing, seek medical help immediately. Your doctor may need to adjust your doses.
Important precautions
Mental health disorders
Pregabalin can cause suicidal thoughts or an urge to self-harm. You must seek medical help immediately if your mood changes or you have thoughts of hurting yourself.
Severe respiratory depression
Pregabalin can cause serious breathing problems, especially if you already have lung disease or if you take it with other sedating medicines like opioids. Seek emergency help if you experience slow, shallow, or difficult breathing.
Pregnancy
Pregabalin use during the first three months of pregnancy may increase the risk of birth defects. Effective contraception must be used during treatment.
Liver disease
Tizanidine can cause severe liver damage. You will need regular blood tests to monitor your liver function, and you must report any yellowing of the skin or eyes (jaundice) immediately.
Drug dependence and withdrawal
Both medicines carry a risk of dependence and addiction. Do not stop taking them suddenly, as this can cause serious withdrawal symptoms such as seizures (with pregabalin) or a dangerous spike in blood pressure and heart rate (with tizanidine).
Low blood pressure (hypotension)
Tizanidine can cause a significant drop in blood pressure, leading to fainting or dizziness. This risk is much higher if taken with certain antibiotics (like ciprofloxacin) or blood pressure medications.
Food and drink warnings
Alcohol
It is best to avoid or strictly limit alcohol while taking these medicines. Both pregabalin and tizanidine cause drowsiness and dizziness; alcohol will significantly increase these effects, making you more likely to have an accident or fall. Combining alcohol with these medicines can also lead to dangerous levels of respiratory depression (slowed breathing).
Caffeine (Coffee, Tea, Energy Drinks)
Caffeine can interfere with how your body breaks down tizanidine. This can lead to higher levels of the medicine in your blood, increasing the risk of side effects like extreme sleepiness, very low blood pressure, or a slow heart rate.
Using other medicines
Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.
Disclaimer
This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
Article also available in English, German, Spanish, French, Italian, Portuguese, Hindi, Hebrew, Arabic, and Swedish.
25 Jan 2026 | Originally published
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