Can I take Tizanidine and Trazodone together?

Why this happens

Both drugs have a 'sedating' effect on the brain and central nervous system. When used together, these effects add up (additive effect). Additionally, both medications can lower blood pressure—tizanidine by acting on certain receptors in the brain and trazodone as a side effect of its antidepressant action.

What you should do

You should speak to your doctor before taking these two medicines together. If your doctor confirms you need both, they may suggest taking them at different times or starting with a very low dose. Do not drive, cycle, or operate machinery until you know how this combination affects you. Get up slowly from a sitting or lying position to avoid dizziness.

Important precautions

Depression and mental health disorders

Trazodone can increase thoughts of self-harm or suicide, particularly when first starting the medicine or changing the dose. Monitor your mood closely and seek urgent medical help if you experience any distressing thoughts.

Serotonin Syndrome

When taken with other serotonergic medicines, trazodone can cause a life-threatening condition called serotonin syndrome. Seek immediate medical attention if you experience high fever, agitation, shivering, or muscle twitching.

Low blood pressure (hypotension)

Tizanidine can cause a severe drop in blood pressure, leading to dizziness or fainting. This is more likely if you take it with certain blood pressure medicines or if you stand up too quickly.

Liver problems

Tizanidine can cause serious 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) or severe nausea immediately.

Bleeding disorders

Trazodone can increase your risk of bleeding, especially if you are also taking blood-thinning medicines (like warfarin) or NSAIDs (like ibuprofen). Report any unusual bruising or bleeding to your doctor.

Priapism (prolonged erection)

Trazodone can cause a painful, persistent erection that lasts for several hours. This is a medical emergency; if this occurs, stop taking the medicine and go to an A&E department immediately to avoid permanent damage.

Stopping treatment suddenly

Do not stop taking tizanidine suddenly. Doing so can cause a rapid increase in heart rate and dangerously high blood pressure. Your dose must be reduced gradually.

Food and drink warnings

Alcohol

It is best to avoid or strictly limit alcohol while taking these medicines. Both tizanidine and trazodone 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 sedation and breathing difficulties.

Grapefruit juice

Grapefruit juice can increase the amount of trazodone in your blood, which may increase the risk of side effects like extreme sleepiness or heart rhythm problems. It is best to avoid drinking large amounts of grapefruit juice.

Caffeine (Coffee, Tea, Energy Drinks)

You should avoid or strictly limit caffeine while taking tizanidine. Caffeine can interfere with how your body breaks down this medicine, which may lead to higher levels of tizanidine in your blood. This increases the risk of side effects such as extreme drowsiness, low blood pressure, and a slow heart rate.

Food (General)

Food can change how much tizanidine your body absorbs. To keep the levels of medicine in your blood consistent, you should choose to always take your doses either with food or always on an empty stomach. Do not switch between the two.

Trazodone should ideally be taken with or shortly after a meal or a snack. Taking it on an empty stomach can increase the risk of feeling dizzy or lightheaded.

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.