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Can I take cyclobenzaprine with ibuprofen?

Most people can safely take both medications, though it may not increase pain relief

Key takeaways

  • It’s generally safe to combine ibuprofen and cyclobenzaprine.

  • However, it’s not proven that taking ibuprofen with cyclobenzaprine decreases pain more effectively than taking either medication alone.

  • Certain people should seek medical advice before taking ibuprofen and cyclobenzaprine together, such as older adults and people with kidney or liver problems.

If you have recurring back or neck pain or are dealing with an acute muscle spasm, over-the-counter pain medications, like ibuprofen, can offer much-needed relief. When those treatments still aren’t taking the edge off, your healthcare provider might prescribe something stronger, such as cyclobenzaprine. Also known by the brand name Flexeril, this medication is FDA approved to treat muscle spasms associated with painful musculoskeletal conditions. But can you take both cyclobenzaprine and ibuprofen at the same time? Most of the time, it’s safe. However, it’s not proven that using these two medications together provides increased pain relief. In certain circumstances, your provider might recommend taking both.

Can you take cyclobenzaprine with ibuprofen?

It’s typically safe to take ibuprofen with skeletal muscle relaxants like cyclobenzaprine, says Thomas Pontinen, MD, a double-board certified anesthesiologist and pain management specialist with MAPS Centers for Pain Control in Chicago, Illinois. “Generally, most people should be fine taking most muscle relaxers with ibuprofen,” says Dr. Pontinen.

Both medications carry risks and side effects. For example, cyclobenzaprine can cause dizziness, drowsiness, or an increased risk of a fast heart rate. Ibuprofen can cause gastrointestinal issues and may increase your risk of heart attack and stroke in patients with heart disease. However, they are not known to exacerbate each other when taken simultaneously. “This is largely because both drugs have different mechanisms of action, acting on different systems in the body,” explains Dr. Pontinen. 

Nevertheless, the combination of cyclobenzaprine and ibuprofen is not recommended for everyone. Whether or not to take these two medications together may depend on factors such as:

  • Underlying medical conditions: For example, “patients with renal impairment or liver disease should discuss these medications with their healthcare provider first,” advises William S. Raoofi, MD, a pain management specialist at Mercy Medical Center in Baltimore, MD. As should patients with ulcers, bleeding disorders, or those taking blood thinners.
  • Duration of treatment: “Generally, both of these medications are not used in the long-term and are limited to a 3-4 week treatment at most,” Dr. Raoofi explains. For chronic conditions, long-term use could increase the risk of kidney or liver problems—especially in high doses. Side effects may increase with long-term use, such as “gastrointestinal bleeding, cardiovascular thrombotic events, and kidney or liver injury” with ibuprofen, says Dr. Raoofi.

In addition, it’s generally not recommended that elderly patients take cyclobenzaprine because of increased sensitivity to the drug’s side effects (such as sedation, confusion, and risk of falls). People taking monoamine oxidase inhibitors (MAOI) must avoid taking cyclobenzaprine for at least 14 days after discontinuation of MAOIs. 

Even though ibuprofen is sold over the counter, you should always discuss its use with a healthcare professional when you’re taking other medications or supplements to avoid drug interactions.

RELATED: Can you take a muscle relaxer with ibuprofen?

What happens if you take cyclobenzaprine and ibuprofen together?

For some people, “these medications taken in combination have a better analgesic effect,” says Dr. Raoofi. In other words, cyclobenzaprine and ibuprofen together may decrease overall pain more than if either are taken separately. However, research suggests the combination is not more effective than either drug taken alone.

Several studies have found that cyclobenzaprine and ibuprofen have a positive effect on pain, taken separately or when combined. For example, a 2005 study looked at three groups of people: those who took cyclobenzaprine alone, those who combined 400 mg of ibuprofen with cyclobenzaprine, and those who combined 800 mg of ibuprofen with cyclobenzaprine. All three groups experienced improvement in muscle spasms and muscle pain. However, the researchers concluded that combining cyclobenzaprine with ibuprofen isn’t more effective than taking cyclobenzaprine alone.

Additionally, a 2010 study compared people who took ibuprofen alone, cyclobenzaprine alone, and both cyclobenzaprine and ibuprofen. This team of researchers found similar outcomes. Pain improved for all three groups, but there were no notable differences between the groups in terms of pain improvements.

When would you need to take ibuprofen and cyclobenzaprine? 

It’s most common to combine ibuprofen and cyclobenzaprine for acute pain related to muscle aches, such as back aches, neck aches, or other muscle sprains and spasms.

Ibuprofen is a basic painkiller of the NSAID [nonsteroidal anti-inflammatory drug] class, and it’s pretty good for any kind of basic musculoskeletal injury, inflammation, arthritis, headaches, and general pain,” says Dr. Pontinen.

Muscle relaxers like cyclobenzaprine are “usually prescribed for short-term use, such as after a muscle injury, for spasms or muscle tightness,” says Dr. Pontinen. “Muscle relaxers are also used long-term to treat certain conditions like spasticity.”

There is no published data on what doses to take together, so stick to the recommended daily dose for each medication. For example, adults should take no more than 1,200 mg of over-the-counter (OTC) ibuprofen in 24 hours, and it’s not recommended to take more than 30 mg of cyclobenzaprine in 24 hours. If you are taking prescription-strength ibuprofen, the dose could be higher, up to 3,200 mg in 24 hours.

Is it safe to take ibuprofen and cyclobenzaprine together? 

Most research finds that the combination of cyclobenzaprine and ibuprofen is well-tolerated, though it may not increase your pain relief. However, one placebo-controlled study showed an increase in central nervous system side effects, such as drowsiness, sedation, and dizziness, when taking these two medications together. Certain people should seek medical advice before taking ibuprofen and cyclobenzaprine together, such as older adults, people with kidney or liver problems, and those with gastrointestinal issues like ulcers. Both medications are typically intended for short-term use. Taking them for longer than four weeks can increase the risk of side effects. If your pain is chronic, talk to your provider about other treatment options, such as physical therapy.