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Key takeaways
Tizanidine is a muscle relaxant medication. Side effects of tizanidine can include liver damage, dizziness, drowsiness, and low blood pressure. The use of this medicine is to treat muscle spasticity.
Ibuprofen is an NSAID. Side effects include stomach upset, an increased risk of a blood clots, allergic reactions, kidney damage, high blood pressure, and much more. This medicine is used to treat pain and reduce fever.
Tizanidine and ibuprofen can be a treatment option for medical conditions, such as pain from muscle spasms and tightness. Otherwise, combining the two doesn’t really have benefits.
Keep both medications at room temperature in a closed container, away from moisture and heat.
Talk to a doctor or other healthcare provider for more medical information and the best results for treating muscle spasticity.
Tizanidine is a skeletal muscle relaxant medication for managing muscle spasticity, which can impact a person’s ability to enjoy daily activities.
Muscle spasticity can be caused by a brain injury, a spinal cord injury, or multiple sclerosis (MS). MS symptoms include numbness or tingling, vision changes, fatigue, stiff muscles, and more; it affects the central nervous system (CNS).
Ibuprofen, on the other hand, is a nonsteroidal anti-inflammatory drug (NSAID) that helps patients manage pain, inflammation, and fever. The two can be taken together but may have some side effects.
Can you take tizanidine with ibuprofen?
As far as any serious side effects or medical problems combining these two medications, you’re in the clear. “There is no clinically significant drug interaction between tizanidine and ibuprofen,” says Dr. Aaron Emmel, Pharm.D., BCPS, a pharmacist and founder at Pharmacy Tech Scholar.
However, this combo has potential risks for some patients, so other doctors advise against it. “Avoid taking these two medications together as it can cause drowsiness and sleepiness,” says Dr. Ashwini Sardana, MD, an internal medicine physician at MedStar Health.
He doesn’t believe the combination will be helpful, either. Pointing to an article on the American Academy of Family Physicians website, he says, “Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain or lessen the number of people reporting moderate to severe back pain one week after starting treatment.”
Benefits of taking tizanidine and ibuprofen together
There aren’t any major pros of taking these two medications together. However, they may be prescribed in conjunction with potential benefits related to some discomfort and pain symptoms.
“For pain [involving] muscle spasms or tightness, there is rationale to believe that adding a muscle relaxant such as tizanidine could be of benefit,” Dr. Emmel says.
Additionally, an old study in The Journal of International Medical Research suggests a tizanidine/ibuprofen mix is more effective in treating moderate-to-severe acute low back pain than ibuprofen and a placebo alone. But again, that study is super old (we’re talking 1988).
What are the potential interactions of taking tizanidine and ibuprofen together?
Before taking tizanidine, tell your healthcare provider if you are pregnant; breastfeeding; smoking; have another medical condition; or take a prescription drug, OTC med, or supplement.
Also, be aware of the potential side effects of tizanidine alone, such as liver damage, dangerously low blood pressure, dizziness or drowsiness, and withdrawal symptoms.
With ibuprofen, use it cautiously—aka take the lowest possible dose for the shortest period of time—and not before or after heart surgery or if you’ve had an allergic reaction to the medication or another NSAID. Before taking it, let your healthcare professional know if you have had or have heart problems, a history of ulcers or gastrointestinal bleeding, kidney disease, asthma, high blood pressure, bleeding problems, dehydration, or are pregnant or breastfeeding.
Ibuprofen can cause side effects such as an increased risk of blood clots, heart attack, stroke, heart failure, edema, gastrointestinal issues, allergic or skin reactions, kidney damage, high blood pressure, anemia, trouble seeing or hearing, and more.
Taking them together can also cause not-super-serious problems: Dr. Sardana mentions drowsiness and sleepiness, for example.
“In very rare cases, NSAIDs have been associated with liver toxicity, and this is a known risk of tizanidine, so the combination of those two warrants close monitoring,” Dr. Emmel adds. “Most of the considerations around combining NSAIDs and other drugs is the risk of additive side effects.”
It’s important to know that food can affect the medication in the body, too. People can take these meds with or without food, according to Dr. Sardana, but be consistent with which one. “Once a decision is made to take tizanidine with or without food, avoid changing how it is given,” he says. “This is because changes will affect how well the medicine works.”
Tizanidine is yet another medication that probably shouldn’t be combined with alcohol, either. Dr. Sardana says the drink can increase the amount of tizanidine in your blood, which can increase the risk of drowsiness and dizziness (and the dangers that come with).
How long after taking ibuprofen can you take tizanidine?
Dr. Emmel says, “There is no specific modification of dosing that is needed when combining the two.”
The recommended starting tizanidine dosage, Dr. Sardana says, is 2 mg every six to eight hours, up to a maximum of three doses in 24 hours.
“Too much of this medicine can damage your liver,” he adds.
The time of day matters, too. He urges people to avoid tizanidine when they need muscle tone for safe balance and movement during certain activities. “It may endanger your physical safety to be in a state of reduced muscle tone,” he explains.
The recommended ibuprofen dosage is typically 200 to 400 mg every four to six hours as needed; it can be taken during the day or night. Otherwise, take it as prescribed.
Both medications are available astablets and capsules. Ibuprofen specifically also comes in the following dosage forms: liquid-filled capsule, chewable tablet, oral suspension (liquid), and injection.
Try to keep the form consistent as well. “Switching between tablets and capsules, or changing the way you take it with regards to eating, can cause an increase in side effects or a decrease in therapeutic effect,” Dr. Sardana says. “Follow your doctor’s instructions carefully.”
What medications not to take with tizanidine or ibuprofen
Do not take tizanidine or ibuprofen if you are allergic to either of those medications. Additionally, avoid the following medicines—ciprofloxacin, fluvoxamine, benzodiazepines, medication that makes you sleepy, and alpha-2 adrenergic receptor agonists—if you take tizanidine. These are just a few of the drugs that can interact with tizanidine. Be sure to check with your healthcare provider before starting any new medications with tizanidine.
Other NSAIDs, blood thinners, blood pressure medications, diuretics, corticosteroids, aminoglycoside antibiotics, and lithium and methotrexate can also cause problems when taken with ibuprofen.
Dr. Sardana wants people to know that cold or allergy medicine; narcotic pain medication; sleeping pills; other muscle relaxers; and medicine for seizures, depression, or anxiety can increase your sleepiness while taking tizanidine.
Dr. Emmel mentions a particular piece to be wary of. “Tizanidine can interact with many medications that are metabolized by an enzyme called CYP1A2, so drug interactions have to be screened carefully,” he says. “Two drugs in particular that should not be used with tizanidine are fluvoxamine or ciprofloxacin.”
You can purchase both ibuprofen and tizanidine at a reduced cost by using one of SingleCare’s prescription discount cards.
Sources
- Tizanidine and ibuprofen in acute low-back pain: results of a double-blind multicentre study in general practice, The Journal of International Medical Research (1988)
- No short-term extra benefit when muscle relaxants are added to ibuprofen for acute low back pain, American Family Physician (2020)