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6 Interactions found for:

Benadryl and tizanidine
Interactions Summary
  • 2 Major
  • 2 Moderate
  • 2 Minor
  • Benadryl
  • tizanidine

Drug Interactions

Moderate
Benadryl + Tizanidine

The following applies to the ingredients: Diphenhydramine (found in Benadryl) and Tizanidine

MONITOR: The sedative effect of tizanidine may be potentiated by concomitant use of other agents with central nervous system (CNS) depressant effects. In addition, tizanidine and many of these agents (e.g., alcohol, anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, muscle relaxants) also can exhibit hypotensive effects, which may be additive during coadministration and may increase the risk of symptomatic hypotension and orthostasis, particularly during initiation of therapy or dose escalation. Tizanidine itself is a central alpha-2 adrenergic agonist. Pharmacologic studies have found tizanidine to possess between 1/10 to 1/50 of the potency of clonidine, a structurally similar agent, in lowering blood pressure. In a single-dose study where blood pressure was monitored closely after dosing, two-thirds of patients treated with an 8 mg dose had a 20% reduction in either the diastolic or systolic blood pressure. The reduction was seen within 1 hour after dosing, peaked 2 to 3 hours after dosing, and was associated at times with bradycardia, orthostatic hypotension, lightheadedness, dizziness, and rarely, syncope. The hypotensive effect of tizanidine is dose-related and has been measured following single doses of 2 mg or more.

MANAGEMENT: Caution is advised and more gradual dose titration may be appropriate when tizanidine is used with other substances that can cause CNS depression and/or hypotension, particularly in elderly or debilitated patients. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to avoid rising abruptly from a sitting or recumbent position. Patients should contact their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or excessive CNS effects that interfere with their normal activities.

References

  1. "Product Information. Zanaflex (tizanidine)." Acorda Therapeutics PROD (2001):

Drug and Food Interactions

Moderate
Benadryl + Food

The following applies to the ingredients: Diphenhydramine (found in Benadryl)

GENERALLY AVOID: Use of anticholinergic agents with alcohol may result in sufficient impairment of attention so as to render driving and operating machinery more hazardous. In addition, the potential for abuse may be increased with the combination. The mechanism of interaction is not established but may involve additive depressant effects on the central nervous system. No effect of oral propantheline or atropine on blood alcohol levels was observed in healthy volunteers when administered before ingestion of a standard ethanol load. However, one study found impairment of attention in subjects given atropine 0.5 mg or glycopyrrolate 1 mg in combination with alcohol.

MANAGEMENT: Alcohol should generally be avoided during therapy with anticholinergic agents. Patients should be counseled to avoid activities requiring mental alertness until they know how these agents affect them.

References

  1. Linnoila M "Drug effects on psychomotor skills related to driving: interaction of atropine, glycopyrrhonium and alcohol." Eur J Clin Pharmacol 6 (1973): 107-12

Drug and Pregnancy Interactions

The following applies to the ingredients: Diphenhydramine (found in Benadryl)

Use is recommended only if clearly needed and the benefit outweighs the risk.

AU TGA pregnancy category: A
US FDA pregnancy category: B

Comment:
-Exposure during the third trimester may result in adverse reactions in premature infants and neonates.

Animal models have failed to reveal evidence of impaired fertility or fetal harm at doses up to 5 times the human dose. There are no controlled data in human pregnancy.

AU TGA pregnancy category A: Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.

US FDA pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

References

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  2. "Product Information. Benadryl Children's Allergy Fastmelt (diphenhydrAMINE)." Pfizer U.S. Pharmaceuticals Group (2022):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. "Product Information. DiphenhydrAMINE Hydrochloride (diphenhydramine)." West-Ward Pharmaceuticals Corporation (previously Roxane Laboratories Inc) (2019):

The following applies to the ingredients: Tizanidine

Benefit should outweigh risk

US FDA pregnancy category: C

Teratogenicity was not shown in animal studies in rats and rabbits. At doses up to 8 times the maximum recommended human dose, increased gestation duration was observed in rats. Pre and prenatal and postnatal pup loss and developmental retardation occurred in rats and rabbits and post-implantation loss was increased in rabbits at doses of 1 mg/kg or more. There are no controlled studies in pregnant women.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

References

  1. "Product Information. Zanaflex (tizanidine)." Acorda Therapeutics PROD (2001):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Diphenhydramine (found in Benadryl)

Use is not recommended.
-According to some authorities: Use is contraindicated.

Excreted into human milk: Yes

Comments:
-The effects in the nursing infant are unknown.
-This drug may affect milk production, especially at high doses given early in the postpartum period and/or when used concomitantly with a sympathomimetic drug.

References

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis PROD (2002):
  2. "Product Information. Benadryl Children's Allergy Fastmelt (diphenhydrAMINE)." Pfizer U.S. Pharmaceuticals Group (2022):
  3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  4. Cerner Multum, Inc. "Australian Product Information." O 0
  5. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):

The following applies to the ingredients: Tizanidine

Safety has not been established

Excreted into human milk: Unknown
Excreted into animal milk: Yes

Comments: If used, monitor infant for toxicity such as sedation, hypotension, and hallucinations.

As a lipid soluble drug, it might be expected to pass into breast milk.

References

  1. "Product Information. Zanaflex (tizanidine)." Acorda Therapeutics PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Consumer Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

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