Modafinil and Tizanidine interaction

Modafinil and Tizanidine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Tizanidine (Zanaflex) label · effective 2026-01-02

Major

Hypotension: monitor for signs and symptoms of hypotension, in particular in patients receiving concurrent antihypertensives; Zanaflex should not be used with other α 2 -adrenergic agonists ( 5.1 , 7.7 )

Warnings and precautionsby drug classView label on DailyMed
Major

It is not recommended that Zanaflex be used with other α 2 -adrenergic agonists.

Warnings and precautionsby drug classView label on DailyMed
Major

α 2 -Adrenergic Agonists Concomitant use of Zanaflex with other α2-adrenergic agonists is not recommended because hypotensive effects may be cumulative [see Warnings and Precautions ( 5.1 )] .

Drug interactionsby drug classView label on DailyMed
Moderate

Hypotension Zanaflex is an α 2 -adrenergic agonist that can produce hypotension [see Adverse Reactions ( 6.1 ) and Drug Interactions ( 7.5 )] .

Warnings and precautionsby drug classView label on DailyMed

From the Modafinil (Provigil) label · effective 2025-10-16

Moderate

However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%).

Warnings and precautionsby drug classView label on DailyMed
Minor

The differential use was slightly larger when only studies in OSA were included, with 3.4% of patients on PROVIGIL and 1.1% of patients on placebo requiring such alterations in the use of antihypertensive medication.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.