Phenobarbital and Tizanidine interaction

Phenobarbital 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 Phenobarbital (SEZABY) label · effective 2025-12-23

Major

CNS depressants: Closely monitor for sedation and respiratory depression.

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Major

CNS Depressants Closely monitor for signs of sedation and respiratory depression with concomitant use of SEZABY with other CNS depressants, including opioids [see Warnings and Precautions (5.1)] .

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

Moderate

Sedation: Zanaflex may interfere with everyday activities; sedative effects of Zanaflex, alcohol, and other central nervous system (CNS) depressants are additive ( 5.3 , 7.4 )

Warnings and precautionsby drug classView label on DailyMed
Moderate

The CNS depressant effects of Zanaflex with alcohol and other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants) may be additive [see Drug Interactions ( 7.4 )] .

Warnings and precautionsby drug classView label on DailyMed
Moderate

Monitor patients who take Zanaflex with another CNS depressant for symptoms of excess sedation.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Alcohol and Other CNS Depressants Alcohol increases the exposure of tizanidine after administration of Zanaflex.

Drug interactionsby drug classView label on DailyMed
Moderate

Concomitant use of Zanaflex with CNS depressants (e.g., alcohol, benzodiazepines, opioids, tricyclic antidepressants) may cause additive CNS depressant effects, including sedation.

Drug interactionsby 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.