Phentermine and topiramate and Tizanidine interaction

Phentermine and topiramate and Tizanidine: both prescribing labels describe an interaction that usually calls for monitoring, a dose change, or spacing the doses.

Moderate

Usually manageable with monitoring or a dose change. Tell your pharmacist you take both.

What the FDA labels say

From the Phentermine and topiramate label · effective 2026-05-18

Moderate

The concomitant use of alcohol or central nervous system (CNS) depressant drugs with phentermine and topiramate extended-release capsules may potentiate CNS depression or other centrally mediated effects of these agents, such as dizziness, cognitive adverse reactions, drowsiness, light-headedness, impaired coordination, and somnolence.

Warnings and precautionsby drug classView label on DailyMed
Moderate

CNS Depressants Including Alcohol Clinical Impact The concomitant use of alcohol or CNS depressant drugs (e.g., barbiturates, benzodiazepines, and sleep medications) with phentermine or topiramate may potentiate CNS depression such as dizziness or cognitive adverse reactions, or other centrally mediated effects of these agents.

Drug interactionsby drug classView label on DailyMed
Moderate

CNS Depressants Including Alcohol : May potentiate CNS depressant effects.

Drug interactionsby drug classView label on DailyMed

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

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

Monitor patients who take Zanaflex with another CNS depressant for symptoms of excess sedation [see Clinical Pharmacology ( 12.3 )] .

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.