Taking Nucynta With Cyclobenzaprine

In our latest question and answer, the pharmacist discusses whether or not it is safe to take Nucynta with cyclobenzaprine.

Apr 18, 2018

Candy asked

Can I use my muscle relaxer, cyclobenzaprine (Flexeril) I just started using today with Nucynta?

Answer

There is a potential major interaction between cyclobenzaprine and Nucynta. They generally should not be taken together.


Nucynta 

Nucynta (tapentadol) is an opioid agonist that is indicated for the treatment of severe pain. In addition to the drugs opioid effects, Nucynta also has an effect on norephinephrine re-uptake, which increases the analgesic effects.

Nucynta can be taken with or without food but the extended release form of Nucynta has very specific requirements for safe and effective administration. When taking the extended release form of Nucynta you should:

  • Not take with any type of alcohol (drinks or cough medications etc.) as it can cause a severe overdose.
  • Take the tablet whole, and do not crush, chew, dissolve, or break the tablets.

Common side effects experienced while taking Nucynta include, but are not limited to:

  • Constipation
  • Vomiting
  • Nausea
  • Drowsiness
  • Headache
  • Constipation
  • Confusion
  • Fatigue
  • Lethargy
Cyclobenzaprine

Cyclobenzaprine (brand name Flexeril) is a skeletal muscle relaxant approved for the treatment of muscle spasms caused by musculoskeletal conditions. Cyclobenzaprine can cause some gastric upset so it may be taken with food but it is not necessary.

The extended release capsule (Amrix) may be opened and sprinkled onto a tablespoon full of applesauce if desired. Common side effects associated with taking cyclobenzaprine include, but are not limited to:

  • Drowsiness
  • Headache
  • Dizziness
  • Confusion
  • Blurred vision
  • Constipation
  • Fatigue
  • Nausea
Taking Nucynta And Cyclobenzaprine Together

Taking Nucynta and cyclobenzaprine together can result in major side effects. 

Both medications are considered CNS (central nervous system) depressants. Combining the medications can result in excess sedation and drowsiness. In addition, there is an increased risk of slowed or difficult breathing.

Use of Nucynta and cyclobenzaprine together should only be considered if there are no alternative treatment options available. If they are to be used together, the lowest doses of each should be used to start and each should be increased slowly to clinical effect, while assessing tolerability.

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