Key takeaways:
Methocarbamol is a muscle relaxer. It’s FDA approved to treat discomfort from muscle-related conditions.
Methocarbamol can have drug interactions. Examples of methocarbamol interactions include opioids such as hydrocodone, benzodiazepines such as alprazolam (Xanax), and diphenhydramine (ZzzQuil, Benadryl). It also interacts with alcohol.
Methocarbamol interactions can cause oversedation or increased dizziness. More seriously, it can lead to slowed breathing or a slowed heart rate.
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If you have muscle pain or spasms, methocarbamol may provide relief. It’s a muscle relaxer that’s FDA approved to treat discomfort from muscle-related conditions.
Before starting methocarbamol, knowing about its drug interactions can help keep you safe. Some of these interactions can be managed, while others are more serious and should be avoided. Here, we’ll cover seven important methocarbamol interactions to know about.
1. Opioids, such as hydrocodone and tramadol
Most opioids are used to treat different types of pain. While they may be effective for treating pain, opioids can also cause side effects like drowsiness and dizziness. They’re also controlled substances, which means they have a risk for dependence and misuse.
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Combining opioids with methocarbamol can worsen drowsiness and dizziness. It can also slow your heart rate and drop your blood pressure. More seriously, there’s an increased risk of serious side effects like slowed breathing and overdose.
Examples of opioids that can interact with methocarbamol include:
Oxycodone (Roxicodone, OxyContin)
Oxycodone / acetaminophen (Percocet)
Fentanyl tablets (Fentora) and patches
Methadone (Methadose)
Tramadol (ConZip, Qdolo)
It’s typically best to avoid combining methocarbamol with opioids. But if your prescriber decides you need both, they may lower your doses of one or both of these medications. And if you or a loved one is prescribed an opioid, it’s a good idea to carry naloxone (Narcan, Zimhi) or nalmefene (Opvee, Zurnai) with you at all times. These medications can reverse the effects of an opioid overdose quickly if it were to occur.
2. Benzodiazepines, such as alprazolam
Benzodiazepines are used to treat many health conditions, such as anxiety and panic disorder. Examples include alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium). Like opioids, benzodiazepines are controlled substances.
Similar to methocarbamol and opioids, benzodiazepines can cause drowsiness and dizziness. Combining methocarbamol with benzodiazepines can increase the risk of oversedation and overdose. It’s best to avoid this combination if possible.
If your prescriber thinks you need both medications, they may lower your doses of either or both medications. And you should monitor closely for side effects, such as extreme drowsiness, dizziness, and confusion.
3. Sleep medications, such as zolpidem
Medications that treat insomnia (trouble sleeping) can slow down brain activity. When taken with methocarbamol, excessive drowsiness may occur. This increases your risk of falls and injuries. Examples of these medications include:
Z-drugs, such as zolpidem (Ambien, Edluar, and ZolpiMist) and eszopiclone (Lunesta)
Some over-the-counter (OTC) antihistamines, like diphenhydramine (ZzzQuil) and doxylamine (Unisom SleepTabs)
Antidepressants, such as trazodone (used off-label for sleep) and doxepin (Silenor)
Orexin receptor antagonists, such as Belsomra (suvorexant) and Dayvigo (lemborexant)
Melatonin and the melatonin receptor agonist ramelteon (Rozerem)
Comparing muscle relaxers: Learn about the similarities and differences between common muscle relaxers.
Risks of methocarbamol: Find out about the most common side effects of methocarbamol and how to manage them.
Methocarbamol FAQs: Learn how long methocarbamol lasts in the body and the answers to other FAQs.
If sleep is an issue for you while taking methocarbamol, talk to a healthcare professional. They can help you troubleshoot possible causes of sleep troubles. Before trying medications, they may recommend creating healthy sleep habits or cognitive behavioral therapy (CBT).
4. Other medications that affect the brain, such as gabapentin
Several medications can slow down brain activity and cause drowsiness and dizziness. These medications work to treat various medical conditions.
Examples of these medications include:
Other muscle relaxers, such as cyclobenzaprine (Amrix) and baclofen
Antipsychotics, such as haloperidol (Haldol), olanzapine (Zyprexa), and quetiapine (Seroquel)
Gabapentinoids, such as gabapentin (Neurontin) and pregabalin (Lyrica)
Seizure medications, such as carbamazepine (Tegretol) and topiramate (Topamax)
OTC products that contain doxylamine or diphenhydramine, such as NyQuil (acetaminophen / dextromethorphan / doxylamine) or Benadryl (diphenhydramine)
Combining these medications with methocarbamol can increase the risk of oversedation, falls, and injuries. But it’s hard to keep track of all the medications that can cause these side effects. So make sure your healthcare team has a complete list of all the medications you take. This will help them check for interactions with methocarbamol.
5. Alcohol
Alcohol affects the body in several ways. Some are similar to methocarbamol, like the potential to cause drowsiness and dizziness.
Since alcohol and methocarbamol can have similar effects, it’s best to avoid combining the two. This is the case with all muscle relaxers. If you have questions about drinking alcohol while taking methocarbamol, talk to your prescriber or pharmacist.
6. Cannabis
Cannabis can affect your coordination, including your ability to drive. Taking it with muscle relaxers like methocarbamol can worsen coordination. Drowsiness and dizziness are also possible.
Though some people may use cannabis to help with pain, make sure to talk to your healthcare professional before taking cannabis, especially if you take methocarbamol. They can let you know whether they consider this combination safe.
7. Pyridostigmine
Pyridostigmine (Mestinon) is used to treat an autoimmune condition called myasthenia gravis. In myasthenia gravis, your immune system mistakenly attacks your body, causing muscle weakness in the face, eyes, and limbs. Pyridostigmine helps improve muscle function.
Pyridostigmine works by stopping the breakdown of acetylcholine. Increasing levels of acetylcholine improves muscle strength. But methocarbamol may block acetylcholine, which can counteract pyridostigmine’s effects.
There isn’t a lot of information or research on this interaction. But still, if you take pyridostigmine, your prescriber may recommend avoiding methocarbamol. They may also recommend avoiding methocarbamol if you take other medications that increase acetylcholine. Examples include donepezil (Aricept) and rivastigmine (Exelon).
Frequently asked questions
Methocarbamol isn’t known to interact with nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil, Motrin), meloxicam (Mobic) and naproxen (Aleve). So it’s typically safe to take these OTC pain medications with methocarbamol.
However, if you have certain health conditions, you may need to avoid NSAIDs. So it’s best to check with your healthcare team before taking an NSAID.
Diclofenac is an NSAID that’s generally safe to combine with methocarbamol. It’s available in prescription-only oral forms, such as oral solution (Cataflam) and tablets (Cambia). It’s also available OTC as a topical gel (Voltaren Arthritis Pain).
Check with your prescriber before using a diclofenac product. In some cases, NSAIDs may need to be avoided, such as if you have heart disease.
Methocarbamol and acetaminophen (Tylenol) aren’t known to interact with each other. So taking them together is typically safe. But if you have liver problems or regularly drink large amounts of alcohol, you may need to avoid Tylenol.
Methocarbamol isn’t known to interact with nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil, Motrin), meloxicam (Mobic) and naproxen (Aleve). So it’s typically safe to take these OTC pain medications with methocarbamol.
However, if you have certain health conditions, you may need to avoid NSAIDs. So it’s best to check with your healthcare team before taking an NSAID.
Diclofenac is an NSAID that’s generally safe to combine with methocarbamol. It’s available in prescription-only oral forms, such as oral solution (Cataflam) and tablets (Cambia). It’s also available OTC as a topical gel (Voltaren Arthritis Pain).
Check with your prescriber before using a diclofenac product. In some cases, NSAIDs may need to be avoided, such as if you have heart disease.
Methocarbamol and acetaminophen (Tylenol) aren’t known to interact with each other. So taking them together is typically safe. But if you have liver problems or regularly drink large amounts of alcohol, you may need to avoid Tylenol.
The bottom line
Methocarbamol is a muscle relaxer used to treat muscle pain and discomfort. It can cause drowsiness and dizziness, which can lead to drug interactions. For example, methocarbamol can interact with opioids like hydrocodone and benzodiazepines like alprazolam (Xanax). It can also interact with sleep medications like zolpidem (Ambien) and diphenhydramine (Zzzquil). Other methocarbamol interactions include alcohol, gabapentin (Neurontin), and zolpidem (Ambien).
Symptoms of methocarbamol interactions might include feeling overly tired, dizzy, or confused. More seriously, methocarbamol interactions can cause slowed breathing and heart rate. If this occurs, seek emergency care. Sharing a medication list with your healthcare team can help them identify potential interactions.
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References
Key Therapeutics. (2024). Methocarbamol- methocarbamol tablet [package insert].
Sam, C., et al. (2023). Physiology, acetylcholine. StatPearls.
Sibrack, J., et al. (2024). Methocarbamol. StatPearls.
