Key takeaways:
Methocarbamol is a muscle relaxer used to treat muscle pain and discomfort. Combining methocarbamol with opioids, benzodiazepines, or sleep medications can raise the risk of excessive sedation, slowed breathing, and overdose.
Methocarbamol may also interact with alcohol, cannabis, and other medications that make you drowsy. Pyridostigmine (Mestinon) may also not work as well if taken with methocarbamol.
Be sure to share your medication list with your prescriber before starting methocarbamol to make sure it’s a safe option for you.
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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 muscle-related pain and discomfort.
Methocarbamol can cause dizziness and drowsiness, which can be dangerous if you take it with other sedating medications. Knowing about methocarbamol interactions in advance can help know what to avoid and keep you safe during treatment.
Methocarbamol interactions at a glance
Methocarbamol interactions include:
Opioids, such as tramadol (ConZip, Qdolo)
Benzodiazepines, such as alprazolam (Xanax)
Sleep medications, such as zolpidem (Ambien)
Other muscle relaxers, such as cyclobenzaprine (Amrix, Flexeril)
First-generation antihistamines, such as diphenhydramine (Benadryl, ZzzQuil)
Some anti-seizure medications, such as carbamazepine (Tegretol)
Gabapentin (Neurontin) and pregabalin (Lyrica)
Alcohol
Cannabis
Pyridostigmine (Mestinon)
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Keep in mind that other interactions are possible. It’s best to review your medication list with your prescriber before taking methocarbamol to identify any interactions that may cause an issue.
1. Opioids, such as hydrocodone and tramadol
Opioids are typically used to treat pain. Examples include:
Oxycodone (Roxicodone, OxyContin)
Oxycodone / acetaminophen (Percocet)
Fentanyl tablets (Fentora) and patches
Methadone (Methadose)
Dizziness and drowsiness are common opioid side effects. Combining them with methocarbamol raises the risk of excessive drowsiness. It can also slow your breathing and raise the risk of overdose.
To avoid this, it’s typically best to avoid combining methocarbamol with opioids. If your prescriber decides you need both, they may lower your doses of one or both of these medications or have you take them at different times of day. Be sure to follow their directions carefully. It may also be a good idea to carry naloxone (Narcan, Zimhi) or nalmefene (Opvee, Zurnai) with you. These medications can reverse the effects of an opioid overdose quickly if needed.
2. Benzodiazepines, such as alprazolam
Benzodiazepines treat many health conditions, such as anxiety and panic disorder. Examples include alprazolam, lorazepam (Ativan), and diazepam (Valium).
Similar to opioids, benzodiazepine side effects include drowsiness and dizziness. Combining methocarbamol with benzodiazepines can increase the risk of excess sedation and overdose. It’s best to avoid this combination if possible.
If your prescriber thinks you need both medications, they may lower your dose of one or both of these medications. Let them know if you experience extreme drowsiness, dizziness, or confusion at any time during treatment.
3. Sleep medications, such as zolpidem
Medications that treat insomnia (trouble sleeping) can slow down brain activity. When taken with methocarbamol, excessive drowsiness or slowed breathing may occur.
Examples of these medications include:
Z-drugs, such as zolpidem and eszopiclone (Lunesta)
Some over-the-counter (OTC) antihistamines, such as diphenhydramine 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)
Let your prescriber know if you take medication to help you sleep before starting methocarbamol. They may have you avoid taking it close to bedtime or recommend a different medication altogether to avoid this interaction.
4. Other medications that can cause drowsiness or dizziness
There are several other types of medications that can slow down brain activity and cause drowsiness and dizziness. Examples include:
Other muscle relaxers, such as cyclobenzaprine and baclofen
Some antipsychotics, such as haloperidol (Haldol), olanzapine (Zyprexa), and quetiapine (Seroquel)
Gabapentin (Neurontin) and pregabalin (Lyrica)
Some anti-seizure medications, such as carbamazepine and topiramate (Topamax)
OTC cough and cold products that contain doxylamine or diphenhydramine, such as NyQuil (acetaminophen / dextromethorphan / doxylamine)
Combining these medications with methocarbamol can increase the risk of dizziness and excess sedation. In turn, this can raise the risk of falls and injuries. Your prescriber may decide it’s OK to take methocarbamol along with one of these medications. But be sure to follow their instructions and let them know if you notice excess side effects.
5. Alcohol
It’s best to avoid alcohol while taking methocarbamol. Alcohol can worsen dizziness and drowsiness caused by methocarbamol. The combination can also raise the risk of slowed breathing and overdose.
If you have concerns about your ability to avoid alcohol while taking methocarbamol, let your prescriber know. They may switch you to a safer option for your muscle pain. They can also give you tips to help you cut back on your drinking, if needed.
6. Cannabis
Cannabis that’s high in THC (tetrahydracannabinol) can cause similar side effects to methocarbamol, such as dizziness, drowsiness, and coordination issues. The combination may make these side effects more likely or more severe.
Let your prescriber know if you consume cannabis before starting methocarbamol. They may want to start with a lower dosage or try a different medication to avoid excessive side effects.
7. Pyridostigmine
Methocarbamol may block the effects of a medication called pyridostigmine (Mestinon). Pyridostigmine helps improve muscle weakness caused by a condition called myasthenia gravis. Methocarbamol can block its effects, so it’s best to avoid this combination.
Frequently asked questions
It’s typically safe to take methocarbamol with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or meloxicam (Mobic). It’s also fine to apply topical diclofenac (Voltaren gel) while taking methocarbamol. There isn’t an interaction between these medications, and they work in different ways to treat pain. But keep in mind that NSAIDs aren’t the best choice for everyone. So it’s a good idea to get your prescriber’s OK before taking one.
It should be fine to take methocarbamol with acetaminophen (Tylenol). They don’t interact and work in different ways to treat pain. But it’s best to talk to your prescriber before taking Tylenol if you’re living with liver problems or regularly drink large amounts of alcohol.
It’s typically safe to take methocarbamol with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or meloxicam (Mobic). It’s also fine to apply topical diclofenac (Voltaren gel) while taking methocarbamol. There isn’t an interaction between these medications, and they work in different ways to treat pain. But keep in mind that NSAIDs aren’t the best choice for everyone. So it’s a good idea to get your prescriber’s OK before taking one.
It should be fine to take methocarbamol with acetaminophen (Tylenol). They don’t interact and work in different ways to treat pain. But it’s best to talk to your prescriber before taking Tylenol if you’re living with liver problems or regularly drink large amounts of alcohol.
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. Combining methocarbamol with opioids, benzodiazepines, or sleep medications can raise the risk of excessive sedation, slowed breathing, and overdose.
Other methocarbamol interactions include alcohol, cannabis, and other medications that make you drowsy. Pyridostigmine (Mestinon) may not work as well when combined with methocarbamol. Be sure to share your medication list with your prescriber before starting methocarbamol to make sure it’s a safe option for you.
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References
Remedyrepack Inc. (2026). Methocarbamol- methocarbamol tablet [package insert].
Sibrack, J., et al. (2024). Methocarbamol. StatPearls.
