7 Soma Interactions to Know About: Alcohol, Opioids, and More

Soma (carisoprodol) is a muscle relaxer medication. It’s used to treat musculoskeletal pain, which is pain that affects various parts of the body, including muscles, joints, and bones. 

While Soma may help you manage muscle spasms and pain, it has important risks to be aware of. For example, Soma is a controlled substance. It has a higher risk of misuse and dependence than non-controlled medications. It also has side effects and drug interactions to be aware of. 

Here, we’ll focus on seven Soma interactions in more detail.

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1. Alcohol

Alcohol can have harmful effects on the body. For example, it can cause liver damage and affect your mood. And similar to Soma, it can also cause drowsiness and dizziness. 

Combining alcohol and Soma can lead to excessive sleepiness, trouble with coordination, and orthostatic hypotension (when your blood pressure drops when switching positions, such as standing up from a sitting position). This can lead to falls and injuries, which are especially dangerous for adults over 65 years old. Older adults are more at risk of serious consequences from falls, such as hospitalizations and disability. In fact, Soma isn’t recommended for adults over 65. This is especially true if you’re taking other medications or substances that increase your fall risk.

What’s more, the alcohol and Soma combination increases your risk of slowed breathing and drug overdose. So it’s best to avoid drinking alcohol while taking Soma. Have an honest discussion with your prescriber if you don’t think you can stop drinking alcohol. They may recommend another medication besides Soma. Or, they may recommend resources to help you cut back on alcohol.

2. Benzodiazepines, such as Xanax

Benzodiazepines are prescription sedative medications. Sedative medications “slow down” how quickly your brain works. They help you feel more relaxed or sleepy. Examples of benzodiazepines include Xanax (alprazolam), Ativan (lorazepam), and Valium (diazepam). 

Although Soma isn’t considered a true sedative, it has sedative-like effects. So Soma and benzodiazepines share some common side effects. These include sleepiness, dizziness, and poor coordination. Combining Soma with benzodiazepines could make these effects worse. More seriously, slowed breathing, overdose, and death can happen in severe cases.

Additionally, benzodiazepines are also controlled substances. They can also cause dependence, misuse, and overdose. When combined with Soma, the risk is greater. That’s why it’s usually best to avoid combining benzodiazepines and Soma, especially for older adults who are more at risk of side effects, such as injuries and falls.

EXPERT PICKS: WHAT TO READ NEXT

• How do you take Soma? This muscle relaxer has dosage recommendations to keep in mind, and sticking to your prescriber’s instructions can help keep side effects to a minimum.

• What are Soma’s side effects? Besides its drug interactions, Soma’s side effects are also something to keep in mind.

• What are the different types of muscle relaxers? There are several muscle relaxers on the market, and they all have their own unique properties.

3. Opioids, such as oxycodone

Opioids are pain medications. Like Soma, they’re controlled substances that can cause dependence and misuse. They also have similar side effects, such as drowsiness and dizziness.

Examples of opioids include oxycodone (Roxicodone, OxyContin), hydrocodone (Hysingla ER), and tramadol (ConZip, Qdolo). Taking Soma with any opioid can increase your risk of side effects. Most seriously, it increases your risk of opioid overdose. What’s more, some research shows that the risk may be greater when combining opioids with Soma compared with other muscle relaxers.

Despite warnings from experts to avoid taking muscle relaxers and opioids together when possible, these medications are sometimes prescribed together. If this is the case for you, follow your prescriber’s instructions exactly for how to take these medications. And report any symptoms of severe drowsiness or slowed breathing. 

Additionally, if you’re prescribed an opioid, it’s a good idea for you and the people you live with to carry naloxone (Narcan, Zimhi) and nalmefene (Opvee, Zurnai). These are fast-acting medications that reverse the effects of an opioid overdose. They’re available as nasal and injectable medications. In fact, naloxone is available over the counter.

4. Sleep medications, such as Ambien

Prescription sleep medications such as Ambien (zolpidem), Sonata (zaleplon), and Lunesta (eszopiclone) are best avoided if you take Soma. 

When combined with Soma, these sleep aids can increase drowsiness. This can lead to excessive sleepiness, slowed or disorganized movements, and even overdose. Other sleep medications — such as doxepin (Silenor, Zonalon), Belsomra (suvorexant), and trazodone (which is used off-label for sleep) — can also cause excessive drowsiness if used with Soma.

Even over-the-counter (OTC) sleep medications can lead to a Soma interaction. Examples include Benadryl (diphenhydramine) and Unisom SleepTabs (doxylamine). And what’s more, these medications are part of several combination OTC products, as well. If you take an OTC medication, check the label to see what is in it. And talk to your prescriber. They may recommend stopping it temporarily while you take Soma. In some cases, this may not bother you too much since Soma is only meant to be taken for a few weeks, at most.

5. Other medications that cause drowsiness, such as gabapentin

Aside from those mentioned above, other medications can cause drowsiness. They have similar risks when combined with Soma, such as the potential to cause severe drowsiness and dizziness. Examples of these medications include:

• Other muscle relaxers, such as tizanidine (Zanaflex) and methocarbamol

• Tricyclic antidepressants, such as amitriptyline

• Anti-seizure medications, such as carbamazepine (Tegretol) and gabapentin (Neurontin)

Your prescriber may recommend an alternative to Soma if you take any of these medications. Or, they may suggest simply monitoring for increased drowsiness.

6. Medications that decrease Soma levels, such as rifampin

Soma is metabolized (broken down) by certain enzymes (proteins) in the liver. Some medications activate these enzymes, causing Soma to leave the body more quickly. This can make it less effective at treating muscle pain. Examples of medications that can have this effect on Soma are rifampin (Rifadin) and the herbal supplement St. John’s wort. 

Giving your pharmacist a list of the medications you take can help them check for medications that may decrease Soma levels. If they find a potential interaction, talk to your prescriber about what to do next. They may recommend a change to your medication regimen.

7. Medications that increase Soma levels, such as Prilosec

Certain medications can slow how quickly Soma leaves the body, leading to higher levels of the medication in your blood. As a result, your risk of side effects such as drowsiness and dizziness may be higher. More seriously, this can lead to slowed breathing and overdose in severe cases.

Examples of medications that can increase Soma levels include Prilosec (omeprazole), Prozac (fluoxetine), and Luvox (fluvoxamine). Your prescriber can help you navigate these potential interactions and recommend what action to take next.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Soojin Jun, PharmD

Soojin has 10 years of experience in various pharmacy settings, from inpatient to outpatient settings, and population health in value-based healthcare models. She completed training in various areas of healthcare to ensure patient safety, from activism, geriatric pharmacy, medication safety, healthcare quality, patient safety, death and dying, and trauma-informed care.

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