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What Are the Risks of Mixing Tramadol and Cyclobenzaprine?

What Are the Risks of Mixing Tramadol and Cyclobenzaprine?

We live in a fast-paced world, and the pressure of keeping up can often lead to sleep disorders, leaving us tossing and turning at night. If you’re experiencing sleep issues and are worried they may affect your work or studies, you’re not alone. The Centers for Disease Control and Prevention (CDC) reports that about 14.5% of adults in the U.S. had trouble falling asleep most days in the past month. 

Seeking help from a specialist should be your first step towards getting peaceful sleep. They might prescribe medications like tramadol and cyclobenzaprine, which can be effective in treating sleeplessness. While these drugs are beneficial, they carry certain risks and can interact with other medications. Check out potential tramadol and cyclobenzaprine interactions and how to use them safely. 

How Tramadol Works—An Overview

Tramadol is an analgesic often prescribed to patients in moderate or severe pain. It can also induce sleep, so sleep doctors sometimes prescribe it off-label to patients grappling with sleepless nights.

Tramadol induces sleep through a two-fold mechanism:

  1. The medication acts on the mu-opioid receptors in the brain, causing a decrease in the perception of pain and resulting in a state of relaxation, which is crucial in inducing sleep
  2. It inhibits the reuptake of serotonin and norepinephrine, neurotransmitters that play a critical role in mood regulation and the sleep-wake cycle. By regulating these neurotransmitters in the brain, tramadol can cause drowsiness, leading to sleep

The medication’s sedative effects kick in within 30–60 minutes and may last for 4–6 hours

In the table below, you can find general information about tramadol:



Active ingredient

Tramadol hydrochloride

FDA approval


Controlled substance

Yes, Schedule IV (low risk for abuse)


Tablet, liquid

Average dose

100 mg per day

Maximum dose

300 mg per day

Suitable for children


Pregnancy risk

Category C (risks can’t be ruled out)

Source: Andrea Piacquadio

How Cyclobenzaprine Works—An Overview

Cyclobenzaprine is a muscle relaxant, but its mechanism of action allows its off-label use in treating sleep disturbances. The drug works in two ways:

  1. The medication acts on gamma and alpha motor systems in the brain—the nerve fibers connected to the skeletal muscle and responsible for muscle contraction. This action reduces muscle hyperactivity, causing a state of relaxation 
  2. Cyclobenzaprine blocks nerve impulses (or pain sensations) sent to the brain, causing drowsiness

Cyclobenzaprine’s sedative effects can be felt within 30–60 minutes of ingestion and typically last for 4–6 hours.  

Check out the key characteristics of cyclobenzaprine in the following table:



Active ingredient

Cyclobenzaprine hydrochloride

FDA approval


Controlled substance

No (low risk for abuse)


Tablet, capsule

Average dose

15 mg per day

Maximum dose

60 mg per day

Suitable for children


Pregnancy risk

Consult your doctor

Can You Take Tramadol With Cyclobenzaprine?

You shouldn’t mix tramadol with cyclobenzaprine. The drugs have major interactions, so combining them increases the risk of seizures and coma. 

Other adverse reactions to a mixture of tramadol and cyclobenzaprine are:

  • Respiratory distress
  • Dizziness
  • Severe drowsiness
  • Difficulty concentrating

Patients who experience the above—or other concerning symptoms not on the list—should contact their healthcare providers for immediate assistance.

Tramadol and Cyclobenzaprine Side Effects

Even when used alone, tramadol and cyclobenzaprine carry risks of side effects. Keep in mind that these adverse reactions rarely occur when you follow your doctor’s instructions. 

Common Side Effects of Tramadol

The common side effects of tramadol are:

  • Nausea
  • Constipation
  • Dizziness
  • Headache
  • Vomiting 
  • Dry mouth
  • Sweating
  • Indigestion

Patients who experience these side effects should avoid operating heavy machinery and doing other tasks that require sharp focus.

Common Side Effects of Cyclobenzaprine

The most common side effects of cyclobenzaprine include:

  • Drowsiness
  • Dizziness
  • Headache 
  • Stomach upset
  • Fatigue
  • Dry mouth
  • Trouble focusing

This list is not exhaustive. Consult your primary care physicians for more details before starting a cyclobenzaprine treatment.

How Long After Tramadol Can I Take Cyclobenzaprine?

Source: Kool Shooters

You should consult your doctor on how long you should wait to take cyclobenzaprine after tramadol and vice versa. Both drugs’ effects typically subside within 4–6 hours, so your doctor may recommend waiting for at least six hours before taking the other.

Still, your healthcare provider will assess your health and medical history before deciding whether you should mix these two drugs—avoid self-medication for your safety.

Which Is Better for Sleep—Cyclobenzaprine or Tramadol?

The most effective treatment depends on the causes and type of your sleeplessness. Tramadol may provide more relief if your sleep issues are due to moderate or severe pain. Cyclobenzaprine would be a better option if your insomnia is due to mild to moderate muscle spasms.

Since there’s no one-size-fits-all treatment for sleep disorders, the best course of action is to visit a sleep specialist to get the most effective solution. The problem is that only about 1% of physicians in the U.S. are trained in sleep medicine, so some patients can wait for a long time before getting an appointment.

Kick, an online performance medicine clinic that connects you with sleep doctors almost instantly, offers a convenient solution to your sleep problems. Kick’s sleep program was designed by a renowned Stanford sleep specialist, Dr. Alex Dimitriu. It combines cognitive behavioral therapy for insomnia (CBT-I) with gentler sleep medications, such as:

  • Hydroxyzine
  • Cyclobenzaprine
  • Ramelteon
  • Doxylamine
  • Trazodone
  • Gabapentin

Kick’s patients attest to the program’s effectiveness, as evidenced by numerous positive reviews on Trustpilot.

Source: Miriam Alonso

Kick—Sleep Well, Be Well

Kick offers a tailored approach to solving your sleep issues. Our doctors review your medical history, lifestyle, and sleeping patterns and prescribe two trial drugs to optimize the treatment quickly. 

Kick’s sleep expert will check in with you throughout the treatment and adjust it if the initial prescription doesn’t yield the desired results. They’ll also offer tips on good sleep hygiene and help you address the underlying issues causing your sleeplessness.

How To Join Kick

Join Kick’s sleep program in three simple steps:

  1. Visit our signup page and start your 15-minute sleep visit
  2. Fill out the questionnaire and provide the relevant information on your sleep issues and medical history
  3. Enter the delivery address and payment details

Our sleep doctor will evaluate your information and prescribe two trial medications you’ll rotate during treatment. The drugs will be delivered to your doorstep or nearest local pharmacy in discreet packaging. 

If our expert decides you won’t benefit from the program, you won’t be billed for the initial consultation, according to our Doctor Guarantee. 


Tramadol for Sleep—Who Should and Shouldn’t Use It?

Tramadol can be used by patients over 12 to treat moderate or severe pain. Keep in mind that this medication is only used off-label in treating sleep issues, so patients under 18 should avoid taking it for sleep disturbances. 

Pregnant women and those planning to get pregnant should avoid tramadol—clinical studies suggest that the drug increases the potential risk of birth defects.

Elderly patients (65+) should approach this medication with caution—studies suggest that tramadol increases the risk of accidental falls and injury.

Individuals with the following conditions shouldn’t use this medication unless advised otherwise by their doctors:

  • Asthma or breathing problems
  • Recent MAO inhibitor treatment
  • Patients under 12 
  • Patients under 18 who recently had surgery to remove adenoids or tonsils
  • Lung disease
  • Obstructive sleep apnea 
  • Obesity

Consult your healthcare provider for more details on the conditions that may prevent you from being a candidate for tramadol.

Cyclobenzaprine for Sleep—Who Should and Shouldn’t Use It?

Cyclobenzaprine is generally safe for adults (18+) grappling with sleep onset and retention insomnia. Still, the drug isn’t suitable for everyone. Individuals with the following conditions should avoid using it:

  • Hyperthyroidism
  • Heart disease
  • Recent MAO inhibitors treatment
  • Liver disease
  • Recent heart attack
  • Patients under 15

Pregnant women should only use the medication if the potential benefits outweigh the risks and only during the initial stages—clinical studies show that using cyclobenzaprine in late pregnancy enhances the risk of birth defects. 

Patients over 65 should consult their doctors before using this medication—muscle relaxants carry the risk of side effects like accidental falls and injury to this group of patients.

Talk to your healthcare provider if you have any medical condition so that they can design safe and effective treatment for your insomnia. 

Tramadol vs. Cyclobenzaprine—Potential Interactions With Other Substances

Cyclobenzaprine and tramadol can interact with other medications and food, increasing the risk of side effects or reducing the drugs’ effectiveness. Here’s a roundup of the potential interactions between tramadol and cyclobenzaprine and other substances:


Interaction With Tramadol

Interaction With Cyclobenzaprine


Can enhance the sedative effects, increasing risks of severe drowsiness and respiratory distress 

Can increase the risk of side effects like excessive drowsiness and confusion


Can contribute to the risk of side effects like dizziness, confusion, and dry mouth

Can enhance the risk of side effects like dry mouth, severe drowsiness, and serotonin syndrome

Anti-seizure medication (like gabapentin)

Can reduce both drugs’ potency, increasing risks of seizures and sleeplessness

Can reduce the potency of anti-seizure drugs

Blood pressure medication

Can contribute to the risk of blood pressure changes

Can raise the risk of side effects like headaches, dizziness, and blood pressure changes

Infection and anti-inflammatory medications

The potential for interaction is low but can’t be ruled out

No interactions were found between cyclobenzaprine and antibiotics, but that doesn’t rule them out

Heart medication

Can contribute to the risk of irregular heartbeat

Can reduce the potency of heart medication

Anti-HIV drugs

Can increase the risk of side effects like drowsiness and dizziness

The potential for interaction is low but can’t be ruled out

Muscle relaxants

Can contribute to the risk of side effects like respiratory distress

Can raise the risk of side effects like drowsiness

Sleep or anxiety medications

Can enhance the risk of side effects like confusion, drowsiness, and dizziness

Can enhance the sedative effects, leading to severe drowsiness

Herbal supplements like St. John’s wort

Can increase the risk of developing serotonin syndrome

Can raise the risk of developing serotonin syndrome

Opioids and CNS depressants

Can contribute to the risk of severe side effects like addiction and excessive drowsiness

Can enhance the risk of side effects 

If your doctor decides you’re not the best candidate for tramadol or cyclobenzaprine, they may suggest these alternatives for sleep problems:

You should tell your doctor if you’re taking any supplements or medication so they can evaluate the potential interactions and prescribe the appropriate tramadol or cyclobenzaprine doses.

Featured image source: Ron Lach