Caution/Monitor.haloperidolMonitor Closely (1)carisoprodol and haloperidol both increase sedation. Use Caution/Monitor.hydrocodoneSerious - Use Alternative (1)hydrocodone, carisoprodol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.hydromorphoneMonitor Closely (1)carisoprodol and hydromorphone both increase sedation. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine and carisoprodol both increase sedation. Use Caution/Monitor.iloperidoneMonitor Closely (1)carisoprodol and iloperidone both increase sedation. Use Caution/Monitor.imipramineMonitor Closely (1)carisoprodol and imipramine both increase sedation. Use Caution/Monitor.incobotulinumtoxinAMonitor Closely (1)carisoprodol, incobotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Muscle relaxants may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.ketamineMonitor Closely (1)ketamine and carisoprodol both increase sedation. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)carisoprodol and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.lasmiditanMonitor Closely (1)lasmiditan, carisoprodol. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.lemborexantMonitor Closely (1)lemborexant, carisoprodol. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.levorphanolMonitor Closely (1)carisoprodol and levorphanol both increase sedation. Use Caution/Monitor.lofepramineMonitor Closely (1)carisoprodol and lofepramine both increase sedation. Use Caution/Monitor.lofexidineMonitor Closely (1)carisoprodol and lofexidine both increase sedation. Use Caution/Monitor.lonafarnibSerious - Use Alternative (1)lonafarnib will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C19 metabolism. Avoid or Use Alternate Drug. Lonafarnib may increase the AUC and peak concentration of CYP2C19 substrates. If coadministration unavoidable, monitor for adverse reactions and reduce the CYP2C19 substrate dose in accordance with its approved product labeling.loprazolamMonitor Closely (1)loprazolam and carisoprodol both increase sedation. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam and carisoprodol both increase sedation. Use Caution/Monitor.lormetazepamMonitor Closely (1)lormetazepam and carisoprodol both increase sedation. Use Caution/Monitor.loxapineMonitor Closely (1)carisoprodol and loxapine both increase sedation. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)carisoprodol and loxapine inhaled both increase sedation. Use Caution/Monitor.lumacaftor/ivacaftorMonitor Closely (1)lumacaftor/ivacaftor, carisoprodol. affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. In vitro studies suggest that lumacaftor may induce and ivacaftor may inhibit CYP2C19 substrates. .lurasidoneMonitor Closely (1)lurasidone, carisoprodol. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.maprotilineMonitor Closely (1)carisoprodol and maprotiline both increase sedation. Use Caution/Monitor.marijuanaMonitor Closely (1)carisoprodol and marijuana both increase sedation. Use Caution/Monitor.melatoninMonitor Closely (1)carisoprodol and melatonin both increase sedation. Use Caution/Monitor.meperidineMonitor Closely (1)carisoprodol and meperidine both increase sedation. Use Caution/Monitor.meprobamateMonitor Closely (1)carisoprodol and meprobamate both increase sedation. Use Caution/Monitor.metaxaloneMonitor Closely (1)carisoprodol and metaxalone both increase sedation. Use Caution/Monitor.methadoneMonitor Closely (1)carisoprodol and methadone both increase sedation. Use Caution/Monitor.methocarbamolMonitor Closely (1)carisoprodol and methocarbamol both increase sedation. Use Caution/Monitor.methylenedioxymethamphetamineMonitor Closely (1)carisoprodol increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metoclopramide intranasalSerious - Use Alternative (1)carisoprodol, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.midazolamMonitor Closely (1)midazolam and carisoprodol both increase sedation. Use Caution/Monitor.midazolam intranasalMonitor Closely (1)midazolam intranasal, carisoprodol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.mirtazapineMonitor Closely (1)carisoprodol and mirtazapine both increase sedation. Use Caution/Monitor.morphineMonitor Closely (1)carisoprodol and morphine both increase sedation. Use Caution/Monitor.motherwortMonitor Closely (1)carisoprodol and motherwort both increase sedation. Use Caution/Monitor.moxonidineMonitor Closely (1)carisoprodol and moxonidine both increase sedation. Use Caution/Monitor.nabiloneMonitor Closely (1)carisoprodol and nabilone both increase sedation. Use Caution/Monitor.nalbuphineMonitor Closely (1)carisoprodol and nalbuphine both increase sedation. Use Caution/Monitor.nortriptylineMonitor Closely (1)carisoprodol and nortriptyline both increase sedation. Use Caution/Monitor.olanzapineMonitor Closely (1)carisoprodol and olanzapine both increase sedation. Use Caution/Monitor.oliceridineMonitor Closely (2)oliceridine, carisoprodol. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation. carisoprodol increases toxicity of oliceridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.olopatadine intranasalSerious - Use Alternative (1)carisoprodol and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment. ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC)Monitor Closely (1)ombitasvir/paritaprevir/ritonavir & dasabuvir (DSC) decreases effects of carisoprodol by unspecified interaction mechanism. Modify Therapy/Monitor Closely. Increase dose if clinically indicated.opium tinctureMonitor Closely (1)carisoprodol and opium tincture both increase sedation. Use Caution/Monitor.orphenadrineMonitor Closely (1)carisoprodol and orphenadrine both increase sedation. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam and carisoprodol both increase sedation. Use Caution/Monitor.oxycodoneMonitor Closely (1)carisoprodol and oxycodone both increase sedation. Use Caution/Monitor.oxymorphoneMonitor Closely (1)carisoprodol and oxymorphone both increase sedation. Use Caution/Monitor.paliperidoneMonitor Closely (1)carisoprodol and paliperidone both increase sedation. Use Caution/Monitor.papaveretumMonitor Closely (1)carisoprodol and papaveretum both increase sedation. Use Caution/Monitor.papaverineMonitor Closely (1)carisoprodol and papaverine both increase sedation. Use Caution/Monitor.pentazocineMonitor Closely (1)carisoprodol and pentazocine both increase sedation. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital and carisoprodol both increase sedation. Use Caution/Monitor.perphenazineMonitor Closely (1)carisoprodol and perphenazine both increase sedation. Use Caution/Monitor.phenobarbitalMonitor Closely (1)phenobarbital and carisoprodol both increase sedation. Use Caution/Monitor.phenylephrine POMonitor Closely (1)carisoprodol increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .pholcodineMonitor Closely (1)carisoprodol and pholcodine both increase sedation. Use Caution/Monitor.pimozideMonitor Closely (1)carisoprodol and pimozide both increase sedation. Use Caution/Monitor.prabotulinumtoxinAMonitor Closely (1)carisoprodol increases effects of prabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Muscle relaxants may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.primidoneMonitor Closely (1)primidone and carisoprodol both increase sedation. Use Caution/Monitor.prochlorperazineMonitor Closely (1)carisoprodol and prochlorperazine both increase sedation. Use Caution/Monitor.promethazineMonitor Closely (1)promethazine and carisoprodol both increase sedation. Use Caution/Monitor.propofolMonitor Closely (1)propofol and carisoprodol both increase sedation. Use Caution/Monitor.propylhexedrineMonitor Closely (1)carisoprodol increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.protriptylineMonitor Closely (1)carisoprodol and protriptyline both increase sedation. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam and carisoprodol both increase sedation. Use Caution/Monitor.quetiapineMonitor Closely (1)carisoprodol and quetiapine both increase sedation. Use Caution/Monitor.ramelteonMonitor Closely (1)carisoprodol and ramelteon both increase sedation. Use Caution/Monitor.remimazolamMonitor Closely (1)remimazolam, carisoprodol. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.risperidoneMonitor Closely (1)carisoprodol and risperidone both increase sedation. Use Caution/Monitor.rucaparibMonitor Closely (1)rucaparib will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C19 substrates, if clinically indicated.sageMinor (1)carisoprodol and sage both increase sedation. Minor/Significance Unknown.scullcapMonitor Closely (1)carisoprodol and scullcap both increase sedation. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital and carisoprodol both increase sedation. Use Caution/Monitor.selinexorSerious - Use Alternative (1)selinexor, carisoprodol. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.shepherd's purseMonitor Closely (1)carisoprodol and shepherd's purse both increase sedation. Use Caution/Monitor.sodium oxybateSerious - Use Alternative (1)carisoprodol, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.sparsentanMonitor Closely (1)sparsentan will decrease the level or effect of carisoprodol by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Sparsentan (a CYP2C19 inducer) decreases exposure of CYP2C19 substrates and reduces efficacy related to these substrates. stiripentolMonitor Closely (2)stiripentol, carisoprodol. Either increases effects of the other by sedation. Use Caution/Monitor. Concurrent use of medications with CNS depressant effects together with thalidomide should be avoided due to the risk for additive sedative effects. stiripentol will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of CYP2C19 substrates, if adverse reactions are experienced when administered concomitantly with stiripentol.sufentanilMonitor Closely (1)carisoprodol and sufentanil both increase sedation. Use Caution/Monitor.sufentanil SLSerious - Use Alternative (1)sufentanil SL, carisoprodol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.tapentadolMonitor Closely (1)carisoprodol and tapentadol both increase sedation. Use Caution/Monitor.tecovirimatMonitor Closely (1)tecovirimat will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C19 metabolism. Use Caution/Monitor. Tecovirimat is a weak inhibitor of CYP2C8 and CYP2C19. Monitor for adverse effects if coadministered with sensitive substrates of these enzymes.temazepamMonitor Closely (1)temazepam and carisoprodol both increase sedation. Use Caution/Monitor.thioridazineMonitor Closely (1)carisoprodol and thioridazine both increase sedation. Use Caution/Monitor.thiothixeneMonitor Closely (1)carisoprodol and thiothixene both increase sedation. Use Caution/Monitor.topiramateMonitor Closely (1)carisoprodol and topiramate both increase sedation. Modify Therapy/Monitor Closely.tramadolMonitor Closely (1)carisoprodol and tramadol both increase sedation. Use Caution/Monitor.trazodoneMonitor Closely (1)carisoprodol and trazodone both increase sedation. Use Caution/Monitor.triazolamMonitor Closely (1)triazolam and carisoprodol both increase sedation. Use Caution/Monitor.triclabendazoleMonitor Closely (1)triclabendazole will increase the level or effect of carisoprodol by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. If plasma concentrations of the CYP2C19 substrates are elevated during triclabendazole, recheck plasma concentration of the CYP2C19 substrates after discontinuation of triclabendazole. triclofosMonitor Closely (1)triclofos and carisoprodol both increase sedation. Use Caution/Monitor.trifluoperazineMonitor Closely (1)carisoprodol and trifluoperazine both increase sedation. Use Caution/Monitor.trimipramineMonitor Closely (1)carisoprodol and trimipramine both increase sedation. Use Caution/Monitor.xylometazolineMonitor Closely (1)carisoprodol increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziconotideMonitor Closely (1)carisoprodol and ziconotide both increase sedation. Use Caution/Monitor.ziprasidoneMonitor Closely (1)carisoprodol and ziprasidone both increase sedation. Use Caution/Monitor.zotepineMonitor Closely (1)carisoprodol and zotepine both increase sedation. Use Caution/Monitor. >10% Drowsiness (13-17%) 1-10% Dizziness (7-8%) Headache (3-5%) Frequency Not Defined Orthostatic hypotension Syncope Tachycardia Agitation Irritability Depression Allergic/idiosyncratic reactions (pruritus, rash, dizziness, etc) Epigastric distress N/V Facial flushing Weakness Contraindications Hypersensitivity to carisoprodol, meprobamate, mebutamate, tybamate History of acute intermittent porphyria Cautions Caution in hepatic/renal impairment May cause CNS depression; use caution when performing tasks which require mental alertness (eg, operating heavy machinery); sedating effects potentiated when used with other CNS-depressant drugs or ethanol Severe weakness may occur Seizures reported with its use in patients with or without seizure history Risk of allergic reactions Use caution in patients with history of drug abuse or acute alcoholism; drug dependency may occur and withdrawal symptoms experienced with abrupt cessation, especially with long-term use; limit use to 2-3 weeks Pregnancy Data over many decades of use of drug in pregnancy have not identified drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes; data on meprobamate, the primary metabolite of carisoprodol, do not show consistent association between maternal use and increased risk of major birth defects Animal data In a published animal reproduction study, pregnant mice administered carisoprodol orally at 2.6- and 4.1-times maximum recommended human dose of 1400 mg per day [350 mg QID] based on body surface area comparison) from gestation through weaning resulted in reduced fetal weights, postnatal weight gain, and postnatal survival Lactation Data from published literature report that carisoprodol and its metabolite, meprobamate, are present in breastmilk; there are no data on effect on milk production; there is one report of sedation in an infant who was breastfed by a mother taking carisoprodol; because there have been no consistent reports of adverse events in breastfed infants over decades of use, the developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant or from underlying maternal condition; infants exposed to drug through breast milk should be monitored for sedationPregnancy Categories A: Generally acceptable. Controlled