From the Guidelines
Combining muscle relaxers with alcohol is dangerous and can potentially affect blood pressure, and it is recommended to limit alcohol intake to no more than 2 standard drinks per day for men and 1 standard drink per day for women to minimize the risk of hypertension and other cardiovascular complications. While muscle relaxers alone don't typically cause hypertension, mixing them with alcohol can lead to enhanced central nervous system depression, which may cause blood pressure fluctuations including hypotension (low blood pressure) rather than hypertension. Common muscle relaxers like cyclobenzaprine (Flexeril), baclofen, and carisoprodol (Soma) can interact dangerously with alcohol, increasing side effects like dizziness, drowsiness, and impaired coordination 1. This combination can also strain the liver, as both substances require liver metabolism. The cardiovascular effects occur because both substances can affect blood vessel dilation and heart rate regulation. Some people might experience a temporary spike in blood pressure as their body responds to the stress of processing these substances together, though the more common immediate effect is blood pressure reduction.
According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults, adult men and women with elevated BP or hypertension who currently consume alcohol should be advised to drink no more than 2 and 1 standard drinks per day, respectively 1. The relationship between alcohol consumption and hypertension is well-established, with studies showing that regular alcohol use raises BP in treated hypertensive subjects 1. Additionally, daily intake of more than moderate amounts of alcoholic beverages is a clear risk factor for the development of hypertension, and patients who are hypertensive should avoid alcoholic beverages 1.
Key points to consider:
- Limit alcohol intake to minimize the risk of hypertension and other cardiovascular complications
- Avoid combining muscle relaxers with alcohol due to the risk of enhanced central nervous system depression and other adverse effects
- Be aware of the potential for blood pressure fluctuations when combining muscle relaxers with alcohol
- Follow the recommended guidelines for alcohol consumption, which is no more than 2 standard drinks per day for men and 1 standard drink per day for women 1.
From the FDA Drug Label
The most common effects associated with cyclobenzaprine overdose are drowsiness and tachycardia Less frequent manifestations include tremor, agitation, coma, ataxia, hypertension, slurred speech, confusion, dizziness, nausea, vomiting, and hallucinations. Cyclobenzaprine may enhance the effects of alcohol, barbiturates, and other CNS depressants.
Taking muscle relaxers, such as cyclobenzaprine, and drinking alcohol may cause hypertension (high blood pressure) as a less frequent manifestation of overdose. However, it is essential to note that this information is related to overdose situations, and the direct interaction between muscle relaxers, alcohol, and hypertension in normal dosage is not explicitly stated.
- Key points:
From the Research
Interaction between Muscle Relaxers and Alcohol
- The interaction between muscle relaxers and alcohol can have various effects on blood pressure, but there is limited direct evidence on whether this combination causes hypertension 3, 4.
- Studies suggest that muscle relaxants can be used in conjunction with other central nervous system depressants, such as alcohol, which may lead to adverse effects like respiratory depression and coma 3.
- However, there is no clear indication that this combination directly causes high blood pressure.
Effects of Muscle Relaxers on Blood Pressure
- Some research indicates that muscle relaxation techniques may have a slight effect on lowering blood pressure in hypertensive patients, although the evidence is not conclusive 5, 6.
- A study on tizanidine, a muscle relaxant, found that it can lower blood pressure, and co-prescription with strong CYP1A2 inhibitors increases the risk of hypotension 7.
Impact of Alcohol on Blood Pressure
- Alcohol consumption is known to affect blood pressure, and reducing alcohol intake can help lower blood pressure in both hypertensive and normotensive individuals 4.
- The Canadian low-risk drinking guidelines recommend limiting alcohol consumption to 2 or fewer standard drinks per day to reduce the risk of hypertension 4.