Introduction
- Generic Name: Cyclobenzaprine
- Brand Names: Flexeril, Amrix, Fexmid
- Pharmacological Class: Muscle relaxant, tricyclic antidepressant derivative
- Mechanism of Action: Acts at the brain stem to reduce tonic somatic motor activity, influencing both gamma and alpha motor systems.
Indications
- Primary Use: Management of muscle spasms associated with acute painful musculoskeletal conditions.
- Off-Label Use: Sometimes prescribed for fibromyalgia as a sleep aid and muscle relaxant.
Dosage
- Adults: Typically, 5 mg to 10 mg three times a day. Dosage adjustments based on response and tolerance.
- Elderly: Start at a lower dose to decrease the likelihood of side effects. Careful monitoring recommended.
- Children: Use is not recommended in children under 15 due to a lack of safety data.
Administration
- Method: Oral intake, with or without food, to avoid gastrointestinal upset.
- Precautions: Ensure proper timing of doses to maintain effective relief throughout the day.
Forms Available
- Immediate Release Tablets: 5 mg, 7.5 mg, 10 mg
- Extended Release Capsules: 15 mg, 30 mg, allowing for once-daily dosing in some patients.
Side Effects
- Common: Drowsiness, dry mouth, and dizziness, affecting daily activities.
- Less Common: Blurred vision, confusion, fatigue, which may diminish over time.
- Rare but Serious: Severe cardiac events, hepatic impairment, potentially life-threatening serotonin syndrome.
Warnings
- Black Box Warnings: The risk of significant cardiac events from overdose.
- Contraindications: Marked by contraindications including recent myocardial infarction and acute recovery phase of heart attacks.
Precautions
- General: Monitor for signs of urinary retention and angle-closure glaucoma.
- Health Conditions: Particular care is needed in those with a history of cardiac conditions or hyperthyroidism.
Interactions
- Medications: Enhanced sedation with CNS depressants, potential severe interactions with MAO inhibitors.
- Food: No significant food interactions, but caution advised with alcohol.
Monitoring Parameters
- Vital Signs: Regular monitoring of blood pressure and heart rate recommended.
- Blood Tests: Liver function tests and periodic blood counts are advisable.
Use in Children
- Guidelines: Not approved for anyone under 15; limited data on safety and efficacy.
Use in Pregnancy
- FDA Category: B. Animal studies have not demonstrated a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women.
Use in Elderly
- Considerations: Greater frequency of hepatic, renal, or cardiac impairment may necessitate dose adjustments.
Use in Kidney Disease
- Adjustments: Usually not required, but monitor for increased drug effects or side effects.
Use in Liver Disease
- Caution: Significant alterations in dosage may be needed depending on liver function.
Patient Counselling Points
- Instructions: Take medication exactly as prescribed to minimize risk of side effects.
- Side Effects: Encourage reporting of all side effects, especially those that are severe or persistent.
- Lifestyle: Discuss potential impacts on daily living and operating machinery.
Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|
Flexeril | Merck & Co. | 10 mg Tablet | $2.00 |
Amrix | Teva Pharmaceuticals | 30 mg Capsule ER | $8.00 |
Fexmid | Cipla | 7.5 mg Tablet | $1.50 |
15 FAQs with Answers
- What is Cyclobenzaprine used for? – To alleviate muscle spasms in acute musculoskeletal conditions.
- Can Cyclobenzaprine be used by children? – Not recommended for use in children under 15 years of age.
- How should I take Cyclobenzaprine? – Take orally, can be with or without food to reduce stomach upset.
- What are the common side effects? – Includes drowsiness, dry mouth, and dizziness.
- Is Cyclobenzaprine safe during pregnancy? – Considered Category B, but always consult a healthcare provider.
- Can Cyclobenzaprine be combined with alcohol? – Alcohol may enhance drowsiness and dizziness; avoid.
- What is the recommended duration for taking Cyclobenzaprine? – Generally limited to short-term use, typically no longer than 2-3 weeks.
- What should I avoid while taking Cyclobenzaprine? – Avoid driving or operating heavy machinery if feeling drowsy.
- What are signs of an overdose of Cyclobenzaprine? – Extreme drowsiness, rapid heartbeat, confusion are indicators.
- Is Cyclobenzaprine addictive? – It’s not considered addictive, but it can cause dependence if used long-term.
- Should I stop taking Cyclobenzaprine suddenly? – Consult with your healthcare provider before stopping to discuss tapering.
- What are the rare but serious side effects of Cyclobenzaprine? – Includes severe cardiac issues and serotonin syndrome.
- What other medications interact with Cyclobenzaprine? – Interacts significantly with other CNS depressants and MAO inhibitors.
- Who should not take Cyclobenzaprine? – Individuals with recent myocardial infarction, untreated glaucoma, or severe liver impairment.
- How does Cyclobenzaprine work to relieve muscle spasms? – It acts on the central nervous system to block nerve impulses.