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Some common muscle relaxants are carisoprodol (Soma) and cyclobenzaprine (Flexeril).
SOURCES: National Sleep Foundation: “Sleepiness, Medication & Drugs: Why Your OTC Medications and Prescription Drugs Might Make You Tired.”National Institute of Mental Health: “Brain Basics.”FDA: “Caution: Some Over-the-Counter Medicines May Affect Your Driving.”National Capital Poison Center: “Antihistamines: Using Them Safely.”Mayo Clinic: “Tricyclic Antidepressants and Tetracyclic Antidepressants.”County of San Mateo Health System: “Benzodiazepines.”American Heart Association: “Types of Blood Pressure Medications.”American Cancer Society: “What Causes Cancer-related Fatigue?
Worse yet, the prescriptions are generally refilled and renewed without question.
Plus, combining cyclobenzaprine with opioids isn’t a pretty picture, considering the sedation associated with this drug class.
This phenomenon has been demonstrated in multiple placebo-controlled studies that showed no improvement in pain beyond 4 weeks with cyclobenzaprine compared with placebo.
Nevertheless, it’s commonplace for providers to prescribe cyclobenzaprine and for pharmacists to fill the prescription without question.
Cyclobenzaprine’s main role is for adjunct treatment for short-term use in acute musculoskeletal conditions, and evidence on benefit with long-term use is sorely lacking.
Non-specific low back pain without identifiable cause is typically acute and resolves within 4 weeks.
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Physiological changes in elderly patients and altered renal and hepatic function also play a role in exposure to such agents.
Metaxalone undergoes extensive hepatic metabolism, yielding active metabolites that are renally cleared, and it’s therefore contraindicated in patients with renal or hepatic impairment.
This article was collaboratively written with Mena Raouf, Pham D. Raouf received his Pharm D from Albany College of Pharmacy and Health Sciences, with a concentration in nephrology. Amrix (cyclobenzaprine hydrochloride) capsule, extended release [package insert].
He is currently pursuing a PGY-1 pharmacy practice residency at the VA Tennessee Valley Healthcare System.. North Wales, PA: Teva Pharmaceuticals USA, Inc.; 2013 Jun.
It’s important to note that not all skeletal muscle relaxants are created equal.