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Skeletal Muscle RelaxantAka: Antispasmodic Muscle Relaxant

See Also
1. Antispastic Muscle Relaxant
2. Cyclobenzaprine (Flexeril)
Indications
Efficacy
1. More effective than Placebo, but less effective than first-line agents such as NSAIDs
Agents: Preferred
1. Cyclobenzaprine (Flexeril) 5 mg orally at bedtime up to three times daily
  1. Still expensive despite generic
  2. Best studied of all antispasmodic agents
2. Methocarbamol (Robaxin) 750 to 1500 mg four times daily
  1. Significantly less expensive than Flexeril
  2. Warn about Urine Color change
Agents: Higher risk of Adverse Effects
1. Chlorzoxazone (Parafon Forte) 250-750 mg 3-4 times daily
  1. Risk of liver abnormalities and GI upset
2. Metaxalone (Skelaxin) 800 mg 3-4 times daily
  1. Risk of liver, hematologic abnormalities and GI upset
3. Orphenadrine (Norflex) 100 mg twice daily
  1. Risk of tachycardia, hematologic abnormalities and GI upset
4. Tizanidine (Zanaflex) 4 mg orally every 6-8 hours (maximum 36 mg/day)
  1. Risk of hepatotoxicity and Blood Pressure changes
Agents: Higher risk of dependence
1. Carisoprodol (Soma) 350 mg up to four times daily
  1. Risk of transient neurologic changes, serious Allergic Reactions
2. Diazepam (Valium) 2-10 mg orally 3-4 times daily
References

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This page was written by Scott Moses, MD. This page was last revised on 10/17/2008 10:16:13 PM. This page was last published on 8/14/2009. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.