II. Precautions
- Schedule IV drug in U.S. as of January 2012
- Risk of transient neurologic changes, serious Allergic Reactions, Substance Abuse, and fatal Overdoses
- Metabolized to Meprobamate, a Sedative and FDA controlled substance similar to Barbiturates
- Two tablets (700 mg dose) may require Endotracheal Intubation in infants
III. Mechanism
- Carisoprodol is a centrally acting Skeletal Muscle Relaxant
-
Meprobamate is primary active metabolite
- Barbiturate-like effects at GABA-A receptors
IV. Dosing
- Carisoprodol (Soma) 350 mg up to four times daily
V. Pharmacokinetics
- Rapid absorption
- Rapid onset
- Drug Clearance (variable)
- Half-Life: 100 minutes
- Hepatic metabolism: CYP2C19
- Renal Excretion
VI. Adverse Effects: Toxicity or Overdose
- Myoclonic encephalopathy (abnormal movements)
- Agitation
- Lethargy to coma (Meprobamate related)
- Seizures (rare)
- Cardiopulmonary depression (apnea, Acute Heart Failure)
- Withdrawal symptoms (e.g. Delirium) after cessation
VII. Labs: Toxicity
- See Unknown Ingestion
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (Chem18)
- Creatinine Kinase (CK)
VIII. Diagnostics: Toxicity
- Electrocardiogram (EKG)
- Consider CT Head, Electroencephalogram (EEG)
IX. Management: Toxicity
- Supportive Care
- ABC Management
- Endotracheal Intubation as indicated
- Gastric Decontamination is not typically indicated
- Sedation for Agitation, rigidity
- Antidotes
- May consider Flumazenil (but risk of severe withdrawal if concurrent Benzodiazepine Abuse)
- Roberge (2000) J Emerg Med 18(1):61-4 +PMID: 10645840 [PubMed]
X. References
- Sun and Tomaszewski (2017) Crit Dec Emerg Med 31(12): 24
- Høiseth (2008) Clin Toxicol 46(4):307-9 +PMID: 18363125
Images: Related links to external sites (from Bing)
Related Studies
| carisoprodol (on 6/7/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CARISOPRODOL 250 MG TABLET | Generic | $1.84 each |
| CARISOPRODOL 350 MG TABLET | Generic | $0.07 each |
| soma (on 10/19/2016 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| SOMA 350 MG TABLET | Generic | $0.07 each |
Ontology: Carisoprodol (C0007248)
| Definition (NCI) | A synthetic propanediol dicarbamate derivative and an adjunct in the treatment of painful muscle spasms, Carisoprodol is a centrally acting skeletal muscle relaxant that relieves stiffness, pain, and discomfort caused by muscle injuries. Its mechanism of action is not clear yet; perhaps due to its sedative actions. (NCI04) |
| Definition (MSH) | A centrally acting skeletal muscle relaxant whose mechanism of action is not completely understood but may be related to its sedative actions. It is used as an adjunct in the symptomatic treatment of musculoskeletal conditions associated with painful muscle spasm. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1202) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D002328 |
| SnomedCT | 25076002, 387133006 |
| LNC | LP14985-3, MTHU002288 |
| English | Carisoprodate, Carisoprodol, Isobamate, Isomeprobamate, Isopropylmeprobamate, Carbamic acid, (1-methylethyl)-, 2-(((aminocarbonyl)oxy)methyl)-2-methylpentyl ester, carisoprodol, muscle relaxants skeletal carisoprodol, carisoprodol (medication), CARISOPRODOL, Carisoprodol [Chemical/Ingredient], isopropylmeprobamate, Carisoprodol (product), Carisoprodol (substance) |
| Swedish | Karisoprodol |
| Czech | karisoprodol |
| Finnish | Karisoprodoli |
| Italian | Isobamato, Carisoprodato, Isomeprobamato, Isopropilmeprobamato, Carisoprodolo |
| Russian | IZMEPROBAMAT, IZOPROPILMEPROBAMAT, IZOPROPAN, KARIZOPRODAT, IZOBAMAT, SKUTAMIL, KARIZOPRODOL, ИЗМЕПРОБАМАТ, ИЗОБАМАТ, ИЗОПРОПАН, ИЗОПРОПИЛМЕПРОБАМАТ, КАРИЗОПРОДАТ, КАРИЗОПРОДОЛ, СКУТАМИЛ |
| Polish | Soma, Karizoprodol |
| Japanese | イソバメート, イソプロピルメプロバメート, イソメプロバメート, カリソプロデート, カリソプロドール |
| Spanish | carisoprodato, carisoprodol (producto), carisoprodol (sustancia), carisoprodol, isobamato, isopropilmeprobamato, Carisoprodato, Carisoprodol, Isobamato, Isomeprobamato, Isopropilmeprobamatos |
| French | Carisoprodol |
| German | Carisoprodat, Carisoprodol, Isobamat, Isomeprobamat, Isopropylmeprobamat |
| Portuguese | Carisoprodato, Carisoprodol, Isobamato, Isomeprobamato, Isopropilmeprobamato |
