Flexeril


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Flexeril

 [flek´sah-ril]
trademark for a preparation of cyclobenzaprine hydrochloride, a skeletal muscle relaxant.

cyclobenzaprine hydrochloride

Amrix, Apo-Cyclobenzaprine (CA), Dom-Cyclobenzaprine (CA), Fexmid, Flexeril, Novo-Cycloprine (CA) PHL-Cyclobenzaprine (CA), PMS-Cyclobenzaprine (CA), Ratio-Cyclobenzaprine (CA), Riva-Cyclobenzaprine (CA)

Pharmacologic class: Autonomic nervous system drug

Therapeutic class: Skeletal muscle relaxant (centrally acting)

Pregnancy risk category B

Action

Unclear. Thought to act primarily at brain stem (and to a lesser extent at spinal cord level) to relieve skeletal muscle spasms of local origin without altering muscle function.

Availability

Capsules (extended-release): 15 mg, 30 mg

Tablets: 5 mg, 7.5 mg, 10 mg

Indications and dosages

Adjunct to rest and physical therapy to relieve muscle spasm associated with acute, painful musculoskeletal conditions

Adults: 5 mg P.O. t.i.d. (immediate-release tablet). May increase to 10 mg P.O. t.i.d. (immediate-release tablet) as needed. Or, 15 mg (extended-release capsule) P.O. daily; some patients may need up to 30 mg/day, given as one 30-mg (extended-release capsule) P.O. daily or two 15-mg (extended-release capsules) P.O. daily.

Contraindications

• Hypersensitivity to drug
• Acute recovery phase after myocardial infarction (MI)
• Heart failure
• Arrhythmias
• Hyperthyroidism
• MAO inhibitor use within past 14 days

Precautions

Use cautiously in:
• cardiovascular disease, closed-angle glaucoma, hepatic impairment, increased intraocular pressure, urinary retention
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 15.

Administration

Don't give within 14 days of MAO inhibitor. Drug interaction may cause hypertensive crisis and severe seizures.
• Give extended-release capsule at approximately the same time each day.
• Know that drug shouldn't be used for more than 3 weeks.
• Be aware that drug may not be first-line agent for elderly patients because of its anticholinergic effects.

Adverse reactions

CNS: dizziness, drowsiness, syncope, confusion, fatigue, headache, nervousness, decreased mental acuity, irritability, weakness, insomnia, depression, disorientation, delusions, peripheral neuropathy, abnormal gait, Bell's palsy, EEG changes, extrapyramidal symptoms, cerebrovascular accident

CV: vasodilation, tachycardia, chest pain, hypotension, MI, heart block

EENT: blurred vision

GI: nausea, constipation, dyspepsia, swollen parotid glands, mouth inflammation, discolored tongue, dry mouth, paralytic ileus

GU: galactorrhea, urinary retention, urinary frequency, gynecomastia, testicular swelling, libido changes, erectile dysfunction

Hematologic: purpura, eosinophilia, bone marrow depression, leukopenia, thrombocytopenia

Metabolic: hyperglycemia, hypoglycemia, syndrome of inappropriate diuretic hormone secretion

Musculoskeletal: muscle ache

Respiratory: dyspnea

Skin: photosensitization, alopecia, angioedema

Other: unpleasant taste, weight gain or loss, edema

Interactions

Drug-drug.Anticholinergics, anti-cholinergic-like drugs (including anti-depressants, antihistamines, disopyramide, haloperidol, phenothiazines): additive anticholinergic effects

Antihistamines, CNS depressants, opioids, sedative-hypnotics: additive CNS depression

Guanadrel, guanethidine: reduction in or blockage of these drugs' actions

MAO inhibitors: hyperpyretic crisis, seizures, death

Drug-herbs.Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors.Alcohol use: increased CNS depression

Patient monitoring

• Assess for adverse CNS effects, such as drowsiness, dizziness, and decreased mental acuity.
• Monitor patient for evidence of drug interactions, especially when giving drug with CNS depressants.

Patient teaching

• Tell patient to take extended-release capsule at approximately the same time each day.
• Tell patient that drug may cause dry mouth.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, alertness, and vision.
• Advise patient not to use alcohol, sedatives, pain medications, over-the-counter preparations, or herbs without consulting prescriber.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

Flexeril

(flĕk′sə-rĭl′)
A trademark for the drug cyclobenzaprine hydrochloride.

Flexeril

a trademark for a muscle relaxant (cyclobenzaprine hydrochloride).

Patient discussion about Flexeril

Q. what are the side effects from taking soma and flexerill together? the person who takes it is almost comatos for a couple of hours. What is a substition?

A. Both medication cause drowsiness in high frequency and both are not recommended together with other medications that may cause drowsiness. However, I know practically nothing about the patient in this case, so in my opinion consulting his or her doctor may be wise - trying to solve this problem over the net is both inaccurate and irresponsible in my opinion,

Take care,

More discussions about Flexeril
References in periodicals archive ?
Toxicology results also found marijuana, Xanax, the muscle relaxant Flexeril and Benadryl in her body.
Worcester, charged with possession of cocaine with intent to distribute, continued without a finding for 18 months, ordered to undergo a drug evaluation with treatment and counseling as recommended by the Probation Department and to submit to random drug tests, $90 victim witness fee; possession of marijuana, found responsible, fined $100; speeding, found responsible, fined $100; trafficking in cocaine, possession of cocaine, possession of Valium, possession of Flexeril and extra-strength Tylenol, and conspiracy to violate a drug law, dismissed.
Other drugs were found in her bloodstream - including marijuana, Xanax, the muscle relaxant Flexeril, and the allergy medication Benadryl.
Worcester, charged with possession of marijuana, found responsible, fined $100; possession of cocaine, possession of Flexeril, and possession of sulfamethoxazole, dismissed.
charged with possession of amphetamines/methamphetamines with intent to distribute, possession of Flexeril, drug violation near a school or park, disorderly conduct, continued to Jan.
Worcester, charged with possession of cocaine with intent to distribute, trafficking in cocaine, possession of cocaine, possession of Valium, possession of marijuana, possession of Flexeril and extra strength Tylenol,
08 percent (second offense), placed on probation for two years, ordered to attend a 14-day in-patient program, two years license loss, $250 head injury fee, $50 victim's assessment fee, $50 victim witness fee; failing to wear a seat belt, found not responsible; speeding, found responsible, filed; possession of Viagra, possession of Xanax, possession of Motrin, possession of Flexeril, and driving negligently, dismissed.
Hartline, 25, of 41 Hemlock Drive, Millbury, charged with possession of Viagra, possession of Xanax, possession of Motrin, possession of Flexeril, driving under the influence of alcohol or .
Blackstone, charged with possession of Seroquel and larceny from a person, sentenced to two concurrent terms of 90 days in the House of Correction; and possession of Flexeril, dismissed.