methocarbamol (redirected from Robax)

methocarbamol /meth·o·car·ba·mol/ (meth″o-kahr´bah-mol) a skeletal muscle relaxant used in the treatment of painful musculoskeletal conditions.

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methocarbamol

[meth′əkär′bəmol]

a skeletal muscle relaxant.

indication It is prescribed in the relief of skeletal muscle spasm.

contraindications Renal dysfunction, central nervous system depression, or known hypersensitivity to this drug prohibits its use. Propylthiouracil is a better choice than methimazole for thyrotoxic crisis.

adverse effects Among the more serious adverse effects are hypotension and tachycardia. Drowsiness, dizziness, vertigo, and nausea may occur.

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relaxant [re-lak´sant]

1. causing relaxation.

2. an agent that causes relaxation.

muscle relaxant an agent that specifically aids in reducing muscle tension.

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methocarbamol,

n brand name: Carbacot, Delaxin, Robamol, Skelex;
drug class: skeletal muscle relaxant;
action: depresses multisynaptic pathways in the spinal cord;
uses: adjunct for relief of spasm and pain in musculoskeletal conditions.

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methocarbamol

a compound used as a skeletal muscle relaxant, particularly in dogs with intervertebral disk disease.

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methocarbamol

Methocarbamol (CA), Robaxin

Pharmacologic class: Autonomic nervous system agent

Therapeutic class: Skeletal muscle relaxant (centrally acting)

Pregnancy risk category C

Action

Unknown. Thought to depress central perception of pain without directly relaxing skeletal muscles or directly affecting motor endplate or motor nerves.

Availability

Injection: 100 mg/ml in 10-ml ampules, 100 mg/ml in 10-ml vials

Tablets: 500 mg, 750 mg

⊘Indications and dosages

➣ Adjunct in muscle spasms caused by acute, painful musculoskeletal conditions

Adults: Initially, 1.5 g P.O. q.i.d. (up to 8 g/day) for 2 to 3 days, then 4 to 4.5 g/day P.O. in three to six divided doses; or 750 mg P.O. q 4 hours or 1 g P.O. q.i.d. or 1.5 g P.O. t.i.d. If oral dosing isn't feasible or if condition is severe, give 1 to 3 g/day I.M. or I.V. for maximum of 3 days.

Off-label uses

• Tetanus

Contraindications

• Hypersensitivity to drug, its components, or polyethylene glycol (with parenteral form)
• Renal impairment (with parenteral form)

Precautions

Use cautiously in:
• seizure disorders (with parenteral use)
• pregnant or breastfeeding patients
• children (safety not established).

Administration

• For direct I.V. injection, administer slowly. Keep patient supine for 10 to 15 minutes afterward.
• For I.V. infusion, dilute 1 g with up to 250 ml 5% dextrose or 0.9% sodium chloride injection.
• Avoid extravasation; drug is hypertonic.
• Don't give subcutaneously.
• For I.M. use, inject no more than 500 mg (5 ml of 10% injection) into each gluteal area.
• Don't use parenteral form in patients with renal impairment. Polyethylene glycol vehicle may irritate kidneys.
• When giving for tetanus, crush and suspend tablets in water or saline solution, and give via nasogastric tube, if necessary.
• Be aware that drug is usually given as part of regimen that includes rest and physical therapy.

Route	Onset	Peak	Duration
P.O.	30 min	2 hr	Unknown
I.V.	Immediate	End of infusion	Unknown
I.M.	Unknown	Unknown	Unknown

Adverse reactions

CNS: dizziness, light-headedness, drowsiness, syncope, seizures (with I.V. use)

CV: bradycardia or hypotension (with I.V. use)

EENT: blurred vision, conjunctivitis, nasal congestion

GI: nausea, GI upset, anorexia

GU: brown, black, or green urine

Musculoskeletal: mild muscle incoordination (with I.V. or I.M. use)

Skin: flushing (with I.V. use), pruritus, rash, urticaria

Other: fever, pain at I.M. injection site, phlebitis at I.V. site, allergic reactions including anaphylaxis (with I.M. or I.V. use)

Interactions

Drug-drug. Antihistamines, CNS depressants (such as opioids, sedative-hypnotics): additive CNS depression

Drug-diagnostic tests. Urinary 5-hydroxyindoleacetic acid, urine vanillylmandelic acid: false elevations

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

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• Assess for orthostatic hypotension, especially with parenteral use. Keep patient supine for 10 to 15 minutes after I.V. administration.
☞ Watch for anaphylaxis after I.M. or I.V. administration.
☞ Stay alert for bradycardia and syncope after I.V. or I.M. dose. As needed and prescribed, give epinephrine, corticosteroids, or antihistamines.
• Monitor I.V. site frequently to prevent sloughing and thrombophlebitis.

Patient teaching

• Tell patient that drug may turn urine brown, black, or green.
• Caution patient to avoid driving and other hazardous activities, because drug may cause drowsiness or dizziness.
• Instruct patient to move slowly when changing position, to avoid dizziness from sudden blood pressure decrease.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.