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.

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 ?
Cyclobenzaprine Watson Laboratories Flexeril tablets
A muscle relaxant called cyclobenzaprine (Flexeril) may temporarily help to improve sleep and reduce pain.
"It used to be that if you were 65 or 70 [years old] and came to the ED with back pain, everyone walked out of there with Flexeril [cyclobenzaprine] or some variant thereof.
Traces of the drug were found in her system plus marijuana, anxiety pills Xanax, muscle relaxant Flexeril, allergy medicine Benadryl and painkiller Ibuprofen.
Breckenridge markets additional ANDA products, including estradiol/norethindrone acetate tablets 1 mg/0.5 mg (generic version of Activella); oxcarbazepine tablets (generic version of Trileptal); meloxicam tablets (generic version of Mobic); Ascomp w/ codeine (generic version of Fiorinal with codeine); butalbital, acetaminophen, caffeine and codeine phosphate (generic version of Fioricet with codeine); cyclobenzaprine (generic version of Flexeril); methylprednisolone (generic version of Medrol); polyethylene glycol powder (generic version of Miralax); folic acid tablets; and Vitamin D capsules (generic of Drisdol).
Bowler, 25, of 35 School St., Winchendon, charged with possession of Flexeril, possession of omeprazole, possession of etodolac, and possession of doxycycline hyclate, sentenced to four concurrent terms of 60 days in the House of Correction; and shoplifting, filed with a guilty finding.
* Treatment includes medications that can improve sleep as well as relieve pain, such as prega-balin (Lyrica) and gabapentin (Neurontin), which block overactivity of nerve cells involved in pain transmission, and cyclobenzaprine (Flexeril) and amitriptyline (Elavil).
(52) Smoking, sex within twenty-four hours of the vaginal examination, frequent sex, and tricyclic anti-depressants or other medications with properties similar to them, such as Flexeril, all could cause diffuse edema of the vaginal walls.
Muscle relaxant, cyclobenzaprine (Flexeril) to improve sleep and reduce pain and muscle spasms.
Cyclobenzaprine (Flexeril) improves both pain and sleep quality (SOR: A, based on a systematic review of RCTs).
Other commonly used and helpful nonspecific treatments include urinary analgesics to reduce bladder pain such as phenazopyridine hydrochloride (Pyridium), anticholinergic/antispasmodic therapies (Ditropan, Detrol, Levbid) to decrease frequency and urgency, and on occasion muscle relaxants such as Valium and Flexeril to reduce pelvic floor muscle spasticity.
Flexeril (cyclobenzaprine) is now approved in a 5-mg tablet dose for use as an adjunct to rest and physical therapy for the relief of muscle spasm associated with acute, painful, musculoskeletal conditions.