Skelaxin


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metaxalone

(me-tax -a-lone) ,

Skelaxin

(trade name)

Classification

Therapeutic: skeletal muscle relaxants
Pregnancy Category: UK

Indications

Muscle spasm associated with acute painful musculoskeletal conditions (with rest and physical therapy).

Action

Skeletal muscle relaxation, probably as a result of CNS depression.

Therapeutic effects

Skeletal muscle relaxation.

Pharmacokinetics

Absorption: Well absorbed following oral administration.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized by the liver; metabolites excreted in urine.
Half-life: 2–3 hr.

Time/action profile

ROUTEONSETPEAKDURATION
PO1 hr2 hr4–6 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Significant hepatic/renal impairment;History of drug-induced hemolytic anemia or other anemia.
Use Cautiously in: Hepatic impairment;History of seizures; Obstetric / Lactation / Pediatric: Pregnancy, lactation or children ≤12 yr (safety not established); Geriatric: Appears on Beers list. Poorly tolerated due to anticholinergic effects.

Adverse Reactions/Side Effects

Central nervous system

  • drowsiness (most frequent)
  • dizziness (most frequent)
  • confusion
  • headache
  • irritability
  • nervousness

Gastrointestinal

  • nausea (most frequent)
  • anorexia
  • dry mouth
  • GI upset
  • vomiting

Genitourinary

  • urinary retention

Interactions

Drug-Drug interaction

↑ CNS depression with other CNS depressants including alcohol, antihistamines, opioid analgesics, and sedative/hypnotics.Concomitant use of kava-kava, valerian, or chamomile can ↑ CNS depression.

Route/Dosage

Oral (Adults) 800 mg 3–4 times daily.

Availability (generic available)

Tablets: 800 mg Cost: Generic — $409.39 / 100

Nursing implications

Nursing assessment

  • Assess for pain, muscle stiffness, and range of motion before and periodically during therapy.
  • Geriatric: Assess geriatric patients for anticholinergic effects (sedation and weakness).
  • Lab Test Considerations: Monitor hepatic function tests closely in patients with pre-existing liver damage.
    • May cause false-positive Benedict’s tests.

Potential Nursing Diagnoses

Acute pain (Indications)
Impaired bed mobility (Indications)
Risk for injury (Side Effects)

Implementation

  • Provide safety measures as indicated. Supervise ambulation and transfer.
  • Oral: Administer 3–4 times daily.

Patient/Family Teaching

  • Instruct patient to take medication as directed. Take missed doses within 1 hr; if not, return to regular dosing schedule. Do not double doses.
  • Encourage patient to comply with additional therapies prescribed for muscle spasm (rest, physical therapy, heat).
  • Medication may cause dizziness, drowsiness, and blurred vision. Advise patient to avoid driving and other activities requiring alertness until response to drug is known.
  • Instruct patient to make position changes slowly to minimize orthostatic hypotension.
  • Advise patient to avoid concurrent use of alcohol and other CNS depressants while taking this medication.
  • Instruct patient to notify health care professional if skin rash or yellowish discoloration of the skin or eyes occurs.
  • Emphasize the importance of routine follow-up exams to monitor progress.

Evaluation/Desired Outcomes

  • Decreased musculoskeletal pain and muscle spasticity.
    • Increased range of motion.

Skelaxin™

A centrally acting muscle relaxant.
 
Adverse effects
Nausea, vomiting, gastrointestinal upset, drowsiness, dizziness, headache, irritability, rash, pruritus, leukopenia, haemolytic anaemia, jaundice.
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References in periodicals archive ?
If You Operate a Business and Indirectly Purchased Skelaxin for Resale, You Could be Affected by a Proposed Class Action Settlement .
Net sales of Sonata and Skelaxin in the United States were about $238 million in 2002, King said.
Elan had sued King after it withdrew from the agreed sale when US regulators began probing alleged patent irregularities over Skelaxin - the investigation was dropped earlier this month.
Sales of Skelaxin plunged to $5 million in the quarter from $102 million in the year-earlier period.
However, the US company indicated last week the sale might not go ahead after it emerged that regulators in the US were probing claims that Elan unfairly blocked genetic competition regarding Skelaxin.
June 11, 2014 /PRNewswire/ -- The following statement is being issued by the Law Offices of Gordon Ball and Hausfeld LLP regarding the Skelaxin Proposed Class Action Settlement.
The US Food and Drug Administration approved a supplemental new drug application for two new treatments - the 800 milligramme strength Skelaxin tablet and a new drug application for tizanidine hydrochloride in capsule form.
As a result of the approval and launch of generic forms of Skelaxin in April 2010, EDT's royalty revenue from this product has ended.
Chief executive officer Donal Geaney said its key products continued powerful performance with revenues for Skelaxin, 51 per cent, and Maxiprime 112 per cent.
This decline was due primarily to milestones received on approval of Ampyra and the supply of initial launch quantities in 2010, together with the impact of generic competition on sales of Skelaxin.
The increase was primarily due to sales of generic versions of Yaz, Cozaar, Hyzaar and Skelaxin launched in the second quarter 2010, as well as sales of new products launched late in 2009 and the first quarter 2010.
The increased gross margin principally reflects higher sales of Tysabri and the Ampyra launch, which more than offset lower revenues from Maxipime, Azactam, Skelaxin and Prialt.