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CYCLOBENZAPRINE


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Drug Uses

Cyclobenzaprine is a muscle relaxant, used to treat the pain and stiffness of muscle injuries, including strains, sprains and muscle spasms. The active ingredient in Cyclobenzaprine is cyclobenzaprine.

How Taken

Cyclobenzaprine comes in 10 mg tablets, and the normal dose in adults is one 10 mg tablet three times daily. You should not exceed a total dosage of 60 mg of Cyclobenzaprine per day. It might be taken with food if stomach upset occurs. Take Cyclobenzaprine as directed. Do not increase your dose or take it more often than prescribed.

Warnings/Precautions

Cyclobenzaprine may not be suitable for all individuals. If you have had any of the following conditions in the past, or are being treated for them now, please inform your doctor. In some cases side effects may be minimized by following your doctor's advice, but you may be advised not to take Cyclobenzaprine. Before taking this drug, tell your doctor if you have: glaucoma, an overactive thyroid gland, heart disease, difficulty urinating or any allergies. Inform your doctor if you are pregnant or breast-feeding before taking this drug.

Missed Dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Possible Side Effects

May cause stomach upset, heartburn, constipation, headache, dizziness or drowsiness or dry mouth the first few days as your body adjusts to the medication. If these symptoms persist or become severe, notify your doctor. Inform your doctor if you develop: muscle stiffness, skin rash, itching, rapid heart rate, swelling of the face, difficulty urinating. When rising quickly from a sitting or lying position, dizziness or lightheadedness may occur. Change positions slowly and use caution on stairs. Avoid activities requiring alertness if dizziness or drowsiness occurs. If you notice other effects not listed above, contact your doctor or pharmacist.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) and out of reach of children.

Overdose

The following symptoms indicate an overdose, get medical help immediately: difficulty breathing, extreme nervousness or restlessness, flushed skin, hallucination, racing or irregular heartbeat, seizure, shortness of breath, tiredness (extreme), unstable temperature, unusual muscle stiffness, vomiting (in combination with these other symptoms).

More Information

Cyclobenzaprine may have life-threatening interactions with MAO inhibitors. Cyclobenzaprine may enhance the effects of alcohol, barbiturates, and other CNS depressants.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.




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Origin of Muscle Spasm
Muscle spasm of local origin needs to be clinically differentiated from spasticity and sustained muscle contraction in the setting of the central nervous system (CNS) and upper motor neuron injury. Baclofen (Lioresal®) and dantrolene sodium (Dantrium®) are two agents whose use is indicated in the setting of spasticity of CNS etiology. Dantrolene sodium is of particular interest, as its mechanism of action is purely at the muscular level where it serves to inhibit the release of calcium form the sarcoplasmic reticulum.
Casale studied the effectiveness of dantrolene sodium, 25-mg daily, in the treatment of low back pain and found patients to demonstrate significant improvements in visual analogue scores, pain behavior, and electromyographic (EMG) evaluations of "antalgic reflex motor unit firing," when compared with the placebo group. The findings of this study are interesting in that they demonstrate improvement secondary to a pure muscle relaxant, which does not possess other outside anti-nociceptive properties.
Baclofen is a derivative of gamma-aminobutryic acid (GABA) and is believed to inhibit mono and polysynaptic reflexes at the spinal level. Treatment with baclofen was compared to placebo in a double blind, randomized study of 200 patients with acute low back pain. Patients with initially severe discomfort were found to benefit from baclofen, 30- to 80-mg daily, on days four and ten of follow up. Forty-nine percent of treatment patients complained of sleepiness, 38% of nausea, and 17% discontinued treatment.
Sedation: Side Effect
Sedation is the most commonly reported adverse effect of muscle relaxant medications. These drugs should be used with caution in patients driving motor vehicles or operating heavy machinery. More absolute contraindications do exist to the use of carisoprodol, cyclobenzaprine, and diazepam. Rare idiosyncratic reactions have also been reported to carisoprodol and its metabolites such as meprobamate. Benzodiazepines have potential for abuse and their use should be avoided. By initially prescribing muscle relaxants at bedtime, the physician might take advantage of their sedative effects and minimize daytime drowsiness.
These agents have been found to be effective when used either alone or in combination with an analgesic/anti-inflammatory agent within seven days of symptom onset. The prescribing physician should monitor patients receiving these medications and tailor dosages in an attempt to minimize the drowsiness and sedation often associated with their use. The use of benzodiazepines does not appear to offer any significant benefit to patients experiencing acute low back pain. Further research is needed before the role of baclofen and dantrolene sodium in the treatment of muscle spasm of local origin can be more clearly defined.

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