Muscle Relaxants

Generic Name

Brand name

Dosage

Side-effects

Comments

methocarbamol

Robaxin, Robaxin-750, Robaxisal,

(methocarbamol 400 plus aspirin 325)

500 mg two tablets qid or 750 mg one or two tid.  Can take 6 gm initially per day and then cut back to 4 gm per day for maintenance.  Robaxisal may be taken two tablets qid

Central nervous system side-effects with drowsiness, dizziness, headache, blurred vision, light-headedness.  May also have some stomach upset with nausea.  May get skin rash or hives.  With Robaxisal may have side-effects from the aspirin component with gastrointestinal upset or burning, also allergic reactions to aspirin

Robaxin and Robaxisal represent a milder muscle relaxant for minor musculoskeletal spasm or in patients who are intolerant to stronger muscle relaxants

tizanidine hydrochloride

Zanaflex

4 mg initially gradually increasing to 8 mg tid if necessary

Sedation, weakness, fatigue, dry mouth and dizziness

This is a medication used for acute spastic conditions with the type of muscular problem that might occur in a patient with multiple sclerosis for example

carisoprodol

Soma

Soma Compound (carisoprodol 200 mg plus aspirin 325 mg)  The dosage is one or two tabs qid.

 

Soma Compound with codeine (carisoprodol 200 mg plus aspirin 325 mg plus codeine phosphate 16 mg).  The dosage is one or two qid

May have central nervous system side-effects including dizziness, sedation, irritability, depression, headache, allergic reactions with skin rash, nausea, vomiting, rapid heart rate.  With Soma Compound may also additionally have side-effects related to the aspirin with gastrointestinal burning and pain with allergic reactions to aspirin in individuals who are sensitive to it.  Soma Compound with codeine may have additional sensitivity to codeine with constipation due to decreased bowel motility or nausea and vomiting and dizziness from the codeine

Soma is a moderately strong muscle relaxant.  Some patients may find it sedating enough that they may only be able to tolerate it at bedtime

cyclobenzaprine

Flexeril

10 mg up to qid

Sedation, dry mouth, dizziness, constipation, fatigue, headache, GI upset

Flexeril is one of the strongest muscle relaxants.  It has been shown to be beneficial in fibromyalgia, but many patients only can tolerate it by taking it at bedtime, either a half or one tablet.  Otherwise they are too sedated or their mouth is too dry in the morning to continue taking it

orphenadrine citrate

Norflex

 

Norgesic

(orphenadrine 25 mg plus caffeine 30 mg plus aspirin 385 mg)

 

Norgesic Forte

(orphenadrine 50 mg, caffeine 60 mg and aspirin 770 mg)

Norflex one po bid

 

Norgesic one or two tablets tid or qid

 

 

 

 

 

Norgesic Forte

May include dryness of the mouth with headaches and dizziness, nausea and vomiting, constipation.  With Norgesic and Norgesic Forte there may be side-effects from aspirin with gastrointestinal upset or bleeding

 

chlorzoxazone

Parafon Forte DSC

500 mg one tid or qid

Dizziness, sedation, fatigue

Parafon Forte is another milder muscle relaxant not as strong as Soma or Flexeril, but also less sedating, so some patients may be able to take it during the day time without adverse effects

diazepam

Valium

5 mg to 10 mg tid or qid

Sedation, depression, dizziness

Since patients may become dependent on Valium with prolonged usage, this is best used in short-term instances for very severe muscle spasm.  The patient may subsequently be switched over to one of the milder muscle relaxants

lorazepam

Ativan

.5, 1 mg or 2 mg tabs with usually 2 to 6 mg per day given in tid or qid type dosage

Sedation, dizziness, weakness

 

metaxalone

Skelaxin

400 mg one or two tid or qid

Sedation, dizziness, headache, GI upset with nausea or vomiting

This is a moderately strong muscle relaxant somewhere in between Robaxin and Norflex at the milder end and Flexeril and Valium at the stronger end

clonazepam

Klonopin

0.25 mg up to 1 mg usually given at night

Sedation, depression, fatigue

Although it has an indication for the treatment of seizures and panic disorders, it is quite effective in patients with restless legs syndrome when given at bedtime


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