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Cyclobenzaprine is often prescribed to people who have acute back injuries, including when people report having muscle spasms or significant tightness in their back, or when the back feels like it’s locked, she explained. It’s also prescribed to treat for muscle strains.

Cyclobenzaprine is used short-term to treat muscle spasms. It is usually used along with rest and physical therapy. It works by helping to relax the muscles. Flexeril (cyclobenzaprine) is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Cyclobenzaprine, a centrally-acting muscle relaxant, was first synthesized in 1961 and has been available for human use since 1977. It was initially studied for use as antidepressant given its structural similarity to tricyclic antidepressants – it differs from Amitriptyline by only a single double bond.  Since its approval, it has remained relatively popular as an adjunctive, short-term treatment for acute skeletal muscle spasms secondary to musculoskeletal injury.

Flexeril is used together with rest and physical therapy to treat skeletal muscle conditions such as pain, injury, or spasms.

Cyclobenzaprine is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.  Cyclobenzaprine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.  Cyclobenzaprine may also be used for purposes not listed in this medication guide.

for more information, please check https://medlineplus.gov/druginfo/meds/a682514.html

How to use Cyclobenzaprine Tablet

Generic Flexeril (cyclobenzaprine) is a muscle relaxer that relieves pain and discomfort caused by strains, sprains, and other muscle injuries. Flexeril is commonly prescribed for short-term use, in combination with rest and physical therapy, after accidents or other circumstances where healing may be slowed by muscle strain. In some cases, Flexeril can be used to treat pain from certain musculoskeletal disorders like fibromyalgia.  Flexeril is chemically related to a class of antidepressants called tricyclic antidepressants, and works by acting on the central nervous system, blocking nerve impulses (or pain sensations) that are sent from sore muscles to the brain.

Take this medication by mouth with or without food as directed by your doctor. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.

The dosage is based on your medical condition and response to treatment. This medication should only be used short-term (for 3 weeks or less) unless directed by your doctor.

Tell your doctor if your condition persists after 2 to 3 weeks or if it worsens.

The Mechanism of action of cyclobenzaprine

The exact mechanism of action of cyclobenzaprine has not been fully elucidated in humans, and much of the information available regarding its mechanism has been ascertained from early animal studies. There is some evidence that cyclobenzaprine exerts its effects at the supraspinal level, specifically within the locus coeruleus of the brainstem, with little-to-no action at neuromuscular junctions or directly on skeletal musculature.

Action on the brainstem is thought to result in diminished activity of efferent alpha and gamma motor neurons, likely mediated by inhibition of coeruleus-spinal or reticulospinal pathways, and ultimately depressed spinal cord interneuron activity.

More recently it has been suggested that inhibition of descending serotonergic pathways in the spinal cord via action on 5-HT2 receptors may contribute to cyclobenzaprine’s observed effects.

Cyclobenzaprine is extensively metabolized in the liver via both oxidative and conjugative pathways. Oxidative metabolism, mainly N-demethylation, is catalyzed primarily by CYP3A4 and CYP1A2 (with CYP2D6 implicated to a lesser extent) and is responsible for the major metabolite desmethylcyclobenzaprine.

Cyclobenzaprine also undergoes N-glucuronidation in the liver catalyzed by UGT1A4 and UGT2B10, and has been shown to undergo enterohepatic circulation.

Important Information

You should not use cyclobenzaprine if you have an allergy to the medication, a certain type of thyroid disorder (hyperthyroidism), heart block, congestive heart failure, a heart rhythm disorder, or you have recently had a heart attack.

Do not use cyclobenzaprine if you have taken an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine.

Flexeril Precautions

Before taking cyclobenzaprine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, overactive thyroid (hyperthyroidism), heart problems (such as irregular heartbeat, heart block, heart failure, recent heart attack), difficulty urinating (such as due to an enlarged prostate), glaucoma.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, constipation, or trouble urinating. Drowsiness and confusion can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.

Before taking this medicine

You should not use cyclobenzaprine if you are allergic to it, or if you have:

  • hyperthyroidism;
  • heart block, heart rhythm disorder, congestive heart failure; or
  • if you have recently had a heart attack.

Cyclobenzaprine is not approved for use by anyone younger than 15 years old.

Do not use cyclobenzaprine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Some medicines can interact with cyclobenzaprine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure cyclobenzaprine is safe for you, tell your doctor if you have:

    • thyroid disease;
    • liver disease;
    • glaucoma;
    • enlarged prostate; or
    • problems with urination.

It is not known whether cyclobenzaprine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.

Older adults may be more sensitive to the effects of this medicine.

Cyclobenzaprine is usually taken taken for up to 2 or 3 weeks. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Follow your doctor’s dosing instructions very carefully.

Swallow the capsule whole and do not crush, chew, break, or open it.

Call your doctor if your symptoms do not improve after 3 weeks, or if they get worse.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of cyclobenzaprine can be fatal.

Overdose symptoms may include severe drowsiness, vomiting, fast heartbeats, tremors, agitation, or hallucinations.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast/irregular heartbeat, fainting, severe drowsiness, slurred speech, seizures, mental/mood changes (such as confusion, hallucinations).

What should I avoid while taking Cyclobenzaprine?

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Avoid drinking alcohol. Dangerous side effects could occur.

Cyclobenzaprine side effects

Get emergency medical help if you have signs of an allergic reaction to cyclobenzaprine: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

    • fast or irregular heartbeats;
    • chest pain or pressure, pain spreading to your jaw or shoulder; or
    • sudden numbness or weakness (especially on one side of the body), slurred speech, balance problems.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults.

Common cyclobenzaprine side effects may include:

    • drowsiness, tiredness;
    • headache, dizziness;
    • dry mouth; or
    • upset stomach, nausea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Cyclobenzaprine may interact with other medications

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: tricyclic antidepressants (such as amitriptyline, imipramine).

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

Before using this medication, report the use of drugs that increase serotonin, including street drugs (such as MDMA/’ecstasy’), St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tramadol, among others.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), other muscle relaxants (such as carisoprodol, methocarbamol), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Cyclobenzaprine oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with cyclobenzaprine are listed below.

Drugs you should not take with cyclobenzaprine

Do not take monoamine oxidase inhibitors (MAOIs) with cyclobenzaprine. Doing so can cause dangerous effects in the body. Examples of these drugs include:

    • selegiline
    • rasagiline
    • tranylcypromine

Taking this drug with an MAOI or within 14 days of stopping an MAOI could increase your risk of serious side effects. These include seizures.

Interactions that increase your risk of side effects

Taking cyclobenzaprine with certain medications raises your risk of side effects from cyclobenzaprine. This is because the amount of cyclobenzaprine in your body is increased. Examples of these drugs include:

    • Benzodiazepines, such as triazolam, alprazolam, and midazolam. You may have more sedation and drowsiness.
    • Barbiturates, such as phenobarbital. You may have more sedation and drowsiness.
    • Certain drugs used to treat depression, such as fluoxetine, venlafaxine, amitriptyline, or bupropion. You may be at a greater risk for serotonin syndrome.
    • Verapamil. You may be at a greater risk for serotonin syndrome.
    • Anticholinergic drugs, such as tolterodine or oxybutynin. You may be at a greater risk for certain side effects. These include dry mouth or not being able to urinate.

Interactions that can make your drugs less effective

When certain drugs are used with cyclobenzaprine, they may not work as well. An example of these drugs includes guanethidine. Cyclobenzaprine can block the blood pressure-lowering effect of guanethidine. This means your blood pressure may increase.

This list is not complete. Other drugs may interact with cyclobenzaprine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Cyclobenzaprine Manufacturers

    • Anesta ag
    • Actavis totowa llc
    • Aurobindo pharma ltd
    • Cadista pharmaceuticals inc
    • Invagen pharmaceuticals inc
    • Mutual pharmaceutical co inc
    • Mylan pharmaceuticals inc
    • Orit laboratories llc
    • Pliva inc
    • Ranbaxy laboratories ltd
    • Sandoz inc
    • Vintage pharmaceuticals inc
    • Watson laboratories inc
    • Mcneil pediatrics

Cyclobenzaprine Abuse and overdose

Cyclobenzaprine may enhance the effects of other central nervous system depressants, such as alcohol, barbiturates, benzodiazepines and narcotics. According to the DEA, abusers often combine cyclobenzaprine with these depressants to produce or enhance psychoactive effects. Though it is not a controlled substance, the DEA has recorded anecdotal reports of use to induce euphoria and relaxation.

Though rare, deaths can occur from cyclobenzaprine overdose, especially in the case of multiple drug ingestion. The FDA recommends that doctors contact a poison control center for current information on treatment for an overdose, as the management of a case is complex.

The most common manifestations associated with overdose are drowsiness and an abnormally rapid heart rate (tachycardia). Less common effects include body twitches (tremor), the loss of control of bodily movements (ataxia), hypertension, agitation, slurred speech, nausea, confusion, dizziness, hallucination, vomiting and coma. Rare but critical effects include cardiac arrest, chest pain and seizures.

Abuse of Cyclobenzaprine

When abused, cyclobenzaprine may have a sedative and relaxing effect and potentially even cause a euphoric “high.” Flexeril may be abused orally, mixed with other drugs, easily dissolved in alcohol, or crushed to be snorted. Flexeril may not be difficult to obtain as it is not classified by the DEA as a controlled substance.

Anytime someone is using a prescription drug without a prescription, or beyond the scope of a legitimate prescription, it is considered drug abuse. The National Institute on Drug Abuse (NIDA) estimates that more than 50 million Americans aged 12 and over have abused a prescription drug one or more times in life. Prescription drugs may seem safer than illicit ones, making them targets for abuse. All drugs act on natural chemicals in the brain, however, and abusing them can lead to drug dependence and addiction.

Drug addiction cost American society close to $200 billion in 2007, in healthcare costs, legal and criminal justice expenses, and lost workplace production, the Office of National Drug Control Policy (ONDCP) reports. Substance abuse treatment can greatly improve some of the behavioral, social, emotional, physical, and financial issues that may arise as the result of drug abuse.

Treatment should be multifaceted and tailored to each individual. Physical drug dependence is often treated with medical detox, for example. The behavioral and emotional aspects of drug abuse and addiction are often treated with behavioral therapies and group and individual counseling sessions that work to improve coping mechanisms, communication skills, self-confidence, and mental health.

Who Abuses Flexeril and Why?

Dramatic image of a sad teenage girl cryingNIDA reports that young adults between the ages of 18 and 25 (according to 2014 data) abuse prescription drugs at the highest rates of any other age demographic. Young adults may use the Internet to access information on how to abuse Flexeril and the possible desirable effects that may come from the drug’s recreational use. Flexeril may be used to heighten the effects of alcohol or other drugs when used recreationally.

Prescription drugs are abused across almost all age, gender, race, cultural, and socioeconomic demographics, however. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that prescription drug abuse is increasing for older adults in their 50s, which may be of particular concern due to the range of negative side effects that specifically impact this population group. Flexeril in particular is not even generally prescribed to the elderly population, according to the FDA, because of the high risk factors.

Additionally, individuals with a legitimate prescription to Flexeril may develop a tolerance to the drug, requiring them to take higher and more frequent doses to feel its effects. Drug dependence can develop wherein the brain becomes accustomed to the interaction of cyclobenzaprine and begins to rely on it in order to keep functioning the same way.

Dependence on cyclobenzaprine is recognized by the onset of withdrawal symptoms when the drug leaves the bloodstream. These may include fatigue, nausea, headache, and general malaise.