Carisoprodol

Action

Unknown. May modify central perception of pain without modifying pain reflexes. Skeletal muscle relaxation may result from sedative properties or from inhibition of activity in descending reticular formation and spinal cord.

Availability

Tablets: 250 mg, 350 mg

Indications and dosages

➣ Adjunctive treatment of muscle spasms associated with acute painful musculoskeletal conditions

Adults: 350 mg P.O. q.i.d.

➣ Relief of discomfort associated with acute painful musculoskeletal conditions

Adults: 250 to 350 mg P.O. t.i.d. and at bedtime

Contraindications

• Hypersensitivity to drug or meprobamate

• Porphyria or suspected porphyria

Precautions

Use cautiously in:

• severe hepatic or renal disease

• history of substance abuse

• pregnant or breastfeeding patients

• children ages 12 and younger.

Administration

• Give last daily dose at bedtime.

• Administer with food if GI upset occurs.

• If patient can't swallow tablets, mix with syrup, chocolate, or jelly.

Adverse reactions

CNS: dizziness, drowsiness, agitation, ataxia, depression, headache, insomnia, vertigo, tremor, depression

CV: hypotension, tachycardia

GI: nausea, vomiting, epigastric distress

Hematologic: eosinophilia, leukopenia

Respiratory: asthma attacks

Skin: flushing (especially of face), rash, pruritus, erythema multiforme

Other: hiccups, fever, psychological drug dependence, anaphylactic shock

Interactions

Drug-drug. Antihistamines, opioids, sedative-hypnotics: additive CNS depression

Drug-diagnostic tests. Eosinophils: increased count

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

• When giving to breastfeeding patient, watch for signs of sedation and GI upset in infant.

• Monitor range of motion, stiffness, and discomfort level.

• Know that drug is metabolized to meprobamate. Monitor for drug dependence, especially in patients with history of substance abuse.

Patient teaching

• Tell patient that psychological drug dependence may occur.

• Instruct patient to avoid over-the-counter drugs and alcohol, because they may increase CNS depression.

• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.