| Muscle relaxants act in the central nervous system to relax
tight muscles. They are prescribed along with rest and physical
therapy for recovery from muscle injuries, and will not replace
appropriate recuperative therapies. Using the pain relief provided
by muscle relaxants to overuse injured muscles could result in far
more severe tissue damage, and may make recovery far more difficult.
On the other hand, not using a muscle at all can result in atrophy,
so always undertake an appropriate level of activity as suggested
by a physical therapist or doctor.
Conditions treated by muscle relaxants include:
- Relaxation of sprained, strained, or otherwise injured muscles
- Chronic muscle pain in fibromyalgia and myofascial pain syndrome
Muscle relaxants are most often prescribed for a period of weeks
depending on how long a particular muscle injury takes to heal.
Few studies have been done on their long-term effects, as their
general labeling is for short-term treatment. However, it is becoming
accepted by the medical profession that muscle relaxants are a suitable
treatment for chronic muscle pain, and may greatly reduce the need
for other pain medications.
While muscle relaxants pose some risk of physical dependence, they
are not generally considered a drug of abuse. Individuals with chronic
muscle pain may be significantly helped by these medications, which
doctors are generally more willing to prescribe than narcotic analgesics.
Muscle relaxants are available only by prescription.
General Side Effects
The most common side effects with muscle relaxants are clumsiness,
dizziness, drowsiness, and temporary vision changes (blurring, or
seeing double). Do not take muscle relaxants before driving or performing
other potentially hazardous tasks.
Other side effects tend to be infrequent to rare, and are usually
dose related. Individuals who have had allergic reactions to one
of these medications will have to switch to another type of muscle
relaxant on the advice of their doctor, as a serious reaction could
occur with any dose. Consult the warnings and instructions for your
individual treatment for a more complete list of possible side effects.
Cautions: All muscle relaxants may not be right for everyone.
Some individuals may want to check with a doctor for safe use guidelines
with a particular condition, or may decide that another treatment
would be more appropriate. Be sure to give your prescribing physician
a complete medical history, being especially sure to mention any
of the following conditions.
- Alcohol or Drug Addiction: There is a slightly increased
risk of chemical dependence with these medications, particularly
for addiction prone individuals. If an addiction is untreated,
combining alcohol or drugs with these medications poses a greatly
increased risk for organ damage and dangerous or fatal overdose.
- Allergies: An allergy to a muscle relaxant in the past
might indicate that you should not use that medication, or some
related medications, ever again. However, because there are different
types of muscle relaxants, your doctor may try a different medication.
Mention any other food or drug allergies you may have experienced,
to be sure that your doctor can prescribe an appropriate medication.
- Blood disease: Inform your prescribing physician about
any history of blood disease caused by medication.
- Dependence: Physical dependence and withdrawal are possible
risks for these drugs. Even though these medications can cause
withdrawal symptoms when use is stopped, they have a low rate
of actual addiction. Addiction should be distinguished from physical
dependence, as it is a psychological need to seek out a drug even
when there is no compelling health need, to the point of decreasing
the quality of life.
- Glaucoma: Certain muscle relaxants may not be safe for
glaucoma. You will want to speak with your doctor about treatment
options.
- Kidney Disease: These medications may stress damaged
kidneys. Ask your doctor if this treatment is right for you, or
if there are dosing guidelines that would make it safe. Drink
6-8 glasses of water daily to reduce strain on the kidneys.
- Liver Disease: Muscle relaxants may stress damaged livers.
Speak to your doctor about appropriate dosage guidelines, or other
available pain control methods. Do not combine alcohol use with
your treatment.
- Medical Emergencies: Inform medical personnel if you
have taken these medications recently, as they may interfere with
diagnosis of certain conditions or interact with some treatments.
Do not take these medications if you need to seek out emergency
services; instead allow the ambulance or hospital staff to manage
your pain control.
- Mental Depression: Therapy with central nervous system
depressants may exaggerate this condition.
- Overdose: This may be indicated by extreme weakness,
coma, dizziness, stupor, shock, or difficulty breathing. If you
suspect an overdose of these medications, seek emergency medical
treatment immediately. To avoid, keep medication out of reach
of children, follow maximum dosing instructions, and do not mix
with alcohol or other drugs which may cause drowsiness.
- Porphyria: Certain muscle relaxants are considered unsafe
for porphyria. Check with your doctor regarding a muscle relaxant
that will be safe for your condition.
- Pregnancy: These medications have not been demonstrated
to cause serious problems in pregnant or nursing women, though
they have not been adequately studied for safety. Speak with your
physician about the risks of treatment.
- Seizures: Some of these medications may increase the
risk of seizure. Discuss this with your prescribing physician
if you have a history of seizure or are taking medication that
makes seizure more likely.
- Surgery: Inform your doctor or dentist beforehand that
you use these medications, and follow any instructions they may
give you.
- Withdrawal: Long-term and frequent use of these medications
may result in withdrawal symptoms if treatment is stopped abruptly.
The severity of symptoms is usually dependent on dosage and length
of use. They may include chills, headache, insomnia, nausea, or
stomach cramping. Your physician may be able to reduce the severity
of this condition by stepping you off your medication gradually,
or by other methods. Moderate, periodic use of these medications
will not generally cause withdrawal symptoms.
Interactions
Muscle relaxants may interact with other medications you may be
taking. The following drugs are especially likely to interact with
these treatments, but you should always check the labels of each
individual medication you use to decrease the likelihood of undesirable
side effects. If medications increase each other's effects, or lead
to undesirable drug buildups in the body, your doctor may recommend
adjusting the dosages of one of the medications if it seems appropriate
to use both treatments.
Medications which increase central nervous system depression should
not generally be taken with muscle relaxants, or within the time
frame that they are active in the body. If your doctor prescribes
other medications that have CNS depressant effects, be sure to work
out a medication schedule that won't leave you oversedated or increase
your risk for overdose.
- Alcohol - Muscle relaxants and alcohol can accelerate central
nervous system depression. Avoid mixing the two, as this could
result in liver damage, or a dangerous and potentially fatal overdose.
- Antihistamines like Tavist or Benadryl may cause oversedation.
- Antiseizure treatments - Oversedation may result from combining
muscle relaxants with seizure medication. Speak with your doctor
about dosage adjustments and arranging a medication schedule.
- Benzodiazepines (a class of antidepressants, anti-panic agents,
and muscle relaxants) such as Ativan
(lorazepam), Valium
(diazepam), Halcion (triazolam),
Restoril (temazepam),
Librium (chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam),
and others, should be used cautiously with muscle relaxants.
- Central Nervous System Depressants - Any prescription medication,
over the counter medication, or herbal supplement that may cause
drowsiness. These medications should be used with caution while
taking muscle relaxants as you may become oversedated. Consult
your doctor or pharmacist to be sure that your treatment is as
safe as possible.
- High blood pressure medication such as Ismelin (guanethidine)
or Tenex (guanfacine) may interact with muscle relaxants.
- MAO inhibitors - Some muscle relaxants must never be mixed with
MAO (monoamine oxidase) inhibitors, a class of antidepressants
and antisenility drugs, such as Eldepryl (selegiline), Furoxone
(furazolidone), Nardil (phenelzine), Marplan (isocarboxazid),
or Parnate (tranylcypromine). Never use them within 2 weeks of
stopping an MAO inhibitor. A drug interaction in this case could
be serious or even fatal. Patients over 65 should allow a longer
wait period between using muscle relaxants and an MAO, as medications
may stay in their system longer than in other patients.
- Muscle relaxants - Combining one of these medications with a
muscle relaxant of any other type, such as Maolate (chlorphenesin),
Paraflex (chlorzoxazone), Soma (carisoprodol), Robaxin (methocarbamol),
Skelaxin (metaxalone), Norgesic (orphenadrine), or Flexeril (cyclobenzaprine)
may overly depress the central nervous system and increase the
risk of a dangerous overdose.
- Narcotic pain medication like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine), nalbuphine,
OxyContin (oxycodone),
Percocet (oxycodone
and acetaminophen), Stadol (butorphanol), Talwin compound
(pentazocine), or Vicodin
(hydrocodone and acetaminophen), Vicoprofen
(hydrocodone and ibuprofen) may increase the central nervous
system depressant effects of muscle relaxants.
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal
(butalbital, aspirin, and caffeine), Phenobarbitol, Seconal, or
other barbiturates.
- Sleep medication like Ambien
(zolpidem), Sonata
(zaleplon), or over the counter sleeping pills may cause oversedation
when combined with muscle relaxants.
- Tranquilizers like Haldol (haloperidol), Mellaril (thioridazine),
or Thorazine (chlorpromazine) could cause oversedation when mixed
with muscle relaxants.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may increase
the central nervous system suppressant effects from either the
antidepressant, or the muscle relaxants.
- Ultram (tramadol) - This
pain reliever may oversedate you if taken in combination with
muscle relaxants.
For maximum safety and effectiveness, follow your
doctor's guidelines when using muscle relaxants, and always check
the individual instructions for each medication you may take.
References:
This document is provided for information only; it is not intended
to diagnose symptoms, prescribe treatment, or to substitute for
consultation with a physician. While we have made every effort to
ensure that this information is accurate and extensive, only your
doctor can tell you if a medication, or drug combination, is safe
for you. Information intended for US residents only. |
