Yes

Skeletal Muscle Relaxant

Dental: Treatment of muscle spasm associated with acute temporomandibular joint pain

Medical: Treatment of muscle spasm associated with acute painful musculoskeletal conditions; supportive therapy in tetanus

B

Hypersensitivity to cyclobenzaprine or any component; do not use concomitantly or within 14 days of MAO inhibitors; hyperthyroidism, congestive heart failure, arrhythmias

Cyclobenzaprine shares the toxic potentials of the tricyclic antidepressants and the usual precautions of tricyclic antidepressant therapy should be observed; use with caution in patients with urinary hesitancy or angle-closure glaucoma

>10%:

Central nervous system: Drowsiness, dizziness, lightheadedness

Gastrointestinal: Xerostomia

1% to 10%:

Cardiovascular: Edema of the face/lips, syncope

Gastrointestinal: Bloated feeling

Genitourinary: Problems in urinating, polyuria

Hepatic: Hepatitis

Neuromuscular & skeletal: Problems in speaking, muscle weakness

Ocular: Blurred vision

Otic: Tinnitus

<1%: Tachycardia, hypotension, arrhythmia, headache, fatigue, nervousness, confusion, ataxia, rash, dermatitis, dyspepsia, nausea, constipation, stomach cramps, unpleasant taste

Symptoms of overdose include troubled breathing, drowsiness, syncope, seizures, tachycardia, hallucinations, vomiting

Following initiation of essential overdose management, toxic symptoms should be treated. Ventricular arrhythmias often respond to systemic alkalinization (sodium bicarbonate 0.5-2 mEq/kg I.V.) and/or phenytoin 15-20 mg/kg (adults). Arrhythmias unresponsive to this therapy may respond to lidocaine 1 mg/kg I.V. followed by a titrated infusion. Physostigmine (1-2 mg I.V. slowly for adults or 0.5 mg I.V. slowly for children) may be indicated in reversing cardiac arrhythmias that are life-threatening. Seizures usually respond to diazepam I.V. boluses (5-10 mg for adults up to 30 mg or 0.25-0.4 mg/kg/dose for children up to 10 mg/dose). If seizures are unresponsive or recur, phenytoin or phenobarbital may be required.

CYP1A2, 2D6 and 3A3/4 enzyme substrate

Do not use concomitantly or within 14 days after MAO inhibitors

Because of similarities to the tricyclic antidepressants, may have additive toxicities

Anticholinergics: Because of cyclobenzaprine's anticholinergic action, use with caution in patients receiving these agents

Alcohol, barbiturates, and other CNS depressants: Effects may be enhanced by cyclobenzaprine

Centrally acting skeletal muscle relaxant pharmacologically related to tricyclic antidepressants; reduces tonic somatic motor activity influencing both alpha and gamma motor neurons

Onset of action: Commonly occurs within 1 hour

Duration: 8 to >24 hours

Absorption: Oral: Completely

Metabolism: Hepatic; may undergo enterohepatic recycling

Time to peak serum concentration: Within 3-8 hours

Elimination: Renally as inactive metabolites and in feces (via bile) as unchanged drug

Oral: Note: Do not use longer than 2-3 weeks

Adults: 20-40 mg/day in 2-4 divided doses; maximum dose: 60 mg/day

No data reported

Drowsiness and dizziness are common; may cause nervousness or confusion

Contraindicated with MAOIs or within 14 days of MAOI; concurrent use with psychotropics may exacerbate the dry mouth and sedation commonly seen with cyclobenzaprine

No information available to require special precautions

>10% of patient experience dry mouth

Take exactly as directed. Do not increase dose or discontinue without consulting prescriber. Do not use alcohol, prescriptive or OTC antidepressants, sedatives, or pain medications without consulting prescriber. You may experience drowsiness, dizziness, lightheadedness (avoid driving or engaging in tasks that require alertness until response to drug is known); or urinary retention (void before taking medication). Report excessive drowsiness or mental agitation, chest pain, skin rash, swelling of mouth/face, difficulty speaking, ringing in ears, or blurred vision. Breast-feeding precautions: Breast-feeding is not recommended.

Raise bed rails, institute safety measures, assist with ambulation

Tablet, as hydrochloride: 10 mg

Ambre JJ, "Cyclobenzaprine Overdose," Ann Intern Med, 1985, 102(4):559-60.

Heckerling PS, Bartow TJ, "Paradoxical Diaphoresis in Cyclobenzaprine Poisoning," Ann Intern Med, 1984, 101(6):881.

Hucker HB, Stauffer SC, Albert KS, et al, "Plasma Levels and Bioavailability of Cyclobenzaprine in Human Subjects," J Clin Pharmacol, 1977, 17(11-12):719-27.

Linden CH, Mitchiner JC, Lindzon RD, et al, "Cyclobenzaprine Overdosage," J Toxicol Clin Toxicol, 1983, 20(3):281-8.

Theoharides TC, Harris RS, and Weckstein D, "Neuroleptic Malignant-Like Syndrome Due to Cyclobenzaprine?" J Clin Psychopharmacol, 1995, 15(1):79-81.