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

C

Renal impairment, hypersensitivity to methocarbamol or any component

Rate of injection should not exceed 3 mL/minute; solution is hypertonic; avoid extravasation; use with caution in patients with a history of seizures

>10%: Central nervous system: Drowsiness, dizziness, lightheadedness

1% to 10%:

Cardiovascular: Flushing of face, bradycardia

Dermatologic: Allergic dermatitis

Gastrointestinal: Nausea, vomiting

Ocular: Nystagmus

Respiratory: Nasal congestion

<1%: Syncope, convulsion, leukopenia, pain at injection site, thrombophlebitis, blurred vision, renal impairment, allergic manifestations

Symptoms of overdose include cardiac arrhythmias, nausea, vomiting, drowsiness, coma

Treatment is supportive following attempts to enhance drug elimination. Hypotension should be treated with I.V. fluids and/or Trendelenburg positioning. Dialysis and hemoperfusion and osmotic diuresis have all been useful in reducing serum drug concentrations. The patient should be observed for possible relapses due to incomplete gastric emptying.

Increased effect/toxicity with CNS depressants

Injection when diluted to 4 mg/mL in sterile water, 5% dextrose, or 0.9% saline is stable for 6 days at room temperature; do not refrigerate after dilution

Causes skeletal muscle relaxation by reducing the transmission of impulses from the spinal cord to skeletal muscle

Onset of muscle relaxation: Oral: Within 30 minutes

Metabolism: In the liver

Half-life: 1-2 hours

Time to peak serum concentration: ~2 hours

Elimination: Metabolites renally excreted

Children: Recommended only for use in tetanus I.V.: 15 mg/kg/dose or 500 mg/m²/dose, may repeat every 6 hours if needed; maximum dose: 1.8 g/m²/day for 3 days only

Adults: Muscle spasm:

Oral: 1.5 g 4 times/day for 2-3 days, then decrease to 4-4.5 g/day in 3-6 divided doses

I.M., I.V.: 1 g every 8 hours if oral not possible

Dosing adjustment/comments in renal impairment: Do not administer parenteral formulation to patients with renal dysfunction

Alcohol: Additive CNS effect, avoid use

Drowsiness and dizziness are common

May rarely cause leukopenia; use caution with clozapine and carbamazepine; concurrent use with psychotropics may produce additive sedation

No information available to require special precautions

No effects or complications reported

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 requiring alertness until response to drug is known); or nausea or vomiting (small, frequent meals, frequent mouth care, or sucking hard candy may help). Report excessive drowsiness or mental agitation, chest pain, skin rash, swelling of mouth/face, difficulty speaking, or vision disturbances. Pregnancy precautions: Inform prescriber if you are or intend to be pregnant.

Monitor closely for extravasation of I.V. injection

Injection: 100 mg/mL in polyethylene glycol 50% (10 mL)

Tablet: 500 mg, 750 mg

Lebby TI, Dugger K, Lipscomb JW, et al, "Skeletal Muscle Relaxant Ingestion," Vet Hum Toxicol, 1990, 32(2):133-5.

Preston KL, Guarino JJ, Kirk WT, et al, "Evaluation of the Abuse Potential of Methocarbamol," J Pharmacol Exp Ther, 1989, 248(3):1146-57.