[PDF] Choosing a skeletal muscle relaxant. | Semantic Scholar (2024)

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101 Citations

Antispasmodics and Muscle Relaxants
    Katherine D. Travnicek

    Medicine

    Deer's Treatment of Pain

  • 2019

Most guidelines and current evidence support short-term use for all medications discussed in this chapter, and there is no clear evidence to show superiority of one muscle relaxant over another in managing acute low back pain.

Tizanidine: An overlooked alternative muscle relaxant for older patients
    Emmanuel M. Knight

    Medicine

    Journal of the American Geriatrics Society

  • 2022

Questions often arise about whether the choice of muscle relaxant matters in older patients; or if there are potentially safer options available that do not contain strong recommendations to avoid use from the AGS Beers Criteria, available literature, or drug references.

  • PDF
Evidências sobre relaxantes musculares de uso ambulatorial: Uma revisão da literatura
    Lívia Helena Freitas da Silva CascaesJardel Corrêa de Oliveira

    Medicine

  • 2018

Muscle relaxants in general compared to placebo or to each other showed little evidence with significant statistics, therefore the drug selection should be based on the profile of adverse effects, patient preference, potential of abuse, Potential of interaction with other drugs, cost and other characteristics of the drugs.

    Ling-ling ZhuYan-hong WangQuan Zhou

    Medicine

    Journal of pain research

  • 2024

Tizanidine is an SMR with unique features and may be an optimal initial choice for older adults and there would be more scientific studies, wider therapeutic applications, and new drug formulations in the future.

Efficacy and tolerability of muscle relaxants for low back pain: Systematic review and meta‐analysis

Five trials provide high quality evidence that muscle relaxants provide clinically significant pain relief in the short term for acute LBP, and there was no eligible RCT evidence to support the efficacy of benzodiazepines in LBP.

  • 80
The Safety and Efficacy of Methocarbamol as a Muscle Relaxant with Analgesic Action: Analysis of Current Data
    Hyun-Jung JungH. Chae

    Medicine

  • 2019

Methocarbamol has proven to be an effective and safe drug for use as a supplement to exercise regimen, physiotherapy and other activities to ease the discomfort associated with acute musculoskeletal disorders.

Muscle Relaxant Use Among Hemodialysis Patients: Prevalence, Clinical Indications, and Adverse Outcomes.
    D. MinaK. JohansenC. McCullochM. SteinmanB. GrimesJulie H. Ishida

    Medicine

    American journal of kidney diseases : the…

  • 2019

Muscle relaxant use was common in hemodialysis patients and associated with altered mental status and falls and the lower risk for death with muscle relaxants may have been the result of residual confounding.

  • 12
Opioid and Non-opioid Therapy
    Dermot P MaherB. ShahYakov Vorobeychik

    Medicine

    Spine Pain Care

  • 2019

Although there is still insufficient evidence to recommend cannabinoids for spine pain treatment, this chapter discusses this emerging medication class because it has been already used to treat certain pain conditions.

Muscle relaxants as adjunctive analgesics in the perioperative setting: A review of the literature
    R. MattisonSarah MidkiffJustin P. ReinertMichael A. Veronin

    Medicine

    Journal of perioperative practice

  • 2021

The objective of this review was to determine the efficacy and safety of adjunctive muscle relaxers for the purposes of analgesia in the perioperative setting.

  • 2
Acute back pain: benefits and risks of current treatments
    B. Mccarberg

    Medicine

    Current medical research and opinion

  • 2010

A wide range of treatments is currently recommended for the management of patients with acute back pain and all are supported by results from controlled clinical trials, which support the view that both NSAIDs and low-level continuous heat treatment are more effective than acetaminophen.

  • 22

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22 References

Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review.
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A Clinical and Pharmacologic Review of Skeletal Muscle Relaxants for Musculoskeletal Conditions
    Frank A. BeebeR. BarkinS. Barkin

    Medicine

    American journal of therapeutics

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Only a limited number of high-quality, randomized, controlled trials (RCTs) provide evidence of the effectiveness of NSAIDs or SMRs in the treatment of acute, uncomplicated MSDs, and remarkably little sound science guides the choice of drug.

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Double-blind study of metaxalone; use as skeletal-muscle relaxant.
    S. Diamond

    Medicine

    JAMA

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Patients with an acute skeletal-muscle spasm frequently pose a considerable problem to the practitioner who must deal with these spastic conditions and hence they seek medical attention for the purpose of shortening the acute phase of the disease.

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Muscle relaxants for non-specific low back pain.
    M. TulderTony TourayA. FurlanS. SolwayL. Bouter

    Medicine

    The Cochrane database of systematic reviews

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There is strong evidence that any of these muscle relaxants are more effective than placebo for patients with acute LBP on short-term pain relief, but the adverse effects require that they be used with caution.

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Efficacy of a low-dose regimen of cyclobenzaprine hydrochloride in acute skeletal muscle spasm: results of two placebo-controlled trials.
    D. BorensteinS. Korn

    Medicine

    Clinical therapeutics

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PPN9 PRESCRIPTION OF NON-STEROIDAL ANTI-INFLAMMATORY DRUGS AND MUSCLE RELAXANTS FOR BACK PAIN IN THE UNITED STATES
    Xu-ri LuoR. PietrobonL. CurtisL. Hey

    Medicine

  • 2004
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Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm.
    D. BorensteinS. LacksS. Wiesel

    Medicine

    Clinical therapeutics

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It is demonstrated that patients with muscle spasm associated with acute low back strain benefited from the use of combination therapy consisting of a nonsteroidal anti-inflammatory agent (naproxen) and a muscle relaxant (cyclobenzaprine).

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Cyclobenzaprine hydrochloride effect on skeletal muscle spasm in the lumbar region and neck: two double-blind controlled clinical and laboratory studies.
    J. Basmajian

    Medicine

    Archives of physical medicine and rehabilitation

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With improvement, myoelectric activity in back muscles is augmented during prescribed stressful movements as measured by electromyography and computer analysis combined with complex electrogoniometry.

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Cyclobenzaprine in intractable pain syndromes with muscle spasm.
    B. R. BrownJ. Womble

    Medicine

    JAMA

  • 1978

The effectiveness of cyclobenzaprine hydrochloride, a new tricyclic skeletal muscle relaxant, was shown in patients with long-term intractable pain of cervical and lumbar origin aggravated by

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Cyclobenzaprine and back pain: a meta-analysis.
    R. BrowningJ. JacksonPatrick G. O’Malley

    Medicine

    Archives of internal medicine

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Cyclobenzaprine is more effective than placebo in the management of back pain; the effect is modest and comes at the price of greater adverse effects, suggesting that shorter courses may be better.

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    [PDF] Choosing a skeletal muscle relaxant. | Semantic Scholar (2024)

    FAQs

    How to choose muscle relaxants? ›

    Choosing a muscle relaxer depends on the cause of the pain (muscle spasms or stiffness, or both). Potential side effects and medication interactions, concomitant medical conditions, and personal preferences are also considered.

    Which drug is considered the best muscle relaxant? ›

    What are the top 5 muscle relaxers?
    • baclofen (Lioresal)
    • dantrolene (Dantrium)
    • carisoprodol (Soma)
    • clorzoxazone (Lorzon)
    • methocarbamol (Robaxin)

    What is the safest muscle relaxer for the elderly? ›

    The Geriatric Lexi-Drugs database recommends the avoidance of muscle relaxants other than diazepam and tizanidine in patients older than age 65 years because efficacy and safety have not been established in geriatric patients.

    Which is better, chlorzoxazone vs thiocolchicoside? ›

    The percentage reduction in pain intensity was 59.7%±12.3% in the thiocolchicoside group and 56.3%±11.5% in the chlorzoxazone group. However, there was no statistically significant difference between the groups in terms of pain intensity reduction (P=0.453).

    What are the drugs of choice for muscle relaxers? ›

    Carisoprodol (Soma®, Vanadom®). Chlorzoxazone (Lorzone®, Parafon Forte DSC®, Relax-DS®, Remular S®). Cyclobenzaprine (Fexmid®, Flexeril®). Metaxalone (Metaxall®, Skelaxin®).

    What are the top three muscle relaxers? ›

    Summary table for antispasmodics
    DrugBrand nameDosage
    CarisoprodolSoma250–350 mg three times a day
    CyclobenzaprineFlexeril5–7.5 mg three times a day (tablet), or 15–30 mg once a day (extended-release capsule)
    MetaxaloneSkelaxin800 mg three to four times a day
    1 more row
    Jan 28, 2021

    What is the best muscle relaxer with the least side effects? ›

    Prescription Muscle Relaxers

    Metaxalone: Metaxalone (Skelaxin) causes the fewest side effects of the muscle relaxers and is less likely to have a sedative effect. It is more expensive than other options, so not all insurance plans cover it.

    What is the strongest natural muscle relaxer? ›

    The Best Natural Muscle Relaxers, According to Experts
    • Magnesium. ...
    • Epsom Salt. ...
    • Tart Cherries. ...
    • Chamomile, Lavender and Peppermint Essential Oils. ...
    • Yoga and Meditation. ...
    • Rest and Hydration.
    Jan 23, 2024

    Which is stronger, Flexeril or Robaxin? ›

    Robaxin and Flexeril are comparable in effectiveness. Some people may prefer extended-release generic Flexeril for its once-daily dosing. But, Flexeril may also cause more adverse effects like drowsiness and dry mouth. Discuss these treatment options with a doctor to find the best medication for you.

    What is the safest skeletal muscle relaxant to take? ›

    The best prescription muscle relaxants are baclofen, carisoprodol, methocarbamol, tizanidine, dantrolene, cyclobenzaprine, orphenadrine, chlorzoxazone, and metaxalone. Naproxen (Aleve) is one of the strongest OTC medications for muscle pain, cramps, and spasms.

    Why don't doctors like to prescribe muscle relaxers? ›

    Abuse and serious risks are possible

    Muscle relaxants can be addictive, so it's ideal to use them for the shortest possible time and keep them away from other adults and children. Because these medications depress the central nervous system, breathing can be affected, and an overdose can be fatal.

    Why is cyclobenzaprine not recommended for older adults? ›

    Because of the possibility of higher blood levels in the elderly as compared to younger adults, use of cyclobenzaprine extended-release capsules is not recommended in the elderly.

    What are the disadvantages of chlorzoxazone? ›

    Drowsiness, dizziness, lightheadedness, tiredness, upset stomach, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. This medication may rarely cause your urine to turn orange or reddish-purple.

    Has chlorzoxazone been discontinued? ›

    PARAFON FORTE DSC (chlorzoxazone) tablets, 500 mg, is listed in the “Discontinued Drug Product List” section of the Orange Book.

    Which is better, tizanidine or chlorzoxazone? ›

    Comparing Chlorzoxazone vs Tizanidine

    Chlorzoxazone has an average rating of 6.8 out of 10 from a total of 61 ratings on Drugs.com. 60% of reviewers reported a positive effect, while 26% reported a negative effect. Tizanidine has an average rating of 6.1 out of 10 from a total of 375 ratings on Drugs.com.

    What mg muscle relaxer should I take? ›

    Adults and children 15 years of age and older—10 milligrams (mg) 3 times a day. The largest amount should be no more than 60 mg (six 10-mg tablets) a day. Children younger than 15 years of age—Use and dose must be determined by your doctor.

    Which muscle relaxer is better cyclobenzaprine or methocarbamol? ›

    Cyclobenzaprine has an average rating of 5.9 out of 10 from a total of 610 ratings on Drugs.com. 47% of reviewers reported a positive effect, while 31% reported a negative effect. Methocarbamol has an average rating of 6.3 out of 10 from a total of 294 ratings on Drugs.com.

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