Cyclobenzaprine

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Cyclobenzaprine Brand Names

Cyclobenzaprine | Amrix | EnovaRX | Fexmid | Flexeril

What is Cyclobenzaprine

Cyclobenzaprine is a skeletal muscle relaxant approved for the relief of muscle spasm associated with acute, painful musculoskeletal conditions.

Cyclobenzaprine is not effective for the treatment of muscle spasm due to central nervous system disease (e.g., cerebral palsy, spinal cord disease).

Cyclobenzaprine is very closely related to the antidepressant amitriptyline. Although it is not used clinically as an antidepressant, cyclobenzaprine does possess some pharmacologic effects similar to tricyclic antidepressants.

Flexeril® (cyclobenzaprine 10 mg) was first approved by the FDA in 1977. In February 2003, the manufacturer reduced the dosage recommendations for cyclobenzaprine based on efficacy and safety data and made available a 5 mg oral dosage form.

In early 2006, a 7.5 mg oral dosage strength of cyclobenzaprine became available.

An extended-release capsule (Amrix®) was approved in February 2007.

Indications

  • fibromyalgia
  • muscle spasm

For relief of muscle spasm associated with acute, painful musculoskeletal conditions as an adjunct to rest and physical therapy

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. agitation
  4. alopecia
  5. anaphylactic shock
  6. anaphylactoid reactions
  7. angioedema
  8. anorexia
  9. anxiety
  10. asthenia
  11. ataxia
  12. blurred vision
  13. breast enlargement
  14. chest pain (unspecified)
  15. cholestasis
  16. confusion
  17. constipation
  18. diaphoresis
  19. diarrhea
  20. diplopia
  21. dizziness
  22. drowsiness
  23. dysarthria
  24. dysgeusia
  25. dyspepsia
  26. dyspnea
  27. edema
  28. eosinophilia
  29. excitability
  30. fatigue
  31. flatulence
  32. galactorrhea
  33. gastritis
  34. gynecomastia
  35. hallucinations
  36. headache
  37. hepatitis
  38. hyperglycemia
  39. hypertension
  40. hypertonia
  41. hypoglycemia
  42. hypotension
  43. ileus
  44. impotence (erectile dysfunction)
  45. increased urinary frequency
  46. insomnia
  47. irritability
  48. jaundice
  49. leukopenia
  50. libido decrease
  51. libido increase
  52. malaise
  53. myalgia
  54. myocardial infarction
  55. nausea
  56. palpitations
  57. paranoia
  58. paresthesias
  59. peripheral neuropathy
  60. peripheral vasodilation
  61. photosensitivity
  62. pruritus
  63. psychosis
  64. purpura
  65. rash
  66. seizures
  67. serotonin syndrome
  68. SIADH
  69. sinus tachycardia
  70. stomatitis
  71. stroke
  72. syncope
  73. testicular swelling
  74. thrombocytopenia
  75. tinnitus
  76. tongue discoloration
  77. tremor
  78. urinary retention
  79. urticaria
  80. vertigo
  81. vomiting
  82. weakness
  83. weight gain
  84. weight loss
  85. xerostomia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • acute myocardial infarction
  • anticholinergic medications
  • AV block
  • bradycardia
  • breast-feeding
  • bundle-branch block
  • cardiac arrhythmias
  • cardiac disease
  • cerebral palsy
  • children
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • contact lenses
  • coronary artery disease
  • depression
  • diabetes mellitus
  • driving or operating machinery
  • ethanol ingestion
  • females
  • geriatric
  • heart failure
  • hepatic disease
  • hypertension
  • hyperthyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • ileus
  • infants
  • long QT syndrome
  • malnutrition
  • MAOI therapy
  • myocardial infarction
  • neonates
  • pregnancy
  • prostatic hypertrophy
  • QT prolongation
  • radiographic contrast administration
  • seizure disorder
  • seizures
  • sunlight (UV) exposure
  • thyroid disease
  • tricyclic antidepressant hypersensitivity
  • urinary retention

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Alfentanil
  • Alosetron
  • Alprazolam
  • Amantadine
  • Ambenonium Chloride
  • Amifampridine
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amoxapine
  • Anticholinergics
  • Anxiolytics; Sedatives; and Hypnotics
  • Apomorphine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Azelastine
  • Azelastine; Fluticasone
  • Bacitracin
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Botulinum Toxins
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Butabarbital
  • Butorphanol
  • Cannabidiol
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pseudoephedrine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cenobamate
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloral Hydrate
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone; Clonidine
  • Cisatracurium
  • Clemastine
  • Clomipramine
  • Clonazepam
  • Clonidine
  • Clorazepate
  • Clozapine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • COMT inhibitors
  • Cyproheptadine
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Desipramine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Diazepam
  • Dicyclomine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Disopyramide
  • Donepezil
  • Donepezil; Memantine
  • Doxacurium
  • Doxepin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Entacapone
  • Escitalopram
  • Esketamine
  • Estazolam
  • Eszopiclone
  • Ethanol
  • Etomidate
  • Fentanyl
  • Flavoxate
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Fluvoxamine
  • Gabapentin
  • Galantamine
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Oxycodone
  • Imipramine
  • Indacaterol; Glycopyrrolate
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Isocarboxazid
  • Isosulfan Blue
  • Lasmiditan
  • Levocetirizine
  • Levorphanol
  • Linezolid
  • Lofexidine
  • Lorazepam
  • Loxapine
  • Lumateperone
  • Maprotiline
  • Meclizine
  • Mepenzolate
  • Meperidine
  • Meperidine; Promethazine
  • Mephobarbital
  • Meprobamate
  • Methadone
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methohexital
  • Methscopolamine
  • Midazolam
  • Mirtazapine
  • Mivacurium
  • Molindone
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Nefazodone
  • Neuromuscular blockers
  • Non-Ionic Contrast Media
  • Nortriptyline
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Ombitasvir; Paritaprevir; Ritonavir
  • Orphenadrine
  • Oxazepam
  • Oxybutynin
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Paroxetine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phenylephrine; Promethazine
  • Pregabalin
  • Primidone
  • Prochlorperazine
  • Promethazine
  • Propantheline
  • Propoxyphene
  • Protriptyline
  • Quazepam
  • Ramelteon
  • Rapacuronium
  • Rasagiline
  • Remifentanil
  • Rivastigmine
  • Rocuronium
  • Safinamide
  • Scopolamine
  • Secobarbital
  • Selegiline
  • Serotonin norepinephrine reuptake inhibitors
  • Sertraline
  • Sodium Iodide
  • Sodium Oxybate
  • Succinylcholine
  • Sufentanil
  • Suvorexant
  • Tacrine
  • Tapentadol
  • Tasimelteon
  • Temazepam
  • Thalidomide
  • Thiopental
  • Thioridazine
  • Thiothixene
  • Tolcapone
  • Tolterodine
  • Tramadol
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trihexyphenidyl
  • Trimipramine
  • Triprolidine
  • Trospium
  • Tubocurarine
  • Valerian, Valeriana officinalis
  • Vecuronium
  • Verapamil
  • Vilazodone
  • Zaleplon
  • Zolpidem

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