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
- abdominal pain
- acne vulgaris
- agitation
- alopecia
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- anorexia
- anxiety
- asthenia
- ataxia
- blurred vision
- breast enlargement
- chest pain (unspecified)
- cholestasis
- confusion
- constipation
- diaphoresis
- diarrhea
- diplopia
- dizziness
- drowsiness
- dysarthria
- dysgeusia
- dyspepsia
- dyspnea
- edema
- eosinophilia
- excitability
- fatigue
- flatulence
- galactorrhea
- gastritis
- gynecomastia
- hallucinations
- headache
- hepatitis
- hyperglycemia
- hypertension
- hypertonia
- hypoglycemia
- hypotension
- ileus
- impotence (erectile dysfunction)
- increased urinary frequency
- insomnia
- irritability
- jaundice
- leukopenia
- libido decrease
- libido increase
- malaise
- myalgia
- myocardial infarction
- nausea
- palpitations
- paranoia
- paresthesias
- peripheral neuropathy
- peripheral vasodilation
- photosensitivity
- pruritus
- psychosis
- purpura
- rash
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- stomatitis
- stroke
- syncope
- testicular swelling
- thrombocytopenia
- tinnitus
- tongue discoloration
- tremor
- urinary retention
- urticaria
- vertigo
- vomiting
- weakness
- weight gain
- weight loss
- 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