carisoprodol
carisoprodol
[kar″i-so´pro-dol]carisoprodol
Pharmacologic class: Carbamate derivative
Therapeutic class: Centrally acting skeletal muscle relaxant
Controlled substance schedule IV (in some states)
Pregnancy risk category C
Action
Unknown. May modify central perception of pain without modifying pain reflexes. Skeletal muscle relaxation may result from sedative properties or from inhibition of activity in descending reticular formation and spinal cord.
Availability
Tablets: 250 mg, 350 mg
Indications and dosages
➣ Adjunctive treatment of muscle spasms associated with acute painful musculoskeletal conditions
Adults: 350 mg P.O. q.i.d.
➣ Relief of discomfort associated with acute painful musculoskeletal conditions
Adults: 250 to 350 mg P.O. t.i.d. and at bedtime
Contraindications
• Hypersensitivity to drug or meprobamate
• Porphyria or suspected porphyria
Precautions
Use cautiously in:
• severe hepatic or renal disease
• history of substance abuse
• pregnant or breastfeeding patients
• children ages 12 and younger.
Administration
• Give last daily dose at bedtime.
• Administer with food if GI upset occurs.
• If patient can't swallow tablets, mix with syrup, chocolate, or jelly.
Adverse reactions
CNS: dizziness, drowsiness, agitation, ataxia, depression, headache, insomnia, vertigo, tremor, depression
CV: hypotension, tachycardia
GI: nausea, vomiting, epigastric distress
Hematologic: eosinophilia, leukopenia
Respiratory: asthma attacks
Skin: flushing (especially of face), rash, pruritus, erythema multiforme
Other: hiccups, fever, psychological drug dependence, anaphylactic shock
Interactions
Drug-drug. Antihistamines, opioids, sedative-hypnotics: additive CNS depression
Drug-diagnostic tests. Eosinophils: increased count
Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression
Drug-behaviors. Alcohol use: increased CNS depression
Patient monitoring
• When giving to breastfeeding patient, watch for signs of sedation and GI upset in infant.
• Monitor range of motion, stiffness, and discomfort level.
• Know that drug is metabolized to meprobamate. Monitor for drug dependence, especially in patients with history of substance abuse.
Patient teaching
• Tell patient that psychological drug dependence may occur.
• Instruct patient to avoid over-the-counter drugs and alcohol, because they may increase CNS depression.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.