Cyclobenzaprine (oral route)

Brand Name

US Brand Name

Amrix

Fexmid

Flexeril

FusePaq Tabradol

Description

Cyclobenzaprine is used to help relax certain muscles in your body. It helps relieve pain, stiffness, and discomfort caused by strains, sprains, or injuries to your muscles. However, this medicine does not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem. Cyclobenzaprine acts on the central nervous system (CNS) to produce its muscle relaxant effects. Its actions on the CNS may also cause some of this medicine's side effects.

This medicine is available only with your doctor's prescription.

This product is available in the following dosage forms:

Capsule, Extended Release
Tablet
Suspension

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of cyclobenzaprine extended-release capsules in the pediatric population. Safety and efficacy have not been established.

Geriatric

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.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Cisapride
Dronedarone
Furazolidone
Iproniazid
Isocarboxazid
Levoketoconazole
Levomethadyl
Linezolid
Mesoridazine
Methylene Blue
Moclobemide
Pargyline
Phenelzine
Pimozide
Piperaquine
Potassium Citrate
Procarbazine
Rasagiline
Safinamide
Saquinavir
Selegiline
Sparfloxacin
Terfenadine
Thioridazine
Tranylcypromine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Adagrasib
Alfentanil
Almotriptan
Alprazolam
Amantadine
Amineptine
Amiodarone
Amisulpride
Amitriptyline
Amitriptylinoxide
Amoxapine
Amphetamine
Anagrelide
Apomorphine
Aripiprazole
Aripiprazole Lauroxil
Arsenic Trioxide
Artemether
Asenapine
Atazanavir
Azithromycin
Balofloxacin
Bedaquiline
Benzhydrocodone
Benzphetamine
Besifloxacin
Bromazepam
Buprenorphine
Buserelin
Butalbital
Butriptyline
Calcium Oxybate
Cannabidiol
Cannabis
Ceritinib
Cetirizine
Chloroquine
Ciprofloxacin
Citalopram
Clarithromycin

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Tobacco

Proper Use

Take this medicine only as directed by your doctor. Do not take more of it and do not take it more often than your doctor ordered. To do so may increase the chance of serious side effects.

Swallow the extended-release capsule whole. If you cannot swallow the capsule whole, you may open the capsule and sprinkle the contents over one tablespoon of applesauce. Swallow the mixture right away without chewing. Rinse the mouth to make sure all of the medicine have been swallowed. Do not save any of the mixture to use later.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For relaxing stiff muscles:
- For oral dosage form (extended-release capsules):
  - Adults—15 milligrams (mg) once a day. Some patients may need 30 mg (one 30 mg capsule or two 15 mg capsules) per day.
  - Children—Use and dose must be determined by your doctor .
- For oral dosage form (tablets):
  - 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.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

If your condition does not improve within 2 or 3 weeks, or if it becomes worse, check with your doctor.

Do not use the extended-release capsules if you have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within 14 days of each other.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, other muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people to have blurred vision or to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and able to see well.

Cyclobenzaprine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

Clumsiness or unsteadiness
confusion
fainting
mental depression
problems in urinating
ringing or buzzing in the ears
skin rash, hives, or itching occurring without other symptoms of an allergic reaction listed above
unusual thoughts or dreams
yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Convulsions (seizures)
drowsiness (severe)
dry, hot, flushed skin
fast or irregular heartbeat
hallucinations (seeing, hearing, or feeling things that are not there)
increase or decrease in body temperature
troubled breathing
unexplained muscle stiffness
unusual nervousness or restlessness (severe)
vomiting (occurring together with other symptoms of overdose)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Blurred vision
dizziness, drowsiness, or lightheadedness
dryness of the mouth

Less common or rare

Bloated feeling or gas, indigestion, nausea or vomiting, or stomach cramps or pain
constipation
diarrhea
excitement or nervousness
frequent urination
general feeling of discomfort or illness
headache
muscle twitching
numbness, tingling, pain, or weakness in hands or feet
pounding heartbeat
problems in speaking
trembling
trouble sleeping
unpleasant taste or other taste changes
unusual muscle weakness
unusual tiredness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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