Strong data comparing skeletal muscle relaxants to each other are scarce. A systematic review evaluated 46 trials head-to-head and placebo-controlled comprising mostly of studies on low back pain or neck syndromes.
The placebo-controlled trials included 17 on cyclobenzaprine, six on tizanidine, four on carisoprodol, and four on orphenadrine, and were mostly conducted more than 15 years ago. The average patient enrollment was less than patients range 12 to patients. In general, all of the drugs were shown to have some benefit. One fair-quality study showed carisoprodol was better than diazepam at improving muscle spasm and global and functional status in patients with low back pain.
A different systematic review did include some studies which were considered to be high quality. Although the evidence for effectiveness of skeletal muscle relaxants in musculoskeletal conditions is limited, strong evidence does exist in terms of toxicity. Selection of a skeletal muscle relaxant should be individualized to the patient. If there are tender spots over the muscle or trigger points on physical examination, a skeletal muscle relaxant is a reasonable adjunct to analgesic treatment of low back pain.
Skeletal muscle relaxants may also be used as an alternative to NSAIDs in patients who are at risk of gastrointestinal or renal complications. Patients with low back pain or fibromyalgia may benefit from treatment with cyclobenzaprine. Recent evidence showed similar effectiveness at half of its manufacturer recommended dose 5 mg , but with fewer adverse effects. Higher doses of cyclobenzaprine or tizanidine would be appropriate to promote sedation in cases of more severe discomfort or perceived muscular spasm.
Although there appears to be insufficient data on metaxalone and methocarbamol, these may be useful in patients who cannot tolerate the sedative properties of cyclobenzaprine or tizanidine. Of note, methocarbamol costs substantially less than metaxalone. Carisoprodol is metabolized to meprobamate a class III controlled substance and has been shown to produce psychological and physical dependence.
Although all skeletal muscle relaxants should be used with caution in older patients, diazepam especially should be avoided in older patients or in patients with significant cognitive or hepatic impairment.
Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. She received her doctor of pharmacy degree from Rutgers University College of Pharmacy in New Brunswick, NJ, and completed an inpatient family medicine pharmacy specialty residency at Deaconess Hospital and the St.
Louis College of Pharmacy in St. Louis, Mo. She received her doctor of pharmacy degree from St. Reprints are not available from the authors. Carisoprodol carisoprodol tablet [package insert]. Philadelphia, Pa. Accessed January 14, Chlorzoxazone chlorzoxazone tablet [package insert]. Sellersville, Pa. Cyclobenzaprine hydrochloride cyclobenzaprine hydrochloride tablet [package insert].
Corona, Calif. Diazepam diazepam tablet [package insert]. Miami, Fla. Skelaxin metaxalone [package insert]. Briston, Tenn. Methocarbamol methocarbamol tablet [package insert]. January 14, Orphenadrine citrate extended-release orphenadrine citrate tablet [package insert]. Princeton, NJ: Sandoz, Inc. Tizanidine hydrochloride tizanidine hydrochloride tablet [package insert].
Pomona, NY: Barr Laboratories. United States Food and Drug Administration. Zanaflex tizanidine hydrochloride tablets and capsules. Top brand-name drugs by units in Top generic drugs by units in Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society [published correction appears in Ann Intern Med.
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Muscle relaxants for non-specific low back pain. Cochrane Database Syst Rev. Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. J Pain Symptom Manage. Diamond S. Double-blind study of metaxalone; use as a skeletal-muscle relaxant. Chou R, Huffman LH. Activity of tetrazepam in low back pain. Clin Trials J. Treatment of chronic low-back syndrome with tetrazepam in a placebo controlled double-blind trial.
J Drug Dev. To understand more, take a look at the table below:. Even though both of the drugs are under the same drug class, Robaxin vs Flexeril differ in dosages and length of use. Robaxin is usually dosed multiple times a day while Flexeril can be taken once a day. For patients who are wondering, which is better between Methocarbamol vs Cyclobenzaprine, there is no proof yet that any particular muscle relaxant is much more effective than the other.
For example, Pharmacists from St. Eventually, this medication will benefit them more since it causes somnolence compared to Robaxin. Additionally, Cyclobenzaprine may cause more severe adverse reactions such as dehydration, serotonin syndrome, overactive thyroid gland, and possible stroke. Both Methocarbamol vs Flexeril medications can harm the fetus during pregnancy. While comparing Methocarbamol vs Soma , it is important to note their collective similarity, which is the ability to relieve spasms and pain, as they both come from the same drug class.
Additionally, both of these medications are available in different strengths and generic types. Moreover, this medication is unsafe for adults over the age of 65 or under For the medication Soma, medical professionals from North Carolina reported that even Carisoprodol, the generic of Soma, can cause drug dependence and withdrawal.
In terms of side effects, both Methocarbamol vs Soma may cause dizziness, headaches, and somnolence. However, for the drug Soma, there is a possibility for patients using this medication to experience seizures.
So, for patients who are wondering about which is more effective between Methocarbamol vs Soma, doctors from Tulane University claimed that both of these drugs may give the same benefits. The only difference is that there are more adverse effects associated with Soma. Although in Methocarbamol vs Baclofen comparison, both of these medications are under the same drug class called muscle relaxants, these two offer different indications.
For those considering the better option between Robaxin vs Baclofen, the former is used mainly for spasticity , as a regimen for individuals suffering from a spinal injury. However, it may not be considered the first choice for muscle pain. Also, while Robaxin side effects are mainly sedation and fetal risk, that of Baclofen is quite extensive.
One advantage of Baclofen in Methocarbamol vs Baclofen comparison is that it can be used as a treatment for the medical condition called Trigeminal Neuralgia , a type of chronic pain in the face.
So, for those wondering which is better in Robaxin vs Baclofen, consider first the other medical conditions of the patient. Then, analyze if the patient can tolerate the side effects of the drug to be used.
For a safer and more effective treatment, always consult a medical professional. In this comparison, both drugs are under the same drug class and both have the same indications — treatment for muscle pain and spasms. Additionally, these two drugs are less sedating compared to other skeletal muscle relaxants.
It does not directly affect muscle contractions. Robaxin is available as a brand name or generic medication. It comes as an injection as well as a mg or mg oral tablet. Those who are prescribed Robaxin tablets need to take two or three tablets four times per day , initially. Then, one or two tablets three to four times per day or more is recommended. Flexeril was initially approved by the FDA in the s. It primarily works on the brain stem and spinal cord in the CNS, which helps reduce motor activity.
Flexeril is also structurally similar to tricyclic antidepressants and has similar side effects such as dry mouth and sedation.
Flexeril is commonly known by its generic name cyclobenzaprine. Brand-name Flexeril has been discontinued; however, cyclobenzaprine is available in two other brand names: Amrix extended-release and Fexmid immediate-release. The extended-release tablet can be taken once per day. Sign up for Robaxin price alerts and find out when the price changes! Get price alerts. Robaxin and Flexeril are FDA approved to treat discomfort or muscle spasms from acute musculoskeletal conditions as well as tetanus.
Robaxin or Flexeril are usually prescribed to treat musculoskeletal pain such as neck pain. Both drugs are also often used to treat low back pain, a common problem in adults in the US. Flexeril has also been studied to treat fibromyalgia, a chronic condition characterized by muscle pain all over the body. Those with fibromyalgia may experience widespread muscle pain as well as problems with sleep, fatigue, and mood. According to a meta-analysis of five clinical trials, cyclobenzaprine was found to improve sleep and pain in patients with fibromyalgia over a period of up to 24 weeks.
Robaxin and Flexeril are effective treatments for treating musculoskeletal pain and muscle spasms. The more effective drug is the one that works best for your specific case. Flexeril is one of the most studied muscle relaxants; thus, it has more supporting evidence for its effectiveness. In a systematic review , it was found that, in general, muscle relaxants are comparable in effectiveness.
This review included other muscle relaxants such as metaxalone, baclofen, tizanidine, orphenadrine, and chlorzoxazone. In a head-to-head trial between methocarbamol and cyclobenzaprine, there was no significant difference in muscle spasms or tenderness. Cyclobenzaprine has been compared to Valium diazepam and Soma carisoprodol in clinical trials.
Cyclobenzaprine was similarly effective to these drugs for treating acute low back pain. Consult a healthcare provider for medical advice to find the best treatment options for you. After a complete assessment from a doctor, one drug may be preferred depending on your overall medical history.
Generic Robaxin tablets are usually covered by Medicare and insurance plans. Get the SingleCare prescription discount card. Generic cyclobenzaprine tablets are often covered by Medicare and insurance plans. Even if you do have insurance, it may be a good idea to find out if you can get a cheaper price on muscle relaxants.
The most common side effects of Robaxin and Flexeril are drowsiness, dizziness, and headache. Flexeril may be associated with more drowsiness compared to Robaxin. Because of its anticholinergic properties, Flexeril can also cause dry mouth.
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