Soma

Generic Name: cyclobenzaprine (sye kloe BEN za preen)
Brand Names:Flexeril

What is Flexeril?

Flexeril is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Flexeril is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Flexeril may also be used for other purposes not listed in this medication guide.

How should I take Flexeril?

Take this medication exactly as it was prescribed for you. Do not take Flexeril in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take this medicine with a full glass of water. Do not crush, chew, break, or open an extended-release capsule. Swallow the pill whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

Flexeril is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures. Follow your doctor’s instructions.
Store Flexeril at room temperature away from moisture, heat, and light.

Flexeril side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Flexeril and call your doctor at once if you have any of these serious side effects:

* fast, pounding, or uneven heartbeats
* chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling
* sudden numbness or weakness, especially on one side of the body
* sudden headache, confusion, problems with vision, speech, or balance
* feeling light-headed, fainting
* confusion, weakness, lack of coordination
* nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)
* seizure (convulsions)
* unusual thoughts or behavior, hallucinations (seeing things)
* easy bruising or bleeding, unusual weakness.

Less serious side effects may include:

* dry mouth or throat
* blurred vision
* drowsiness, dizziness, tired feeling
* loss of appetite, stomach pain, nausea
* diarrhea, constipation, gas
* muscle weakness

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Strains, sprains, and other muscle injuries can result in pain, stiffness, and muscle spasms. Muscle relaxants do not heal the injuries, but they do relaxmuscles and help ease discomfort and stop muscle spasms. The muscle relaxantcyclobenzaprine (Flexeril) is also sometimes used to treat fibromyalgia, a condition that involves aches, stiffness, and fatigue.

Muscle relaxants work by acting on the central nervous system. In the UnitedStates, they are available only with a physician’s prescription. Examples of muscle relaxants are carisoprodol (Soma), chlorzoxazone, cyclobenzaprine (Flexeril), and methocarbamol. Most come only in tablet form. However, methocarbamol is available in both tablet and injectable forms. Some muscle relaxants are available in Canada without a prescription.

Muscle relaxants are usually prescribed along with rest, exercise, physical therapy, or other treatments. Although the drugs may provide relief, they should never be considered a substitute for these other forms of treatment. Thesedrugs may make the injury feel so much better that one is tempted to go backto normal activity, but doing too much too soon can actually make the injuryworse.

Muscle relaxants work quite well for relieving muscle pain due to injuries, but are not effective for other types of pain. Some people feel drowsy, dizzy,confused, lightheaded, or less alert when using muscle relaxants drugs. These drugs may also cause blurred vision, clumsiness, or unsteadiness.

Because muscle relaxants work on the central nervous system, they may add tothe effects of alcohol and other drugs that slow down the central nervous system. They may also add to the effects of anesthetics, including those used for dental procedures. For this reason, anyone who takes these drugs should notdrive, operate machinery, or do anything else that might be dangerous untilthey have found out how the drugs affect them.

People with certain medical conditions or who are taking certain other medicines can have problems if they take muscle relaxants. Diabetes should be awarethat the metaxalone (Skelaxin) may cause false test results on one type of test for sugar in the urine. People with epilepsy should be cautioned that taking the muscle relaxant methocarbamol may increase the likelihood of seizures.

Anyone who has allergies, who is breastfeeding has kidney disease, has suffered a recent heart attack or irregular heartbeat, has an overactive thyroid gland, hepatitis or liver disease, is a current or former drug or alcohol abuser, has glaucoma, or has problems with urination should discuss their condition with their doctor before taking muscle relaxants.

The most common side effects or muscle relaxants are vision changes, such asdouble vision or blurred vision; dizziness; lightheadedness; drowsiness; anddry mouth. These problems usually go away as the body adjusts to the drug anddo not require medical treatment. Methocarbamol and chlorzoxazone may causeharmless color changes in urine –orange or reddish-purple with chlorzoxazoneand purple, brown, or green with methocarbamol. The urine will return to itsnormal color when the patient stops taking the medicine.

Less common side effects, such as stomach cramps or pain, nausea and vomiting, constipation, diarrhea, hiccups, clumsiness or unsteadiness, confusion, nervousness, restlessness, irritability, flushed or red face, headache, heartburn, weakness, trembling, and sleep problems also may occur and do not need medical attention unless they do not go away or they interfere with normal activities.

More serious side effects are not common, but may occur. Anyone who experiences breathing problems, facial swelling, fainting, unusually fast or unusuallyslow heartbeat, fever, tightness in the chest, rash, itching, hives, burning, stinging, red, or bloodshot eyes, or unusual thoughts or dreams after taking muscle relaxants should seek medical help promptly

The muscle relaxant chlorzoxazone has caused serious, life-threatening liver problems in some people. The reaction is rare, but anyonetaking the drug should stop taking it and notify his or her physician immediately if any of these symptoms occur: fever, rash, loss of appetite, nausea,vomiting, fatigue, pain in the upper right part of the abdomen, dark urine, or yellow skin or eyes.

Muscle relaxants may interact with some other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effectsmay be greater. Anyone who plans to take muscle relaxants should let the physician know all other medicines, including over-the-counter or nonprescription medicines, that he or she is taking.

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How is it abused?

Abusers typically ingest Soma orally. Many abusers take it in combination with other drugs to enhance the effects of those drugs. Alcohol, codeine, diazepam, heroin, hydrocodone (especially Vicodin), meprobamate, and propoxyphene commonly are abused in combination with Soma. Abusers who combine Soma with Vicodin claim that this combination produces effects similar to those of heroin.

Soma is generally safe when prescribed by a physician and used as directed. However, individuals who abuse Soma can develop psychological addictions to the drug. Common side effects of Soma abuse include blurred vision, dizziness, drowsiness, and loss of coordination. More serious side effects include chills, depression, racing heartbeat, tightness in chest, vomiting, and unusual weakness. Withdrawal symptoms associated with Soma dependency include abdominal cramps, headache, insomnia, and nausea. Signs that an overdose has occurred include difficulty in breathing, shock, and coma. A Soma overdose may result in death.

Is it illegal to abuse Soma?

Yes, abusing Soma is illegal. Reports of Soma abuse have resulted in a number of states scheduling Soma as a controlled substance. States that have taken this action are Alabama, Arizona, Arkansas, Florida, Georgia, Hawaii, Indiana, Kentucky, Minnesota, New Mexico, Oklahoma, Oregon, and West Virginia. Soma is not scheduled at the federal level. However, reports of Soma abuse are being monitored by the Drug Enforcement Administration, and Soma could be listed under the Controlled Substances Act if warranted.

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This review examines the efficacy, side effects, and safety of three commonly prescribed skeletal muscle relaxants metaxalone (Skelaxin), cyclobenzaprine (Flexril), and carisoprodol (Soma).

Skeletal muscle relaxants are commonly used drugs prescribed for the treatment of muscle spasms and discomfort. Muscle relaxants are not really a class of drugs, but rather a group of different drugs that each has an overall sedative effect on the body.

Muscle relaxants treat both muscle spasm and spasticity. These drugs relieve muscle spasms due to low back pain, neck pain, fibromyalgia, tension headaches. They also relieve spasticity due to cerebral palsy, multiple sclerosis, spinal cord injury, or stroke.

* Carisoprodol (brand name: Soma) was approved by the FDA in 1959. Carisoprodol is a muscle relaxant that is used to treat muscle spasms and musculoskelatal pain. Carisoprodol is also a drug treatment option for fibromyalgia symptoms.
* Cyclobenzaprine was FDA approved on August 26, 1977. Cyclobenzaprine is distributed and marketed by McNeil under the brand name Flexeril. Flexeril is one of the strongest muscle relaxants. It has been shown to be beneficial in fibromyalgia, muscle spasms and musculoskelatal pain.
* Metaxalone was approved by FDA on August 13, 1962. This medication is manufactured by by King Pharmaceuticals under the brand name Skelaxin. Skelaxin is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomforts associated with acute, painful musculoskeletal conditions.

The mechanisms of action of the medications in this class are widely varied and many are not thoroughly understood.

Carisoprodol: The actions of carisoprodol are related to a central nervous system (CNS) mechanism and not to a direct effect on skeletal muscle. Carisoprodol appears to interrupt neuronal communication within the reticular formation and spinal cord. CNS depression produces sedation, and the perception of pain could be altered. Some believe that most of the benefit seen with carisoprodol is secondary to a generalized sedative effect.

Cyclobenzaprine: Since cyclobenzaprine is closely similar to amitriptyline in chemical structure, some of its effects are similar to the tricyclic antidepressants. Cyclobenzaprine relieves muscle spasms through a central action, possibly at the brain stem level, with no direct action on the neuromuscular junction or the muscle involved. It is not a peripheral neuromuscular blocker. Treatment with the drug reduces pain and tenderness, and improves mobility.

Metaxalone: The mechanism of action of metaxalone has not been established. Metaxalone has no direct effect on the contractile mechanism of striated muscle, the motor end plate, or the nerve fiber. Its mode of action may be due to general central nervous system depression.

All three drugs appear to have equal efficacy, but their side effects vary considerably.

Sedation is the most commonly reported adverse effect of muscle relaxants. These medications should be used with caution in people driving motor vehicles or operating heavy machinery. More absolute contraindications do exist to the use of carisoprodol and cyclobenzaprine. By initially prescribing muscle relaxants at bedtime, the physician might take advantage of their sedative effects and minimize daytime drowsiness.

While cyclobenzaprine may not share the dangerous cardiac and neurological potential of its close relatives the TCAs, it does share other properties, particularly confusion, lethargy, and anticholinergic side effects, and may have some toxicity in overdose and in combination with other substances.

Carisoprodol presents the most significant concern, due particularly to its potential for dependence and abuse. Several investigators have called for carisoprodol to be classified as a controlled substance. Carisoprodol is thought to carry an important risk for abuse because of its metabolism to meprobamate.

In the head to head trial of cyclobenzaprine and carisoprodol, dry mouth was more frequent with cyclobenzaprine (38% vs. 10%) and dizziness less frequent (8% vs. 26%). Withdrawal rates due to adverse events were equal (8%).

Metaxalone has the fewest reported side effects of any skeletal muscle relaxants and appears to be the safest.

Key differences among drugs

* Cyclobenzaprine has been evaluated in the most clinical trials and so has the most proof of being effective. Related to TCAs, use with caution in cardiac patients
* Carisoprodol can be addictive.
* Metaxalone is the least likely to cause drowsiness making it more compatible with day time use. Do not use in hepatic dysfunction or patients with history of drug-induced anemia.

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Muscles tend to seize up after an injury (muscle spasm). They do this to protect you from re-injury. While that is certainly a worthy purpose, it can get pretty painful and limiting. Sometimes skeletal muscle relaxants are prescribed in conjunction with physical therapy and rest, to help release the tension. A word of caution, though, while on these medications, you may feel better, but this does not mean it is time for vigorous activity or heavy lifting! Take it slowly - you are healing.

Top 3 Best Muscle Relaxer Medications

1. Skelaxin
Skelaxin is only available in brand form. It is tolerated well by most people, but as with any medication, it is important to tell your doctor your complete medical history, and everything you are taking, including supplements. Because metaxalone is meant for acute injuries, it should not be taken longer than 3 weeks. One side effect to be concerned about is drowsiness, especially if you operate machinery.

2. Carisoprodol - Soma
Carisoprodol is available generically, and also comes in Soma brand.

Carisoprodol is very similar to Skelaxin. Remember is is crucial to talk to your doctor about which medication will be best for you — give him or her your complete history including all medications and supplements you are currently taking.

3. Cyclobenzeprine or Flexeril
Cyclobenzeprine is more tricky to use safely than Skelaxin or carisoprodol. DISCUSS THIS ONE WITH YOUR DOCTOR! If you take MAO inhibitors, as well as some other meds, drug interactions could be serious, even fatal.

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Cyclobenzaprine is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain.

Cyclobenzaprine is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Cyclobenzaprine may also be used for other purposes not listed in this medication guide.

Carisoprodol Soma is a muscle relaxer that works by blocking pain sensations between the nerves and the brain.

Carisoprodol Soma is used together with rest and physical therapy to treat injuries and other painful musculoskeletal conditions.

Carisoprodol soma may also be used for other purposes not listed in this medication guide.

They both are VERY powerful muscle relaxer.

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Reasons why we have neck pain and how to find relief of this excruciating pain.

What is neck pain and how does one find relief after experiencing this type of pain? Neck pain is usually a result of a strain or spasm in the muscles of the neck, which also includes pain in the shoulder area. The pain can also be caused by inflammation in the joints of the neck, arthritis, or damaged disks.

Muscle strain occurs when one sleeps on a pillow that doesn’t support the neck properly, such as, sleeping with a twisted neck (happens when sleeping on stomach), lying down reading or watching TV with the neck in an awkward position, improper positioning of the computer monitor, working too long in front of the computer without a break, sitting hunchback while working at one’s desk, stress, and injuries to the neck.

Knowing this, how can one prevent neck pains in the future?

· Using good posture while walking, sitting, and sleeping.
· Avoid slouching.
· Avoid keeping your head bent forward for long periods of time.
· Exercise the neck muscles by using stretching exercises geared towards the neck.
· Avoid sitting for long periods of time without getting up or changing positions.
· Adjust the computer monitor so that the top of the computer screen is at eye level.
· Use a document holder that attaches to the side of the computer screen, instead of looking down at the paper, which increases neck strain.
· Learning to type without having to look at the keyboard will also decrease neck strains.
· Getting a headpiece, or a speakerphone, will also decrease neck pain for those who spend more than a half hour at time on the phone.
· When driving in one’s car, consider sitting the seat straight up and down.
· Purchase a hard mattress instead of a one with a lot of cushions.
· Purchase a neck support.
· If stress is the cause for the pain, consider relaxation exercises.

Home remedies that may help ease some of the pains associated with neck pain are:

· Place an ice pack, such as a bag of frozen peas, on the neck for fifteen minutes.
· Never use heat to sooth neck pain.
· Sitting in a lukewarm tub of water, or a Jacuzzi, with jet streams hitting the soar muscles will also help to decrease the swelling of the neck muscles.

Neck pain should never be masked with pain relief medications, such as aspirin, ibuprofen or acetaminophen. If your neck pain is severe and constant, seek the help of your doctor or chiropractor.

When home remedies do not seem to relieve the neck pains, chiropractic care may be needed. Sometimes, the nerves in one’s neck may become pinched, causing inflammation in the muscles. To relieve the pain, one has to un-pinch the pinched nerves.

Caution: Meningitis can cause neck pain. If you experience neck pain along with headaches, fever, sleepiness, vomiting, and/or loss of consciousness, get to your doctor right away. While viral meningitis is not usually life threatening, bacterial meningitis can be life threatening if left untreated.

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Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.

During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

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Neck pain may begin in any of the structures in the neck. These include muscles and nerves as well as spinal vertebrae and the cushioning disks in between. Neck pain may also come from regions near the neck, like the shoulder, jaw, head, and upper arms.

When your neck is sore, you may have difficulty moving it, especially to one side. Many people describe this as having a stiff neck.

If neck pain involves nerves (for example, significant muscle spasm pinching on a nerve or a slipped disk pressing on a nerve), you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

If the pain is due to muscle spasm or a pinched nerve, your doctor may prescribe a muscle relaxant like Soma or Tramadol, and possibly a more powerful pain reliever. Prescription drugs are not necessarily better than over-the-counter medications. The doctor may prescribe a neck collar or, if there is nerve damage, refer you to a neurologist or neurosurgeon for consultation.

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Generic Name: metaxalone (me TAX a lone)
Brand Names: Skelaxin

What is Skelaxin?

Skelaxin is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) in the brain.

Skelaxin is used together with rest and physical therapy to treat skeletal muscle conditions such as pain or injury.

Skelaxin may also be used for other purposes not listed in this medication guide.

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take Skelaxin on an empty stomach, unless your doctor tells you otherwise.

Skelaxin can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using Skelaxin.

Skelaxin is only part of a complete program of treatment that may also include rest, physical therapy, or other pain relief measures. Follow your doctor’s instructions.
Store Skelaxin at room temperature away from moisture and heat.

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