Table Of Contents
- Flexeril Price Comparison Table
- Flexeril Information
- Flexeril Ingredients and Composition
- How Does Flexeril Work?
- How To Take Flexeril and Flexeril Dosage and Administration
- If you suspect a Flexeril Overdose
- Flexeril Pill Identification / ID and Appearance
- Flexeril Side Effects
- Flexeril Warnings
- Flexeril Precautions and Contraindications
- Contraindications to Flexeril
- Flexeril Clinical Trials and Studies
- Credits for Flexeril Information
Brand names: Flexeril
Flexeril Price Comparison Table
| Product | Qty | Price | Medical Fees & Shipping | Price/ Qty | Click to Order |
|---|---|---|---|---|---|
| Flexeril 10mg | 30 | $99.00 | $18.00 | $3.30 | Buy from MPllc |
| Flexeril 10mg | 30 | $100.00 | $18.00 | $3.33 | Buy from JRB |
| Flexeril 10mg | 30 | $114.00 | $15.00 | $3.80 | Buy from RxPayouts |
| Flexeril 10mg | 30 | $129.00 | $18.00 | $4.30 | Buy from IntegraRx |
| Flexeril 10mg | 30 | $129.00 | $18.00 | $4.30 | Buy from Billing-md |
| Flexeril 10mg | 90 | $315.00 | $15.00 | $3.50 | Buy from RxPayouts |
| Flexeril 10mg | 100 | $90.95 | $10.95 | $0.91 | Buy from PharmaWebCanada |
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Flexeril Information
Brand Name: Flexeril
Generic Name: Cyclobenzaprine HCl
Flexeril is a muscle relaxant used to relieve the pain and stiffness of muscle spasms and discomfort due to strain and sprain.
Flexeril Indications
Flexeril (cyclobenzaprine HCl) is indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions.
Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living.
Flexeril should be used only for short periods (up to two or three weeks) because adequate evidence of effectiveness for more prolonged use is not available and because muscle spasm associated with acute, painful musculoskeletal conditions is generally of short duration and specific therapy for longer periods is seldom warranted.
Flexeril has not been found effective in the treatment of spasticity associated with cerebral or spinal cord disease, or in children with cerebral palsy.
Flexeril Ingredients and Composition
Cyclobenzaprine HCl, the active ingredient in Flexeril, is a white, crystalline tricyclic amine salt with the empirical formula C20H21N•HCl and a molecular weight of 311.9. It has a melting point of 217°C, and a pKa of 8.47 at 25° C. It is freely soluble in water and alcohol, sparingly soluble in isopropanol, and insoluble in hydrocarbon solvents. If aqueous solutions are made alkaline, the free base separates. Cyclobenzaprine HCl is designated chemically as 3-(5H-dibenzo[a,d] cyclohepten-5-ylidene)-N, N-dimethyl-1-propanamine hydrochloride.
Cyclobenzaprine HCl is supplied as 10 mg Flexeril tablets for oral administration.
Inactive Flexeril Ingredients:
- hydroxypropyl cellulose
- hydroxypropyl methylcellulose
- iron oxide
- lactose
- magnesium stearate
- starch
- titanium dioxide
There are no additional Flexeril ingredients.
How Does Flexeril Work?
Cyclobenzaprine HCl, the active ingredient in Flexeril, relieves skeletal muscle spasm of local origin without interfering with muscle function. It is ineffective in muscle spasm due to central nervous system disease.
Cyclobenzaprine reduced or abolished skeletal muscle hyperactivity in several animal models. Animal Flexeril studies indicate that cyclobenzaprine does not act at the neuromuscular junction or directly on skeletal muscle. Such studies wshow that cyclobenzaprine acts primarily within the central nervous system at brain stem as opposed to spinal cord levels, although its action on the latter may contribute to its overall skeletal muscle relaxant activity. Evidence suggests that the net effect of cyclobenzaprine is a reduction of tonic somatic motor activity, influencing both gamma (g) and alpha (a) motor systems.
Pharmacological Flexeril studies in animals showed a similarity between the effects of cyclobenzaprine and the structurally related tricyclic antidepressants, including reserpine antagonism, norepinephrine potentiation, potent peripheral and central anticholinergic effects, and sedation. Cyclobenzaprine caused slight to moderate increase in heart rate in animals.
Cyclobenzaprine, the active ingredient in Flexeril, is well absorbed after oral administration, but there is a large intersubject variation in plasma levels. Cyclobenzaprine is eliminated quite slowly with a half-life as long as one to three days. It is highly bound to plasma proteins, is extensively metabolized primarily to glucuronide-like conjugates, and is excreted primarily via the kidneys.
No significant effect on plasma levels or bioavailability of cyclobenzaprine HCl or aspirin was noted when single or multiple doses of the two drugs were administered concomitantly. Concomitant administration of cyclobenzaprine HCl and aspirin is usually well tolerated and no unexpected or serious clinical or laboratory adverse effects have been observed. No studies have been performed to indicate whether cyclobenzaprine HCl enhances the clinical effect of aspirin or other analgesics, or whether analgesics enhance the clinical effect of cyclobenzaprine HCl in acute musculoskeletal conditions.
How To Take Flexeril and Flexeril Dosage and Administration
The usual dosage of Flexeril is 10 mg 3 times a day, with a range of 20 to 40 mg a day in divided doses. Flexeril dosage should not exceed 60 mg a day. Use of Flexeril for periods longer than 2 or 3 weeks is not recommended.
Take this medication with food to avoid stomach upset.
If you suspect a Flexeril Overdose
Flexeril Overdose Manifestations
High Flexeril doses may cause temporary confusion, disturbed concentration, transient visual hallucinations, agitation, hyperactive reflexes, muscle rigidity, vomiting, or hyperpyrexia, in addition to anything listed under Side Effects. Based on the known pharmacologic actions of the drug, overdosage may cause drowsiness, hypothermia, tachycardia and other cardiac rhythm abnormalities such as bundle branch block, ECG evidence of impaired conduction, and congestive heart failure. Other manifestations may be dilated pupils, convulsions, severe hypotension, stupor, and coma.
The acute oral LD50 of cyclobenzaprine HCl is approximately 338 and 425 mg/kg in mice and rats, respectively.
Treatment
Treatment of Flexeril overdose is symptomatic and supportive. Empty the stomach as quickly as possible by emesis, followed by gastric lavage. After gastric lavage, activated charcoal may be administered. Twenty to 30 g of activated charcoal may be given every 4 to 6 hours during the first 24 to 48 hours after ingestion. An ECG should be taken and close monitoring of cardiac function must be instituted if there is any evidence of dysrhythmia. Maintenance of an open airway, adequate fluid intake, and regulation of body temperature are necessary.
The intravenous administration of 1-3 mg of physostigmine salicylate is reported to reverse symptoms of poisoning by atropine and other drugs with anticholinergic activity. Physostigmine may be helpful in the treatment of cyclobenzaprine overdose. Because physostigmine is rapidly metabolized, the dosage of physostigmine should be repeated as required, particularly if life-threatening signs such as arrhythmias, convulsions, and deep coma recur or persist after the initial dosage of physostigmine. Because physostigmine itself may be toxic, it is not recommended for routine use.
Standard medical measures should be used to manage circulatory shock and metabolic acidosis due to Flexeril overdose. Cardiac arrhythmias may be treated with neostigmine, pyridostigmine, or propranolol. When signs of cardiac failure occur, the use of a short-acting digitalis preparation should be considered. Close monitoring of cardiac function for not less than five days is advisable.
Anticonvulsants may be given to control seizures.
Dialysis is probably of no value because of low plasma concentrations of the drug.
Since Flexeril overdosage is often deliberate, patients may attempt suicide by other means during the recovery phase. Deaths by deliberate or accidental overdosage have occurred with Flexeril.
Flexeril Pill Identification / ID and Appearance
Flexeril tablets are "D"-shaped, film coated tablets. 10 mg Tablets: Butterscotch yellow colored, with code "156" one one side and "WPPh" on the other.
Flexeril Side Effects
The following list of Flexeril side effects is based on the experience in 473 patients treated in controlled clinical studies, 7607 patients in the post-marketing surveillance program, and reports received since the drug was marketed. The overall incidence of Flexeril side effects among patients in the surveillance program was less than the incidence in the controlled Flexeril clinical studies.
The side effects reported most frequently with Flexeril were drowsiness, dry mouth, and dizziness. The incidence of these common adverse reactions was lower in the surveillance program than in the controlled clinical studies.
Clinical Studies Surveillance Program Reported Flexeril Side Effects
- Drowsiness: 16%
- Dry mouth: 7%
- Dizziness: 3%
Among the less frequent side effects, there was no appreciable difference in incidence in controlled clinical studies or in the surveillance program. Adverse reactions which were reported in 1% to 3% of the patients were:
- fatigue/tiredness
- asthenia
- nausea
- constipation
- dyspepsia
- unpleasant taste
- blurred vision
- headache
- nervousness
- confusion
As with any drug, you may experience additional Flexeril side effects.
Flexeril Warnings
Cyclobenzaprine in Flexeril is closely related to the tricyclic antidepressants, e.g., amitriptyline and imipramine. In short term studies for indications other than muscle spasm associated with acute musculoskeletal conditions, and usually at doses somewhat greater than those recommended for skeletal muscle spasm, some of the more serious central nervous system reactions noted with the tricyclic antidepressants have occurred.
Cyclobenzaprine HCl in Flexeril may interact with monoamine oxidase (MAO) inhibitors. Hyperpyretic crisis, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressants and MAO inhibitor drugs.
Tricyclic antidepressants have been reported to produce arrhythmias, sinus tachycardia, prolongation of the conduction time leading to myocardial infarction, and stroke.
Flexeril may enhance the effects of alcohol, barbiturates, and other CNS depressants.
Flexeril Precautions and Contraindications
General
Because of its atropine-like action, Flexeril should be used with caution in patients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in patients taking anticholinergic medication.
Information for the Patient
Flexeril may impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle.
Contraindications to Flexeril
- Hypersensitivity to Flexeril or any of its ingredients
- Concomitant use of monoamine oxidase inhibitors or within 14 days after their discontinuation.
- Acute recovery phase of myocardial infarction, and patients with arrhythmias, heart block or conduction disturbances, or congestive heart failure.
- Hyperthyroidism
Flexeril Clinical Trials and Studies
Controlled clinical Flexeril studies show that cyclobenzaprine HCl significantly improves the signs and symptoms of skeletal muscle spasm as compared with placebo. The clinical responses include improvement in muscle spasm as determined by palpation, reduction in local pain and tenderness, increased range of motion, and less restriction in activities of daily living. When daily observations were made, clinical improvement was observed as early as the first day of therapy.
Eight double-blind controlled clinical studies were performed in 642 patients comparing Flexeril, diazepam, and placebo. Muscle spasm, local pain and tenderness, limitation of motion, and restriction in activities of daily living were evaluated. In three of these studies there was a significantly greater improvement with cyclobenzaprine HCl than with diazepam, while in the other studies the improvement following both treatments was comparable.
Although the frequency and severity of adverse reactions observed in patients treated with Flexeril were comparable to those observed in patients treated with diazepam, dry mouth was observed more frequently in patients treated with Flexeril and dizziness more frequently in those treated with diazepam. The incidence of drowsiness, the most frequent adverse reaction, was similar with both drugs.
Analysis of the data from controlled studies shows that cyclobenzaprine HCl produces clinical improvement whether or not sedation occurs.
Surveillance Program
A post-marketing surveillance program was carried out in 7607 patients with acute musculoskeletal disorders, and included 297 patients treated for 30 days or longer. The overall effectiveness of Flexeril was similar to that observed in the double-blind controlled studies; the overall incidence of adverse effects was less.
Credits for Flexeril Information
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