What is the use of Cyclobenzaprine (Flexeril)?

From the Guidelines

Cyclobenzaprine is a muscle relaxant medication primarily used to treat muscle spasms and pain associated with acute musculoskeletal conditions, with a recommended dosage of 5-10 mg taken orally three times daily, and a maximum duration of 2-3 weeks 1.

Key Points

• The medication works by acting on the central nervous system to reduce muscle hyperactivity without affecting muscle function directly, and is structurally similar to tricyclic antidepressants 1.
• Common side effects include drowsiness, dry mouth, and dizziness, making it important to avoid activities requiring mental alertness until you know how the medication affects you.
• Cyclobenzaprine should be used as part of a comprehensive treatment plan that includes rest, physical therapy, and other appropriate measures.
• It should not be used for spasticity associated with cerebral or spinal cord disease, or in patients with hyperthyroidism, heart block, conduction disturbances, or during MAO inhibitor therapy.

Important Considerations

• Long-term use of cyclobenzaprine can lead to withdrawal symptoms, which can be prevented by tapering the medication over 2 to 3 weeks 1.
• Concomitant use of cyclobenzaprine with monoamine oxidase inhibitors may increase the potential for serotonin syndrome.
• Elderly patients or those with liver impairment should start with a lower dose of 5 mg, and the medication's effects should be closely monitored.

Evidence-Based Recommendations

• The use of cyclobenzaprine for acute low back pain has been found to be moderately superior to placebo for short-term pain relief, with a relative risk of not achieving pain relief of 0.80 (CI, 0.71 to 0.89) at 2 to 4 days 1.
• However, the evidence for its use in chronic low back pain is limited, and more research is needed to determine its efficacy and safety in this population.

From the FDA Drug Label

Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions The use of Cyclobenzaprine (Flexeril) is as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions. The main goal is to provide relief of muscle spasm and its associated signs and symptoms, including:

• Pain
• Tenderness
• Limitation of motion
• Restriction in activities of daily living 2

From the Research

Use of Cyclobenzaprine (Flexeril)

• Cyclobenzaprine is a muscle relaxant used to treat muscle spasm associated with acute, painful musculoskeletal conditions 3, 4, 5, 6.
• It is effective in improving muscle spasm, reducing local pain and tenderness, and increasing range of motion in acute, painful musculoskeletal conditions 3.
• Cyclobenzaprine can be administered in immediate-release or extended-release formulations, with the extended-release formulation allowing for once-daily dosing 4, 5.
• The medication has been shown to be well-tolerated, with common adverse events including somnolence, dry mouth, and dizziness 3, 4, 6.
• Cyclobenzaprine has also been used to treat other conditions, such as levator ani syndrome, with reported success 7.

Administration and Dosage

• Cyclobenzaprine can be administered at a dosage of 5-10 mg three times daily for immediate-release formulations 3.
• Extended-release formulations can be administered at a dosage of 15-30 mg once daily 4, 5, 6.
• The choice of dosage and formulation may depend on the individual patient's needs and response to treatment 3, 4, 5, 6.

Efficacy and Tolerability

• Cyclobenzaprine has been shown to be effective in relieving acute muscle spasm and improving patient-rated measures of medication helpfulness and global impression of change 3, 6.
• The medication has been found to be generally well-tolerated, with a low rate of reported somnolence and other adverse events 3, 4, 6.
• Cyclobenzaprine may be a useful treatment option for patients with muscle spasm associated with acute, painful musculoskeletal conditions, as well as other conditions such as levator ani syndrome 3, 4, 5, 6, 7.