Robaxin (Methocarbamol) Dosing Recommendations
The recommended initial dosing for Robaxin (methocarbamol) is 1500 mg (three 500 mg tablets) four times daily for the first 48-72 hours, followed by a maintenance dose of 1000 mg (two 500 mg tablets) four times daily. 1
Dosing Schedule
For 500 mg tablets:
- Initial dosage: 3 tablets (1500 mg) four times daily
- Maintenance dosage: 2 tablets (1000 mg) four times daily
For 750 mg tablets:
- Initial dosage: 2 tablets (1500 mg) four times daily
- Maintenance dosage: 1 tablet (750 mg) every 4 hours or 2 tablets (1500 mg) three times daily
Maximum Daily Dosage
- Standard recommendation: 6 grams per day
- For severe conditions: Up to 8 grams per day may be administered during the first 48-72 hours
- After initial treatment period: Dosage can usually be reduced to approximately 4 grams per day
Special Considerations
Alcohol Interaction
- Concurrent use of methocarbamol with alcohol should be avoided due to the risk of enhanced central nervous system depression
- This combination can lead to potentially fatal interactions due to the interactive sedative-hypnotic properties of both substances 2
Elderly Patients
- Consider starting at the lower end of the dosing range
- Monitor closely for side effects, particularly sedation
Renal Impairment
- Dose adjustment may be necessary in patients with significant renal impairment
- Monitor for increased side effects
Hepatic Impairment
- Use with caution in patients with hepatic impairment
- Consider dose reduction and monitor for side effects
Common Side Effects
- Drowsiness/sedation
- Dizziness
- Lightheadedness
- Headache
- Nausea
Monitoring
- Assess clinical response to therapy
- Monitor for adverse effects, particularly excessive sedation
- Evaluate the need for continued therapy beyond 2-3 weeks
Important Precautions
- Patients should be cautioned about operating machinery or driving while taking methocarbamol due to potential sedative effects
- The medication should be used as part of a comprehensive treatment plan that may include physical therapy and other non-pharmacological approaches
- Discontinue if hypersensitivity reactions occur
Remember that methocarbamol is intended for short-term use in most cases, and the need for continued therapy should be reassessed regularly.