Contraindications of Tab. Myoril (Tolperisone)
Tab. Myoril (tolperisone) is contraindicated in patients who are pregnant or actively trying to conceive, nursing mothers, and those with known hypersensitivity to the drug due to risk of anaphylactic reactions.
Major Contraindications
- Pregnancy or women actively trying to conceive 1
- Nursing mothers 1
- Hypersensitivity to tolperisone (risk of anaphylactic reactions) 2
- Severe liver or kidney dysfunction 1
- Myasthenia gravis (similar to other muscle relaxants) 1
Specific Patient Populations to Use with Caution
- Patients with history of seizures (tolperisone overdose can cause seizures) 3
- Patients with cardiovascular conditions (overdose may cause cardiovascular symptoms) 3
- Patients taking monoamine oxidase inhibitors (potential drug interaction similar to other centrally acting muscle relaxants) 1
- Elderly patients (increased risk of anticholinergic effects and cardiovascular instability) 1
Clinical Considerations
- Tolperisone is a centrally acting muscle relaxant that blocks voltage-gated sodium and calcium channels 3
- Unlike many other muscle relaxants, tolperisone appears to have lower incidence of somnolence (1.2% vs 2.6% for placebo in clinical trials) 4
- Acute overdose can lead to severe neurological, respiratory, and cardiovascular symptoms with rapid onset (0.5-1.5 hours) 3
- The minimal dose associated with severe symptoms including seizures in adults is approximately 1500 mg 3
Adverse Effects to Monitor
- Common side effects include headache (7.1%) and diarrhea (2.4%) 4
- Severe allergic reactions can occur within an hour of oral intake 2
- CNS effects may include somnolence, agitation, and in overdose cases, seizures and coma 3
- Cardiovascular and respiratory effects may occur, particularly in overdose situations 3