Dosing Interval for Tonmya (Cyclobenzaprine)
Tonmya (cyclobenzaprine) should be dosed three times daily, with the standard regimen being 5 mg three times a day for most patients, which may be increased to 10 mg three times a day based on individual response. 1
Standard Dosing Regimen
- The FDA-approved dosing is three times daily (TID), not once or twice daily 1
- Most patients should start with 5 mg three times a day 1
- The dose may be increased to 10 mg three times a day if the 5 mg dose is insufficient 1
- Duration should not exceed 2-3 weeks of continuous use 1
Evidence Supporting Three Times Daily Dosing
- The immediate-release formulation has a duration of action of 4-6 hours, which necessitates three-times-daily dosing to maintain therapeutic effect throughout the day 2
- Clinical trials demonstrating efficacy used the three times daily regimen (5 mg or 10 mg TID) 2
- Reducing dosing frequency to twice daily would create a potentially painful untreated interval between doses 2
Efficacy Data by Dose
- Cyclobenzaprine 5 mg TID was as effective as 10 mg TID in clinical trials, with significantly higher efficacy scores compared to placebo on all primary measures 2
- The 2.5 mg TID dose was not significantly more effective than placebo and should not be used 2
- Onset of relief occurs within 3-4 doses of the 5 mg regimen 2
Special Population Considerations
- Elderly patients and those with hepatic impairment should receive less frequent dosing 1
- For these populations, consider starting with 5 mg once or twice daily rather than three times daily 1