From the Guidelines
Taking 20mg of Flexeril (cyclobenzaprine) daily is considered a high dose and may increase the risk of adverse events, particularly central nervous system effects such as drowsiness and dizziness. The typical recommended dosage for adults is 5-10mg three times daily, with a maximum daily dose of 30mg, as noted in studies evaluating skeletal muscle relaxants for acute and chronic low back pain 1. Most healthcare providers aim to use the lowest effective dose, often starting at 5mg three times daily.
Some key points to consider when evaluating the use of Flexeril at this dose include:
- The duration of therapy in most trials was 2 weeks or less, suggesting that long-term use at high doses may not be well-studied 1.
- Skeletal muscle relaxants, including cyclobenzaprine, were associated with a higher total number of adverse events and central nervous system adverse events compared with placebo, although most events were self-limited and serious complications were rare 1.
- The medication can cause cardiac effects at higher doses, and individualized dosing based on medical history, response to treatment, and other medications is crucial.
Given the potential risks associated with higher doses of Flexeril, it is essential to consult with a healthcare provider to determine if the current dosage is appropriate for the specific condition being treated, taking into account the individual's medical history and other medications being used.
From the FDA Drug Label
For most patients, the recommended dose of cyclobenzaprine hydrochloride tablets is 5 mg three times a day. Based on individual patient response, the dose may be increased to 10 mg three times a day. The dose of 20mg daily is lower than the maximum recommended dose of 30mg daily (10mg three times a day). However, it is higher than the initial recommended dose of 15mg daily (5mg three times a day) [ 2 ].
- The recommended dose is 5-10mg three times a day.
- 20mg daily is equivalent to approximately 6.7mg three times a day, which is within the recommended range, but on the lower end of the maximum dose. Considering the information provided, 20mg daily can be considered not high compared to the maximum recommended dose [ 2 ].
From the Research
Dosage Comparison
- The usual dosage of cyclobenzaprine (Flexeril) is 10 mg three times a day 3.
- A study found that cyclobenzaprine 5 mg three times a day was as effective as 10 mg three times a day, and was associated with a lower incidence of sedation 3.
- Another study compared the efficacy and safety of cyclobenzaprine extended release (CER) 15 and 30 mg to cyclobenzaprine immediate release (CIR) 10 mg three times a day and placebo 4.
- The study found that CER 15 and 30 mg were effective in relieving acute muscle spasm, with similar improvements to CIR, but with less reported daytime drowsiness 4.
High Dosage Consideration
- A daily dose of 20mg of Flexeril is not explicitly mentioned in the provided studies as a standard or recommended dosage.
- However, the studies suggest that higher doses of cyclobenzaprine may be associated with more adverse events, such as somnolence and dry mouth 3, 4.
- It is essential to consider the potential risks and benefits of taking a higher dose of Flexeril, and to consult with a healthcare professional for personalized advice 5, 6.
Safety and Efficacy
- Cyclobenzaprine has been found to be effective in relieving acute muscle spasm, with a relatively low rate of adverse events 3, 4.
- However, the use of muscle relaxants, including cyclobenzaprine, has been associated with significant adverse events, such as drowsiness and dizziness, particularly in patients with rheumatoid arthritis 5.
- The safety and efficacy of cyclobenzaprine should be carefully evaluated in individual patients, taking into account their medical history, current medications, and potential risks and benefits 7, 6.