Muscle Relaxants in Psoriatic Arthritis
Yes, patients with psoriatic arthritis can safely take muscle relaxants like cyclobenzaprine while on TNF inhibitors or methotrexate, as there are no known contraindications or significant drug interactions between these medication classes.
Safety Profile and Drug Interactions
Muscle relaxants such as cyclobenzaprine do not interact with the mechanism of action of TNF inhibitors (etanercept, infliximab, adalimumab) or methotrexate, and no guidelines or evidence documents contraindications to their concurrent use 1.
The EULAR guidelines for psoriatic arthritis management do not list muscle relaxants as contraindicated medications when using DMARDs or biologics 1.
Clinical Context for Use
Muscle relaxants may be appropriate for symptomatic relief of muscle spasm or pain that can accompany psoriatic arthritis, particularly in patients with axial disease or enthesitis-related muscle tension 1.
However, muscle relaxants should be considered adjunctive symptomatic therapy only, not disease-modifying treatment, and should not replace appropriate DMARD or biologic therapy for controlling the underlying inflammatory disease 1.
Important Caveats
NSAIDs remain the first-line symptomatic therapy for musculoskeletal pain in psoriatic arthritis and should be tried before or alongside muscle relaxants 1.
If muscle pain or spasm persists despite standard psoriatic arthritis treatment, ensure the underlying disease is adequately controlled—uncontrolled inflammation may be the root cause rather than simple muscle spasm requiring relaxants 1.
Monitor for sedation and central nervous system side effects from muscle relaxants, which may be additive with fatigue that can occur with methotrexate or as part of the disease itself 2, 3.
Avoid using muscle relaxants as a substitute for addressing inadequately controlled disease activity—if musculoskeletal symptoms are prominent, reassess disease activity and consider escalating DMARD therapy per guidelines 1.