CARISOPRODOL

CARISOPRODOL
(kar-eye-soe-proe'dole)
Soma
Classifications: skeletal muscle relaxant, central-acting;
Therapeutic: skeletal muscle relaxant, central-acting

Prototype: Cyclobenzaprine
Pregnancy Category: C

Availability

350 mg tablets

Action

Skeletal muscle relaxant effect, unlike that of neuromuscular blocking agents, appears to be due to sedative action. Voluntary motor function is not lost, but there may be slight reduction in muscle tone leading to relief of pain and discomfort of muscle spasm.

Therapeutic Effect

Effective spasmolytic and reduces pain associated with acute musculoskeletal disorders.

Uses

Skeletal muscle spasm, stiffness, and pain in a variety of musculoskeletal disorders and to relieve spasticity and rigidity in cerebral palsy.

Contraindications

Hypersensitivity to carisoprodol and related compounds (e.g., meprobamate, tybamate); acute intermittent porphyria; children <5 y; pregnancy (category C), lactation.

Cautious Use

Impaired liver or kidney function, addiction-prone individuals; seizure disorder.

Route & Dosage

Muscle Spasm
Adult: PO 350 mg t.i.d.
Child (>5 y): PO 25 mg/kg/d in 4 divided doses

Administration

Oral
  • Give with food, as needed, to reduce GI symptoms. Last dose should be taken at bedtime.
  • Store in tightly closed container.

Adverse Effects (≥1%)

Body as a Whole: Eosinophilia, asthma, fever, anaphylactic shock. CV: Tachycardia, postural hypotension, facial flushing. GI: Nausea, vomiting, hiccups. CNS: Drowsiness, dizziness, vertigo, ataxia, tremor, headache, irritability, depressive reactions, syncope, insomnia. Skin: Skin rash, erythema multiforme, pruritus.

Interactions

Drug: Alcohol, cns depressants potentiate CNS effects.

Pharmacokinetics

Onset: 30 min. Duration: 4–6 h. Distribution: Crosses placenta. Metabolism: In liver by CYP2C19. Elimination: By kidneys; excreted in breast milk (2–4 times the plasma concentrations). Half-Life: 8 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor for allergic or idiosyncratic reactions that generally occur from the first to the fourth dose in patients taking the drug for the first time. Symptoms usually subside after several hours; they are treated by supportive and symptomatic measures.

Patient & Family Education

  • Avoid driving and other potentially hazardous activities until response to the drug has been evaluated. Drowsiness is a common side effect and may require reduction in dosage.
  • Report to physician if symptoms of dizziness and faintness persist. Symptoms may be controlled by making position changes slowly and in stages.
  • Do not take alcohol or other CNS depressants (effects may be additive) unless otherwise directed by physician.
  • Discontinue drug and notify physician if skin rash, diplopia, dizziness, or other unusual signs or symptoms appear.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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