CARISOPRODOL (kar-eye-soe-proe'dole)
Soma Classifications: skeletal muscle relaxant, central-acting; Therapeutic: skeletal muscle relaxant, central-acting Prototype: Cyclobenzaprine Pregnancy Category: C
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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
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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: 46 h.
Distribution: Crosses placenta.
Metabolism: In liver by CYP2C19.
Elimination: By kidneys; excreted in breast milk (24 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.