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Although these agents aren’t recommended for long-term use, approximately 44.5% of patients who receive them remain on them for more than a year.Nevertheless, we tend to see cyclobenzaprine prescribed to patients with multiple refills.Efficacy, safety, and cost are the cornerstones of pharmacotherapy and important factors to consider when evaluating medication use and contemplating best therapeutic options.These factors must be considered at therapy initiation and reassessment should be ongoing throughout the course of treatment.Cyclobenzaprine undergoes extensive hepatic metabolism through CYP1A2, CYP3A4, and CYP2D6, which is a setup for drug interactions and also additional accumulation in the elderly. Jeff Fudin graduated from Albany College of Pharmacy & Health Sciences with a BS and Pharm D.Cyclobenzaprine is structurally similar to amitriptyline, differing only by 1 bond in the central ring. Comparison of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia. He is a Diplomate to the Academy of Integrative Pain Management, a Fellow to ACCP, ASHP, & FSMB, a member of several other professional organizations.Furthermore, when used in patients receiving opioid therapy, cyclobenzaprine and other CNS depressants potentiate the risk for opioid-induced respiratory depression. Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration. Therefore, it’s important to counsel patients on opioids who present a prescription for cyclobenzaprine, or better yet, call the prescriber and share your knowledge.
Cyclobenzaprine and other skeletal muscle relaxants are listed on the Beers Criteria due to central nervous system (CNS) depression. Van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM. He practices as a clinical pharmacy specialist (WOC) and director of PGY-2 pharmacy pain residency programs at the Stratton Veterans Administration Medical Center in Albany, New York and has academic affiliations with Western New England University and Albany Colleges of Pharmacy.When patients request refills, it’s important to follow up on the safety and efficacy of the medication to determine if continued use is warranted. Patients on opioids should be informed about the increased potential for respiratory depression with skeletal muscle relaxants and reminded not to add other sedating agents, like OTC cough and cold products containing diphenydramine, antivertigo agents like dimenhydrinate, alcohol, or any number of prescription medications. Cyclobenzaprine’s main role is for adjunct treatment for short-term use in acute musculoskeletal conditions, and evidence on benefit with long-term use is sorely lacking.Non-specific low back pain without identifiable cause is typically acute and resolves within 4 weeks.
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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Flexeril only for the indication prescribed.