Cyclobenzaprine and Back Pain: A Meta-analysis Clinical Pharmacy and Pharmacology JAMA Internal Medicine

While our results suggest a modest benefit from the use of cyclobenzaprine, there are several important limitations to these findings. First, 10 of the 14 trials had evidence that blinding may not have been effective; patients receiving cyclobenzaprine had more adverse effects than those treated with placebo. The most common adverse effects were sedation, dry mouth, fatigue, and dizziness (Table 3).

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Methocarbamol and metaxalone are less sedating, although effectiveness evidence is limited. Adverse effects, particularly dizziness and drowsiness, are consistently reported with all skeletal muscle relaxants. The potential adverse effects should be communicated clearly to the patient.

Is Flexeril a Narcotic?

Several measures of the sensitivity of the meta-analysis results to various assumptions were conducted. A test for the relative influence of each individual study on the results was determined by sequentially dropping individual studies and calculating summary measures. We explored several sources of heterogeneity, including year of publication, type of syndrome (acute vs chronic back pain), study quality scores, and duration and dose of therapy using metaregression. The efficacy of FLEXERIL 5 mg was demonstrated in two seven-day, double-blind, controlled clinical trials enrolling 1405 patients.

Since many of these treatments may be operating on different aspects of back pain, there may be an additive effect. On the other hand, overmedication is a common problem among patients, and more may not be better. Studies to look at back pain management with a combination of common therapies are needed. Some clinicians, well versed with the sedative effects of cyclobenzaprine, prescribe it for the short term as a nighttime medicine. The trials in our analysis all used a 2 or 3 times daily dose.

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. This is often why people will be admitted into anaddiction treatment clinic for Flexeril withdrawal.

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Systematic reviews and meta-analyses support using skeletal muscle relaxants for short-term relief of acute low back pain when nonsteroidal anti-inflammatory drugs or acetaminophen are not effective or tolerated. Comparison studies have not shown one skeletal muscle relaxant flexeril and acetaminophen to be superior to another. Cyclobenzaprine is the most heavily studied and has been shown to be effective for various musculoskeletal conditions. The sedative properties of tizanidine and cyclobenzaprine may benefit patients with insomnia caused by severe muscle spasms.

The tablet is usually taken with or without food three times a day. The extended-release capsule is usually taken with or without food once a day. Do not take this drug for more than 3 weeks without talking to your doctor.

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Another study30 explored the potential biasing effect of higher rates of adverse effects by stratifying patient results by the presence or absence of adverse effects. This study30 found the rate of improvement between both groups to be equal, and concluded that the potential unmasking of treatment group by adverse effects had no impact on patient outcomes. Skeletal muscle relaxants are prescription medications commonly used to treat muscle pain and muscle spasms. If you have back pain or have suffered a strain or sprain, your healthcare provider may offer you a skeletal muscle relaxant such as methocarbamol (Robaxin) or cyclobenzaprine (Fexmid, Amrix). Among these 14 trials, 11 found benefit and 3 did not, although only 8 were placebo controlled.

• Comparison studies have not shown one skeletal muscle relaxant to be superior to another.
• Analysis of the continuous outcome involved comparing standardized differences in means between control and treatment groups.
• This document does not contain all possible drug interactions.

Abstracted data included setting, country of origin, treatment characteristics (dose, duration, and follow-up), demo graphics, number of participants enrolled, follow-up losses, adverse effects, and outcomes. Outcomes were extracted as either dichotomous or continuous variables (or both), depending on how they were reported in the studies. Likelihood of experiencing overall improvement in back pain by the end of the study among patients treated with cyclobenzaprine hydrochloride compared with placebo. Squares represent the sample size; horizontal lines, the respective 95% confidence intervals of the odd ratios. Cyclobenzaprine has not been tested in pediatric patients younger than 15 years of age. The elderly may be at a higher risk for adverse events, including hallucinations and confusion, cardiac events and drug interactions.

Cyclobenzaprine (Flexeril): Dosage & Side Effects

That way, you can find out for sure if what you’re dealing with is an actual addiction. If it is, you can begin to take the necessary steps that you’ll need to recover. At Northpoint Recovery, we know that there are challenges when recovering from an addiction.