List of Common Muscle Relaxers

A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term “muscle relaxant” is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics. Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system (CNS) activity. They are often used during surgical procedures and in intensive care and emergency medicine to cause temporary paralysis. Spasmolytics, also known as “centrally acting” muscle relaxant, are used to alleviate musculoskeletal pain and spasms and to reduce spasticity in a variety of neurological conditions. While both neuromuscular blockers and spasmolytics are often grouped together as muscle relaxant, the term is commonly used to refer to spasmolytics only.

Tense, spasming muscles are often the underlying cause of back and neck pain. If the pain is severe or chronic and does not respond to over-the counter medications, muscle relaxants may be prescribed. Muscle relaxers:

Reduce skeletal muscle spasms
Relieve pain
Increase mobility of the affected muscles

Muscle relaxers are used in addition to rest, physical therapy, and other measures to relieve discomfort. They are typically prescribed for short-term use to treat acute, painful musculoskeletal conditions. Muscle relaxers are occasionally prescribed for chronic pain (pain lasting longer than 3 months).

Muscle relaxers are not a class of drugs—meaning they do not all have the same chemical structure or work the same way in the brain. Rather, the term muscle relaxer is used to describe a group of drugs that act as central nervous system depressants and have sedative and musculoskeletal relaxant properties.

Muscle relaxers may be prescribed to treat back pain:

Early in the course of back pain, on a short-term basis, to relieve pain associated with muscle spasms
When back pain causes insomnia (for their sedative effect)

Muscle relaxers are also prescribed for other conditions such as fibromyalgia, multiple sclerosis, and seizure disorders.There are several types of muscle relaxer medications commonly used to treat back pain.

Common Muscle Relaxants

Muscle relaxers are usually prescribed to treat back pain in conjunction with rest and physical therapy. Common muscle relaxants include:

Baclofen. Muscle tightness and muscle spasms, including those related to spine injuries, may be eased with baclofen. The medication may be helpful in treating multiple sclerosis and stabbing nerve pain. It is available as a tablet and can be taken by children as young as 12 years old. Some common side effects could include nausea and vomiting, confusion, drowsiness, headache, or muscle weakness. Baclofen is rated C in the FDA’s A through X pregnancy safety ranking for medications, with A being the safest. The C category means that the medication should only be used if the benefits outweigh the risks.
Benzodiazepines. In addition to treating anxiety, alcohol withdrawal, and seizure disorders, such as epilepsy, benzodiazepines can also treat muscle spasms and skeletal pain. Benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), and temazepam (Restoril), are typically only intended for short-term use. This limitation is due to their habit-forming potential and because they alter sleep cycles, leading to sleep difficulties once the drug is stopped. Benzodiazepines are sold as tablets, liquid, injections, and rectal gels. People who have myasthenia gravis, severe liver disease, serious breathing troubles, or some forms of glaucoma, should avoid taking diazepam. All benzodiazepines are rated D by the FDA for safety during pregnancy and are not recommended for women who are pregnant.

Carisoprodol (Soma). Carisoprodol relaxes muscles and eases pain and stiffness caused by acute bone and muscle problems, often caused by an injury. It is taken by mouth in tablet form and is also available in combination with aspirin or aspirin and codeine. Carisoprodol can be habit-forming, particularly if used in conjunction with alcohol or other drugs that have a sedative effect, including opioids (such as codeine). Common side effects include drowsiness, dizziness, and headache. People with a history of blood disorders, kidney or liver disease, and seizures may need to avoid Carisoprodol. It is rated C in the FDA’s pregnancy safety ranking for medications.
Chlorzoxazone (Lorzone). Chlorzoxazone is used for the relief of discomfort from acute, painful, musculoskeletal conditions. Chlorzoxazone is available as a tablet. Common side effects include drowsiness, dizziness, and nausea. Chlorzoxazone is not recommended for people with liver disease. It has not been rated by the FDA for safety during pregnancy.
Cyclobenzaprine (Amrix, Fexmid, FlexePax Kit, FusePaq Tabradol). Cyclobenzaprine eases stiffness and pain from muscle cramps, also called muscle spasms. It is available as a tablet and extended-release capsule. Cyclobenzaprine itself is not intended for long-term use (more than 2 to 3 weeks). Common side effects include blurred vision, dizziness or drowsiness, and dry mouth. It is not advised for those with an overactive thyroid, heart problems, or liver disease. Cyclobenzaprine is rated B by the FDA for safety during pregnancy, making it the safest muscle relaxant to use while pregnant.
Dantrolene (Dantrium). Dantrolene helps control chronic spasticity related to spinal injuries. It is also used for conditions such as stroke, multiple sclerosis, and cerebral palsy. Dantrolene is taken as a capsule or intravenous powder for injection. Drowsiness and sensitivity to light are common side effects. It can cause severe liver problems, and should not be taken by people with active liver disease. The FDA has given dantrolene a C rating for safety in pregnancy.

Metaxalone (Skelaxin, Metaxall, and Metaxall CP, Lorvatus PharmaPak). Metaxalone targets pain and muscle spasms from sprains, strains, and muscle injuries. It is available as a tablet or injection. Common side effects include drowsiness, dizziness, nausea, and vomiting. Metaxalone is generally not recommended for people with a known tendency to become anemic, and who have kidney or liver disease. Metaxalone may affect blood sugar tests for people with diabetes. The FDA has not rated metaxalone for safety during pregnancy.

Methocarbamol (Robaxin, Robaxin-750). Methocarbamol eases acute muscle and bone pain. It can be taken as a tablet or by injection. Common side effects include dizziness, headache, nausea, flushing, and blurred vision. Methocarbamol is generally not recommended to people with renal disease or failure, or a history of allergic reaction to the medication. The FDA has given methocarbamol a C rating for safety during pregnancy.
Orphenadrine. Orphenadrine is a medication used to relieve pain and stiffness caused by muscle injuries. It is available as an extended-release tablet. Common side effects include dry mouth, lightheadedness, difficult urination, heartburn, nausea and vomiting. It is generally not recommended to people with previous sensitivities to the ingredients, myasthenia gravis, those with glaucoma or certain types of ulcers. The FDA has given orphenadrine a C rating for safety during pregnancy.
Tizanidine (Comfort Pac with Tizanidine, Zanaflex). Tizanidine is used to treat muscle spasms caused by spinal cord injuries and other conditions such as multiple sclerosis. Tizanidine is available in tablet and capsule form and absorbs differently depending on whether it is taken on an empty stomach or with food. Common side effects include dry mouth, dizziness, constipation and tiredness. It should not be used by people taking fluvoxamine or ciprofloxacin or those who have liver disease. Tizanidine is rated in the C category for safety during pregnancy.

Sometimes the first muscle relaxers a doctor prescribes does not work as well as expected. It may be necessary to try an alternative if the initial prescription is not effective. Many drugs interact with muscle relaxers and a person should keep their health care provider informed of all prescription and non-prescription medications he or she is taking.

There is very little research regarding which muscle relaxers are most effective, so the choice of which medication—or whether to use one at all—is based on factors such as a person’s reaction to the medication and personal preferences, potential for abuse, possible drug interactions, and adverse side effects.

Medication is just one part of pain relief. These medications are intended to be one element, usually on a short-term basis, of an overall recovery strategy that includes rest, stretching, physical therapy, and other exercise.

Side Effects Associated with Muscle Relaxers

Side effects of muscle relaxers include:

Sleepiness or grogginess
Fatigue
Dry mouth
Constipation
Nausea

More serious side effects include:

Light-headedness or fainting
Blurred vision
Confusion
Urinary retention

Any serious side effects should be reported to a doctor immediately.

Risks Associated with Muscle Relaxers

Muscle relaxers are a group of drugs that have a sedative effect on the body. They work through the brain, rather than directly on the muscles. Muscle relaxants are generally used for a few days and up to 3 weeks, but are sometimes prescribed for chronic back pain or neck pain.

To minimize risk, the doctor should be informed of any history of seizures, liver disease, and any other medical conditions or concerns. Women should inform their doctors if they are pregnant, plan to become pregnant, or are breast-feeding.

Sleepiness. Because muscle relaxers are total body relaxants, they typically induce grogginess or sleepiness. As a result, it is not safe to drive or make important decisions while taking muscle relaxers. Muscle relaxers are often suggested for evening use due to their sedative effect.
Interactions with alcohol. Drinking alcohol can be especially dangerous when taking muscle relaxers. The sedative effect of the medication is intensified with alcohol use, and combining the two can be fatal.
Allergic reactions. No medication should be taken if the person has had an allergic reaction to it in the past, even if the reaction seemed mild. Symptoms of an allergic reaction include swelling in the throat or extremities, trouble breathing, hives, and chest tightness.
Potential for abuse. Muscle relaxers have a risk of misuse and abuse. Some muscle relaxers, such as cyclobenzaprine, can be habit-forming on their own. Others may be taken in conjunction with other drugs, such as opioids, to create a high, and are therefore more likely to be abused.
Tapering off. Stopping a muscle relaxer abruptly can be harmful. Instead, the doctor will prescribe a gradual reduction in dosage.

Muscle relaxers are widely prescribed for acute back pain, often in conjunction with an over-the-counter or prescription pain medication. They are generally prescribed for a short time to relieve pain in the lower back or neck caused by muscle spasms, also called muscle cramps.

If a medication seems to cause problems, it is important to notify the doctor. Each medication works a little differently, and the doctor may be able to prescribe another that fits the individual’s needs better.

What is Muscle Relaxants and What is the Main Side Effect of Muscle Relaxants ?

Muscle relaxers or muscle relaxants are medications used to treat acute muscle pain and discomfort caused by muscle spasms. Muscle spasms are involuntary contractions that cause excessive strain in muscles and are often associated with conditions such as lower back pain and neck pain.

Medications used as muscle relaxers can differ in their chemical structures and the way they work in the brain. In general, muscle relaxers act as central nervous system depressants and cause a sedative effect or prevent your nerves from sending pain signals to your brain. The onset of action is rapid and effects typically last from 4-6 hours.

Muscle Relaxants for Muscle Spasms

Muscle spasms are painful and may restrict mobility, which can limit your ability to perform even basic activities. Painful, tight muscles can also interfere with getting a good night’s sleep.

Muscle relaxants may help reduce pain, and improve movement and range of motion, but your doctor will likely recommend that you first try acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). In some cases, these over-the-counter medications will be enough to help alleviate your pain.

If your muscle pain persists, your doctor may prescribe a muscle relaxant in addition to your pain medication. Below are common muscle relaxants (the generic names are listed first, with a brand name example in parentheses):

Baclofen (Lioresal)
Carisoprodol (Soma)
Cyclobenzaprine (Amrix)
Metaxalone (Skelaxin)
Methocarbamol (Robaxin)

When You Might Need a Muscle Relaxer

Your doctor might first suggest you try an over-the-counter medicine like acetaminophen (Tylenol) or ibuprofen (Advil) to treat your pain. But if those don’t work, or you can’t take them because you have another issue like liver problems or ulcers, you may need to try a muscle relaxant.

Muscle relaxants are ideally prescribed for acute rather than chronic pain. They may be an option if pain is preventing you from getting enough sleep. Because muscle relaxants cause drowsiness, they can help you get rest when you take them at night.

Some of the common side effects of muscle relaxers include:

Drowsiness
Dizziness
Agitation
Irritability
Headache
Nervousness
Dry mouth
Decreased blood pressure

The most commonly prescribed muscle relaxers are carisoprodol (Soma) and cyclobenzaprine (Flexeril). According to data from IMS Health, there were 4.2 million prescriptions of Soma and 28.4 million prescriptions of Flexeril dispensed in the United States in 2017.

What Are Side Effects of Flexeril?

Common side effects of Flexeril include:

dry mouth or throat
headache
blurred vision
drowsiness
dizziness
fatigue
loss of appetite
stomach pain
nausea
diarrhea
constipation
gas, or
muscle weakness.

Dosage for Flexeril – For most patients, the recommended dose of Flexeril is 5 mg three times a day.

You shouldn’t drink alcohol while taking muscle relaxants. These medications make it hard to think and function normally, even if you take a low dose, so combining them with alcohol can increase your risk of an accident.

You also shouldn’t drive or operate heavy machinery while taking muscle relaxants. Some muscle relaxers start working within 30 minutes of taking them, and the effects can last anywhere from 4 to 6 hours

Muscle Relaxant Abuse

Muscle relaxers have a potential for abuse and addiction. Prolonged use can lead to increased tolerance and physical dependence, especially with Soma.³ For this reason, muscle relaxers are intended as a short-term treatment not to be prescribed for more than 2-3 weeks.

Unfortunately, many individuals take muscle relaxers alone or in combination with other illicit drugs for nonmedical reasons, such as to produce or enhance feelings of euphoria and dissociation. According to the Drug Enforcement Administration, Soma is one of the most commonly diverted drugs in the United States.² Evidence also indicates prevalent misuse of Flexeril. In 2010 there were over 12,000 emergency room visits associated with Flexeril, and in 2016 over 10,000 calls to the Poison Control Centers had involved Flexeril.¹

Muscle relaxer abuse can lead to serious dangers such as an increased risk of overdose, which can result in:

stupor
hallucinations
seizures
shock
respiratory depression
cardiac arrest
coma
death

Alcohol and Muscle Relaxers

Like muscle relaxers, alcohol also depresses the central nervous system. When alcohol is consumed with muscle relaxers the side effects are exacerbated. This can be very dangerous, leading to symptoms like:

Blurred vision
Urine retention
Extreme dizziness
Extreme drowsiness
Low blood pressure
Fainting
Memory problems
Liver damage
Increased risk of overdose

It is recommended to not drive or operate heavy machinery when under the influence of muscle relaxers. It is especially important to avoid drinking, as combining muscle relaxers with alcohol greatly increases your risk of an accident.

Withdrawal and Treatment

Regular use of muscle relaxers causes the brain to become used to its effects. If you attempt to suddenly stop using muscle relaxers you may experience withdrawal symptoms. Depending on the specific drug and how long you have been using it, there are various treatment options available to help you overcome your addiction.

For many people, Flexeril withdrawal causes mild symptoms such as nausea, headache, drowsiness, malaise, and discomfort. Symptoms tend to peak about 2-4 days after you last took the Flexeril, although in some people withdrawal symptoms may last for up to 1-2 weeks. For many people Flexeril detox can be done at home. However, if Flexeril addiction is accompanied by alcohol or opioid abuse the withdrawal symptoms from these other substances can be severe. In these situations, it may be best to undergo professional medical detox.

Soma withdrawal is usually more severe and can include symptoms like hallucinations and seizures. For your safety and comfort, it is often best to find an inpatient treatment program that includes a detox program to manage withdrawal symptoms. After detox patients can transition into the actual treatment phase of the program. Some people may not require a supervised detox program and will be able to undergo treatment on an outpatient basis.

Most inpatient and outpatient rehab programs include cognitive behavioral therapy that will help you learn the coping skills needed for long-term recovery.

Which Muscle Relaxants Are Best for Neck and Back Pain?

Stiffness and soreness in your neck and back can be difficult to deal with, especially when sleeping. Maybe you have a new injury, or you’ve aggravated an old one. Either way, if you feel this kind of pain at night, you may not sleep well. And then you may have more pain when you wake up.

In some cases, muscle relaxants can help relieve this pain and get you through these tough days. They do exactly what their name says: relax muscles. Reducing muscle tightness may improve new (acute) neck and back pain, especially when used at night.

But you need a prescription for muscle relaxers. And the evidence is mixed regarding how well they work. Treatment guidelines don’t even agree on whether they should be prescribed.

Over-the-counter (OTC) pain relievers work better for neck and back pain than muscle relaxants alone. Examples of these are acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve). Plus, there are effective treatments that don’t involve any medication at all, like home exercises, physical therapy, and/or posture training. That said, some people may benefit from taking an NSAID and a muscle relaxer together, especially at night.

Muscle relaxers work in different ways. They act on the muscles, nerves, or central nervous system. There isn’t enough evidence to suggest one muscle relaxer is better than another. So let’s look at nine popular muscle relaxants, including how well they work and their side effects.

1. Methocarbamol

Methocarbamol (Robaxin) is a well-studied medication that treats back pain. Compared to other options, it’s inexpensive and less likely to make you sleepy (sedated).

Taken as needed, 1,500 mg every 6 to 8 hours is a cheap and well-tolerated option for people who have new neck and back pain. It’s less sedating than other options, like cyclobenzaprine and carisoprodol. However, it may be less effective. In one study, almost 20% of those taking it stopped because it wasn’t helping their pain go away.

2. Cyclobenzaprine

Cyclobenzaprine is a reasonable first choice because it’s a cheap generic. But it has more potential for side effects, like sedation. This limits how you can use it during the day. Cyclobenzaprine may also cause dry mouth, especially in older adults. If this is a concern, consider a better non-sedating option.

At the standard dose of 10 mg to 30 mg a day, cyclobenzaprine (formerly branded as Flexeril) will make you sleepy. If you use it during the day, you’ll want to break your 10 mg tab in half and take 5 mg to lessen the drowsiness. Interestingly, one study found that a lower dose (15 mg per day) worked just as well as a higher dose (30 mg per day). There may not be any benefit when you take it alongside an NSAID like naproxen.

3. Carisoprodol

Carisoprodol (Soma) is a Schedule 4 drug (similar to benzodiazepines Ativan, Valium, and Xanax). Because of this, it has the potential for misuse. For this reason, you should not use it if you have a history of substance use.

Many believe that carisoprodol should be phased out as a muscle relaxant in favor of much better options. If prescribed, you should only use it for short periods of 2 to 3 weeks. Scientists don’t know how effective it is when taken for longer periods. Carisoprodol may cause drowsiness and dizziness. People over age 65 should not use it.

4. Metaxalone

Taken as 800 mg tablets 3 to 4 times a day, metaxalone (Skelaxin) has the fewest reported side effects. It’s also the least likely of the muscle relaxants to make you sleepy. It may work better for chronic lower back pain that is flaring up, rather than for pain that is new.

Metaxalone is a generic alternative for the brand medication Skelaxin, but it still costs more than most others. Insurance companies often don’t cover it because there are cheaper alternatives. But it works as well as cyclobenzaprine and carisoprodol (more info on those above) with fewer side effects and less sedation. So, paying cash may be worth it.

5. Tizanidine

Tizanidine (Zanaflex) is often used for spasticity in people with multiple sclerosis or cerebral palsy. Spasticity is where the muscles contract continuously, which leads to tightness and stiffness. The FDA has not approved tizanidine to treat neck or back pain.

For multiple sclerosis or cerebral palsy, tizanidine tends to have fewer side effects than Baclofen. But either medication may not make much difference in new low back pain when compared with ibuprofen alone. Tizanidine is not a first choice for new neck or back muscle pain.

6. Baclofen

Similar to tizanidine, Baclofen (Gablofen, Lioresal) is primarily used for spasticity in people who have multiple sclerosis or spinal cord injuries. Up to 20% of people taking it have drowsiness. It’s not a first choice: There are better options for neck and back muscle pain. The FDA has not approved baclofen to treat neck or back pain.

7. Oxazepam and diazepam

Benzodiazepine medications like oxazepam (Serax, Zaxopam) and diazepam (Valium) are anti-anxiety medications. They are sometimes prescribed as muscle relaxants. But these really aren’t recommended because they don’t work well, are sedating, and can be habit-forming.

Plus, the FDA has not approved benzodiazepines for neck or back pain. Avoid these medications for neck and back muscle pain. There are much better options.

8. Chlorzoxazone

Chlorzoxazone (Lorzone) is not well studied for new low back and neck pain in adults. It wasn’t found to be effective for pain after spine surgery. Chlorzoxazone has also been reported as a rare cause of acute liver toxicity. Don’t choose this medication until you’ve exhausted all other options.

9. Orphenadrine

For neck and back pain in adults, the first four medications on this list work better than orphenadrine (Norflex), so save this as another last resort in the event the others don’t work.

Do muscle relaxers make you sleepy?

Yes, they can make you sleepy. In fact, sedation is one of the most common side effects reported. Dizziness and drowsiness are also commonly reported. That’s why they usually have a warning on the label that instructs you to avoid certain things while taking them, such as driving, caring for children, and operating heavy machinery.

Muscle relaxers can also cause other side effects and interact with other medications. It’s important to let your healthcare provider know about your medical history and which medications and supplements you’re taking.

Remedies For Muscle Pain

Muscle spasms occur when a muscle is irritated and they begin to spasm in order to protect themselves from further injury. A muscle may be used over and over for and tighten over time, but the muscle may not go into spasm until a simple movement occurs. So even the simplest task such as picking up a cup could lead to a painful muscle spasm. This can feel like tightness in the muscles of the affected area. If the initial injury is not treated the spasms will continue.

The common symptoms of stiffness, pain and swelling in joints could easily affect the surrounding muscles and give you mixed signals. Therefore , recognizing whether the pain comes from a joint or a muscle may not be an easy task for someone suffering from rheumatoid arthritis.

There are also some homes remedies to relieve muscle pain. These include treatments like putting ice packs, engaging in physical aides such as wrist, wraps or back braces that tend to minimize muscle strain via helping to hold joints and bones in correct positions.

muscle pain after exercise:

1 . Amino Acids – These are very inexpensive and can be purchased at your local vitamin store for less than $ 7 for a 15 day supply.

2 . Fish Oil – Fish oil contains Omega 3 fatty acids and will reduce inflammation in the joints as well as shorten the length of your muscle pain.

3. Aspirin – This is a tried and true pain reliever. 2-4 aspirin tablets taken a few hours after a workout will help reduce DOMS.

4. Stretching – Performing a few minutes of stretching before a workout or sports activity will not only help eliminate later muscle pain but will also help prevent serious injury.

With this cause of lower back muscle pain, the reason you feel it in this region is because the lower back muscles are the ones that do the extra work when lifting and carrying things. If you had a stronger core, however , you would feel the deep abdominal muscles engage when you properly lifted items and would be able to avoid lower back muscle pain.

The best treatment protocol is to never allow the muscle pain to start but with chronic pain patients it’s rare for any patient to have effective intervention prior to the muscle pain starting. Muscle pain is generally a secondary pain originating due to guarding, shielding, and posturing due to original pain sourcing.

To reduce muscle pain you can have regular massages, use ice packs, or resting periods. There are also certain lotions and balms that provide muscle pain relief.

Natural Remedies to Reduce Muscle Pain

1 . Get 7 to 8 hours of sleep a night.
2 . Take a green-lipped mussel oil supplement.
3. Massage a blend of essential oils of arnica, Calendula and St John’s work into the affected painful area.
4. Eat a whole food, mineral rich diet with plenty of vegetables and whole grains.

There are many causes of joint pains making you restless and bothersome. Joint pain is not the disease itself but the symptom of mild to serious disease. Fever can be the cause of generalized joint pains. It can be caused due to sprain or ligament injury, cartilage tearing, dislocations and sports injuries such as tennis elbow and swimmers shoulder in the case of injuries with swelling and redness around the injured part.

Another way to control the pain is by simply applying ice on the affected muscle. Cold temperature can relax the muscle and make the swelling controllable. It can manage the pain quickly because the ice will reduce the inflammation of the muscle. Use cold compress method within the first 72 hours of muscle pain.

There are several herbal oils that can have a wonderful effect on muscle pains. Some of the oils that are prevalently used for muscle pain massages include castor oil and olive oil. The massage must be done by an expert, always moving the hands in the direction of the pain. The idea is to allow the muscle wastes to enter the circulatory stream of the body and then go out with the other wastes. Done properly, a single massage session should be great for muscle pain relief.

Cures:

Chronic pain in the upper back that is not relieved by any of the above treatments can be a sign of a more serious condition. If this is the case, consult a doctor. You might be suffering from scoliosis (misalignment of the spine), which can be corrected surgically. If you have seriously injured your back muscles, your doctor might also try ultrasound treatments for a deep muscle massage.

What is the most popular muscle relaxant?

Some of the popular and commonly prescribed muscle relaxants are briefly described below. These are prescription drugs and are typically only used when other medications like non-steroidal anti-inflammatory drugs (NSAIDs), have not provided sufficient pain relief from muscle spasms.

BACLOFEN

Brand names: Lioresal, Lioresal Double Strength.

Best for: Muscle spasms and tightness caused by spinal cord injuries and multiple sclerosis.

Dosage forms: Tablet, solution, suspension, packet.

Common side effects: Drowsiness, headache, nausea, vomiting, confusion, and muscle weakness.

CARISOPRODOL

Brand names: Soma, Vanadom.

Best for: Painful muscle and bone conditions like acute low back pain or neck pain.

Dosage forms: Tablet.

Common side effects: Drowsiness, dizziness, headache.

Note: Carisoprodol (Soma) tablet is a Schedule IV controlled substance with abuse potential (it can be habit-forming).

METHOCARBAMOL

Brand names: Robaxin, Robaxin-750.

Best for: Painful muscle and bone conditions like back pain.

Dosage forms: Tablet, injection.

Common side effects: Dizziness, headache, blurred vision, flushing, nausea.

TIZANIDINE

Brand names: Zanaflex, Comfort Pac with Tizanidine.

Best for: Muscle cramping and tightness caused by multiple sclerosis and spinal cord injury.

Dosage forms: Tablet, capsule.

Common side effects: Fatigue, dizziness, dry mouth, constipation.

CHLORZOXAZONE

Brand names: Lorzone, Remular-S, Parafon Forte DSC.

Best for: Painful musculoskeletal conditions.

Dosage forms: Tablet.

Common side effects: Dizziness, drowsiness, nausea.

CYCLOBENZAPRINE

Brand names: Flexeril, Amrix, Fexmid, FusePaq Tabradol.

Best for: Muscle spasms, pain, stiffness, and discomfort caused by strains and sprains.

Dosage forms: Tablet, extended-release capsule, suspension.

Common side effects: Dizziness, drowsiness, dry mouth, blurred vision.

METAXALONE

Brand names: Skelaxin.

Best for: Painful bone and muscle conditions like sprains, strains, and muscle injuries.

Dosage forms: Tablet, injection.

Common side effects: Dizziness, drowsiness, nausea, vomiting.

ORPHENADRINE

Brand names: Norflex.

Best for: Pain, discomfort, stiffness (increased muscle tone) caused by strains, sprains, and muscle injuries, shaking or trembling in Parkinson’s disease.

Dosage forms: Extended-release tablet.

Common side effects: Dry mouth, dizziness, heartburn, nausea, vomiting, difficulty urinating.

DANTROLENE

Brand names: Dantrium.

Best for: Muscle cramps and tightness associated with conditions like multiple sclerosis, cerebral palsy, stroke, and spinal cord injuries.

Dosage forms: Capsule, injection.

Common side effects: Drowsiness, light sensitivity.

A List of Skeletal muscle relaxants

A muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone.

It may be used to alleviate symptoms such as muscle spasms, pain, and hyperreflexia. The term “muscle relaxant” is used to refer to two major therapeutic groups: neuromuscular blockers and spasmolytics. Neuromuscular blockers act by interfering with transmission at the neuromuscular end plate and have no central nervous system (CNS) activity.

They are often used during surgical procedures and in intensive care and emergency medicine to cause temporary paralysis. Spasmolytics, also known as “centrally acting” muscle relaxants, are used to alleviate musculoskeletal pain and spasms and to reduce spasticity in a variety of neurological conditions. While both neuromuscular blockers and spasmolytics are often grouped together as muscle relaxants, the term is commonly used to refer to spasmolytics only.

How Skeletal Muscle Contracts

A single α-motor neuron can innervate up to 200 muscle fibers, forming a complex called motor unit (Figure 1).¹⁰ With movement, an action potential originates from the UMN in the motor cortex.⁹ This action potential depolarizes the motor neuron terminal, resulting in the opening of voltage-gated calcium (Ca²⁺) channels and the subsequent release of the neurotransmitter acetylcholine (Ach) into the synaptic cleft. In the synaptic cleft, Ach binds to nicotinic cholinergic receptors on the muscle fiber membrane, leading to an influx of sodium (Na⁺) and a discharge of potassium (K) across the muscle fiber’s membrane, which results in depolarization of the muscle fiber.¹¹ This depolarization opens voltage-gated Ca²⁺ channels on the sarcoplasmic reticulum (via ryanodine and inositol triphosphate receptors), allowing for Ca²⁺ influx into the cytoplasm of striated muscle cells.¹² The Ca²⁺ then binds to troponin C, which exposes myosin-binding sites on actin filaments. A cross-link forms between actin and myosin, leading to muscle contraction. The pumping of Ca²⁺ back into the sarcoplasmic reticulum, using adenosine triphosphate, leads to cessation of contraction.

View by: Brand

Drug Name	Reviews	Avg. Ratings
Antiflex Generic name: orphenadrine	1 review		10
Dantrium (Pro) Generic name: dantrolene	2 reviews		10
Vanadom Generic name: carisoprodol	1 review		9.0
Soma (Pro) Generic name: carisoprodol	180 reviews		8.9
Zanaflex (Pro) Generic name: tizanidine	100 reviews		7.7
Xeomin (Pro) Generic name: incobotulinumtoxinA	2 reviews		7.5
Amrix (Pro) Generic name: cyclobenzaprine	48 reviews		7.3
Myobloc (Pro) Generic name: rimabotulinumtoxinB	3 reviews		7.2
Skelaxin (Pro) Generic name: metaxalone	82 reviews		7.2
Lioresal (Pro) Generic name: baclofen	20 reviews		6.8
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Further information

Muscle Spasms

A muscle spasm is a sudden involuntary contraction of a muscle group that involves jerking and twitching. Unlike spasticity, which is a disorder of the CNS, muscle spasms arise from a variety of peripheral musculoskeletal conditions, such as mechanical low back pain. Common skeletal muscle conditions that cause spasms include fibromyalgia, myofascial pain syndrome, and mechanical low back or neck pain.

Antispasm Agents

Most of the agents discussed here are FDA approved for adjunctive use to treat muscle spasms and pain associated with acute musculoskeletal conditions (Table 4). Health data from 2003 to 2004 revealed that cyclobenzaprine (Amrix, Fexmid, others), carisoprodol (Soma, others), and metaxalone (Metaxall, Skelaxin, others) accounted for more than 45% of medications prescribed for acute musculoskeletal pain.

Due to CNS depression, cyclobenzaprine, metaxalone, orphenadrine (Norflex, others), methocarbamol (Robaxin, others), carisoprodol, and chlorzoxazone (Lorzone, Parafon Forte DSC, others) are on the American Geriatrics Society’s Beers List of inappropriate drugs for elderly patients.

Despite this, approximately 300,000 annual prescriptions for skeletal muscle relaxants (15%) are issued to patients older than 65 years of age.

Skeletal muscle relaxants represent a diverse pharmacotherapeutic group of medications across several chemical classes that are structurally dissimilar. These agents are effective for spasticity, skeletal muscle spasms, or both.

Because of the breadth of pharmacologic mechanisms and variable pharmacokinetics, the drugs have a huge range of AEs and potential drug interactions.

Considering that these agents are most often used in the elderly and also as adjuvants for the treatment of chronic pain patients with multiple comorbidities who are likely receiving a polypharmaceutical regimen (including opioids), skeletal muscle drug selection for each patient requires careful attention to these factors.

Warnings for prescription muscle relaxants

Muscle relaxants such as carisoprodol and diazepam can be habit forming. Be sure to take your medication exactly as prescribed by your doctor.

Muscle relaxants can also cause withdrawal symptoms, such as seizures or hallucinations (sensing things that aren’t real). Do not suddenly stop taking your medication, especially if you’ve been taking it for a long time.

Also, muscle relaxants depress your central nervous system (CNS), making it hard to pay attention or stay awake. While taking a muscle relaxant, avoid activities that require mental alertness or coordination, such as driving or using heavy machinery.

You should not take muscle relaxants with:

alcohol
CNS depressant drugs, such as opioids or psychotropics
sleeping medications
herbal supplements such as St. John’s wort

Talk to your doctor about how you can safely use muscle relaxants if you:

are older than 65 years
have a mental health problem or brain disorder
have liver problems

Off-label medications for spasticity

Doctors can use certain medications to treat spasticity even when the drugs are not approved for that purpose by the U.S. Food and Drug Association (FDA). This is called off-label drug use. The following drugs are not actually muscle relaxants, but they can still help relieve symptoms of spasticity.

Benzodiazepines

Benzodiazepines are sedatives that can help relax muscles. They work by increasing the effects of certain neurotransmitters, which are chemicals that relay messages between your brain cells.

Examples of benzodiazepines include:

clonazepam (Klonopin)
lorazepam (Ativan)
alprazolam (Xanax)

Side effects of benzodiazepines can include drowsiness and problems with balance and memory. These drugs can also be habit forming.

Clonidine

Clonidine (Kapvay) is thought to work by preventing your nerves from sending pain signals to your brain or by causing a sedative effect.

Clonidine should not be used with other muscle relaxants. Taking it with similar drugs increases your risk of side effects. For instance, taking clonidine with tizanidine can cause very low blood pressure.

Clonidine is available in brand-name and generic versions.

Gabapentin

Gabapentin (Neurontin) is an anticonvulsant drug typically used to relieve seizures. It’s not fully known how gabapentin works to relieve muscle spasticity. Gabapentin is available in brand-name and generic versions.

Over-the-counter options for muscle spasms

OTC treatment is recommended as first-line therapy for muscle spasms caused by conditions such as acute lower back pain or tension headache. This means you should try OTC treatments before prescription medications.

OTC treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or a combination of both. Your doctor or pharmacist can help you choose an OTC treatment.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs work by blocking your body from making certain substances that cause inflammation and pain. NSAIDs are available in generic and brand-name versions. They’re typically sold over the counter. Stronger versions are available by prescription.

NSAIDs come as oral tablets, capsules, or suspensions. They also come as chewable tablets for children. Side effects of these drugs can include upset stomach and dizziness.

Examples of NSAIDs include:

ibuprofen (Advil, Motrin)
naproxen (Aleve)

Acetaminophen

Acetaminophen (Tylenol) is thought to work by blocking your body from making certain substances that cause pain. Acetaminophen is available in generic and brand-name versions. It comes as immediate-release and extended release oral tablets and capsules, orally disintegrating tablets, chewable tablets, and oral solutions.

The more common side effects of acetaminophen can include nausea and upset stomach.