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🤥🤩😲 Pharmacologic class: Autonomic nervous system drug
🤥🤩😲 Therapeutic class: Skeletal muscle relaxant (centrally acting)
🤥🤩😲 Pregnancy risk category B
🤥🤩😲 Unclear. Thought to act primarily at brain stem (and to a lesser extent at spinal cord level) to relieve skeletal muscle spasms of local origin without altering muscle function.
🤥🤩😲 Capsules (extended-release): 15 mg, 30 mg
🤥🤩😲 Tablets: 5 mg, 7.5 mg, 10 mg
Indications and dosages
🤥🤩😲 ➣ Adjunct to rest and physical therapy to relieve muscle spasm associated with acute, painful musculoskeletal conditions
🤥🤩😲 Adults: 5 mg P.O. t.i.d. (immediate-release tablet). May increase to 10 mg P.O. t.i.d. (immediate-release tablet) as needed. Or, 15 mg (extended-release capsule) P.O. daily; some patients may need up to 30 mg/day, given as one 30-mg (extended-release capsule) P.O. daily or two 15-mg (extended-release capsules) P.O. daily.
🤥🤩😲 • Hypersensitivity to drug
🤥🤩😲 • Acute recovery phase after myocardial infarction (MI)
🤥🤩😲 • Heart failure
🤥🤩😲 • Arrhythmias
🤥🤩😲 • Hyperthyroidism
🤥🤩😲 • MAO inhibitor use within past 14 days
🤥🤩😲 Use cautiously in:
🤥🤩😲 • cardiovascular disease, closed-angle glaucoma, hepatic impairment, increased intraocular pressure, urinary retention
🤥🤩😲 • elderly patients
🤥🤩😲 • pregnant or breastfeeding patients
🤥🤩😲 • children younger than age 15.
🤥🤩😲 ☞ Don't give within 14 days of MAO inhibitor. Drug interaction may cause hypertensive crisis and severe seizures.
🤥🤩😲 • Give extended-release capsule at approximately the same time each day.
🤥🤩😲 • Know that drug shouldn't be used for more than 3 weeks.
🤥🤩😲 • Be aware that drug may not be first-line agent for elderly patients because of its anticholinergic effects.
🤥🤩😲 CNS: dizziness, drowsiness, syncope, confusion, fatigue, headache, nervousness, decreased mental acuity, irritability, weakness, insomnia, depression, disorientation, delusions, peripheral neuropathy, abnormal gait, Bell's palsy, EEG changes, extrapyramidal symptoms, cerebrovascular accident
🤥🤩😲 CV: vasodilation, tachycardia, chest pain, hypotension, MI, heart block
🤥🤩😲 EENT: blurred vision
🤥🤩😲 GI: nausea, constipation, dyspepsia, swollen parotid glands, mouth inflammation, discolored tongue, dry mouth, paralytic ileus
🤥🤩😲 GU: galactorrhea, urinary retention, urinary frequency, gynecomastia, testicular swelling, libido changes, erectile dysfunction
🤥🤩😲 Hematologic: purpura, eosinophilia, bone marrow depression, leukopenia, thrombocytopenia
🤥🤩😲 Metabolic: hyperglycemia, hypoglycemia, syndrome of inappropriate diuretic hormone secretion
🤥🤩😲 Musculoskeletal: muscle ache
🤥🤩😲 Respiratory: dyspnea
🤥🤩😲 Skin: photosensitization, alopecia, angioedema
🤥🤩😲 Other: unpleasant taste, weight gain or loss, edema
🤥🤩😲 Drug-drug.Anticholinergics, anti-cholinergic-like drugs (including anti-depressants, antihistamines, disopyramide, haloperidol, phenothiazines): additive anticholinergic effects
🤥🤩😲 Antihistamines, CNS depressants, opioids, sedative-hypnotics: additive CNS depression
🤥🤩😲 Guanadrel, guanethidine: reduction in or blockage of these drugs' actions
🤥🤩😲 MAO inhibitors: hyperpyretic crisis, seizures, death
🤥🤩😲 Drug-herbs.Chamomile, hops, kava, skullcap, valerian: increased CNS depression
🤥🤩😲 Drug-behaviors.Alcohol use: increased CNS depression
🤥🤩😲 • Assess for adverse CNS effects, such as drowsiness, dizziness, and decreased mental acuity.
🤥🤩😲 • Monitor patient for evidence of drug interactions, especially when giving drug with CNS depressants.
🤥🤩😲 • Tell patient to take extended-release capsule at approximately the same time each day.
🤥🤩😲 • Tell patient that drug may cause dry mouth.
🤥🤩😲 • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, alertness, and vision.
🤥🤩😲 • Advise patient not to use alcohol, sedatives, pain medications, over-the-counter preparations, or herbs without consulting prescriber.
🤥🤩😲 • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.
Patient discussion about Flexeril
🤥🤩😲 Q. what are the side effects from taking soma and flexerill together? the person who takes it is almost comatos for a couple of hours. What is a substition?