II. Indications

  1. Acute back or Neck Pain interfering with sleep despite Analgesics

III. Class

  1. Antispasmodic Skeletal Muscle Relaxant

IV. Dosing

  1. Start: 5 mg orally at bedtime (5 mg is as effective as 10 mg and with less Sedation)
  2. Maximum: 10 mg orally three times daily (primarily at bedtime for pain interfering with sleep)

V. Contraindications

  1. Older patients
    1. See Medications to Avoid in Older Adults
  2. Seizure disorder (if concurrently on Tramadol)
  3. Glaucoma
  4. Cardiac arrhythmia
  5. Congestive Heart Failure
  6. Recent Myocardial Infarction

VI. Efficacy

  1. See Antispasmodic Skeletal Muscle Relaxant

VII. Adverse effects

  1. See Antispasmodic Skeletal Muscle Relaxant for precautions
  2. Common: Anticholinergic
    1. Drowsiness
    2. Dry Mouth
    3. Urinary Retention
    4. Increased Intraocular Pressure
  3. Rare
    1. Arrhythmia
    2. Seizure
    3. Myocardial Infarction

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Cost: Medications

CYCLOBENZAPRINE (on 2/19/2015 at Target.com)
CYCLOBENZAPRINE 10 MG Tablet #90 for $10.00 $0.11 each
CYCLOBENZAPRINE 5 MG Tablet #90 for $10.00 $0.11 each
cyclobenzaprine (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
CYCLOBENZAPRINE 7.5 MG TABLET Generic $3.77 each

Ontology: cyclobenzaprine (C0056732)

Definition (NCI) A centrally acting skeletal muscle relaxant with antidepressant activity. The exact mechanism of action of cyclobenzaprine has not been fully determined, but this drug seems to primarily act at the brain stem to reduce tonic somatic motor activity, influencing both gamma and alpha motor neurons leading to a reduction in muscle spasms.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C004704
SnomedCT 373779004, 80802008
LNC LP17189-9, MTHU004256
English cyclobenzaprine, N,N-dimethyl-3-(dibenzo(a,d)cycloheptene-4-ylidene)propylamine, cyclobenzaprine [Chemical/Ingredient], CYCLOBENZAPRINE, Cyclobenzaprine, Cyclobenzaprine (product), Cyclobenzaprine (substance)
Spanish ciclobenzaprina (producto), ciclobenzaprina (sustancia), ciclobenzaprina