Robaxin what is it. Robaxin: Understanding the Drug and Its Effects
What is Robaxin? How does it work? What are the side effects and precautions to take. Get the answers to these questions and more in this comprehensive overview.
What is Robaxin?
Robaxin, also known as methocarbamol, is a muscle relaxant medication used to treat muscle spasms and pain. It works by helping to relax the muscles, often used in combination with rest, physical therapy, and other treatments for muscle-related issues.
How to Use Robaxin
Robaxin is typically taken orally, with or without food, as directed by a doctor. The dosage is based on the individual’s medical condition and response to treatment. It’s important not to increase the dose or use the drug more often or for longer than prescribed, as this can increase the risk of side effects without improving the condition any faster.
Potential Side Effects of Robaxin
Common side effects of Robaxin may include drowsiness, dizziness, lightheadedness, stomach upset, nausea, vomiting, or blurred vision. If any of these effects persist or worsen, it’s important to inform the doctor or pharmacist.
Serious side effects, though rare, can occur and require immediate medical attention. These may include nausea/vomiting that doesn’t stop, fainting, slow heartbeat, yellowing of the eyes or skin, or changes in mental state such as confusion or forgetfulness.
Precautions and Interactions
Before taking Robaxin, it’s crucial to inform the doctor or pharmacist about any allergies, medical history (especially liver disease), and other medications or supplements being taken, as Robaxin can interact with various drugs and substances.
Robaxin may cause drowsiness or dizziness, so caution should be exercised when driving, operating machinery, or engaging in activities that require alertness or clear vision. Alcohol and marijuana use can further increase these effects.
Pregnancy, Breastfeeding, and Elderly Considerations
Robaxin should only be used during pregnancy when the benefits outweigh the risks, as the effects on the unborn baby are not fully known. It’s also unclear if the medication passes into breast milk, so breastfeeding mothers should consult their doctor.
Older adults may be more sensitive to the side effects of Robaxin, particularly confusion, dizziness, and drowsiness, which can increase the risk of falls.
Overdose and Emergency Measures
In the event of an overdose with serious symptoms, such as passing out or trouble breathing, it’s crucial to call emergency services immediately. Otherwise, contact a poison control center for guidance on the appropriate course of action.
Robaxin is a medication that can be helpful in treating muscle spasms and pain, but it’s important to use it as directed and be aware of the potential side effects and interactions. By understanding the proper use and precautions, individuals can safely and effectively utilize Robaxin as part of their treatment plan.
Does Robaxin cause drowsiness? Yes, Robaxin can cause drowsiness as a common side effect. This is why it’s important to exercise caution when driving, operating machinery, or engaging in activities that require alertness or clear vision.
Can Robaxin be taken with alcohol? No, Robaxin should not be taken with alcohol, as the combination can further increase the risk of drowsiness and dizziness, which can be dangerous.
Is Robaxin safe for pregnant women? Robaxin should only be used during pregnancy when the benefits outweigh the risks, as the effects on the unborn baby are not fully known. Pregnant women should consult their doctor before taking Robaxin.
How long does Robaxin stay in the system? The length of time Robaxin remains in the system can vary depending on factors such as the individual’s metabolism, dose, and frequency of use. Generally, Robaxin has a relatively short half-life of about 1-2 hours, but it may take several days for the drug to be fully eliminated from the body.
Can Robaxin cause liver damage? Robaxin is generally well-tolerated, but in rare cases, it may be associated with liver damage. Individuals with a history of liver disease should inform their doctor before taking Robaxin, as the medication may need to be used with caution or an alternative treatment may be recommended.
Does Robaxin interact with other medications? Yes, Robaxin can interact with a variety of other medications, including opioid pain relievers, sleep or anxiety medications, antihistamines, and more. It’s crucial to inform the doctor or pharmacist about all medications and supplements being taken to avoid potentially dangerous interactions.
How effective is Robaxin in treating muscle spasms? Robaxin can be an effective treatment for muscle spasms when used as directed and in combination with other therapies, such as physical therapy and rest. However, the effectiveness may vary depending on the underlying cause and severity of the muscle spasms.
Robaxin Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
Methocarbamol is used to treat muscle spasms/pain. It is usually used along with rest, physical therapy, and other treatment. It works by helping to relax the muscles.
How to use Robaxin 750 Mg Tablet
Take this medication by mouth with or without food as directed by your doctor. 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.
The dosage is based on your medical condition and response to treatment.
Tell your doctor if your condition does not improve or if it worsens.
Side Effects
Drowsiness, dizziness, lightheadedness, stomach upset, nausea/vomiting, or blurred vision may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects.
Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: nausea/vomiting that doesn’t stop, fainting, slow heartbeat, yellowing eyes/skin, mental/mood changes (such as confusion, forgetfulness).
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking methocarbamol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease.
This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially confusion, dizziness, or drowsiness. These side effects can increase the risk of falling.
During pregnancy, this medication should be used only when clearly needed.
Discuss the risks and benefits with your doctor.
It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
Interactions
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), other muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness.
Ask your pharmacist about using those products safely.
This medication may interfere with certain laboratory tests (including VMA or 5-HIAA urine screening test), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Does Robaxin 750 Mg Tablet interact with other drugs you are taking?
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Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness/dizziness, seizures, loss of consciousness.
Do not share this medication with others.
This medication has been prescribed for your current condition only. Do not use it later for another condition unless your doctor directs you to do so.
A different medication may be necessary in that case.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Methocarbamol – StatPearls – NCBI Bookshelf
Continuing Education Activity
Methocarbamol is a medication used in the management and treatment of acute musculoskeletal pain. It is in the skeletal muscle relaxant class of medications. This activity reviews the indications, mechanism of action, and contraindications for methocarbamol as an option in the multimodal treatment of acute musculoskeletal pain.
This activity will also underscore critical factors to consider when prescribing methocarbamol: adverse event profile, evidence of efficacy, pharmacodynamic and pharmacokinetic considerations, and recommendations for monitoring in managing patients with musculoskeletal pain and related conditions.
Objectives:
Review the indications for the use of methocarbamol in the treatment of musculoskeletal pain.
Identify populations at risk for adverse effects of methocarbamol.
Summarize different approaches for the use of anti-spastic and anti-spasmodic classes of skeletal muscle relaxants.
Describe common adverse effects of skeletal muscle relaxants, and review methods of educating patients on how to avoid harm.
Access free multiple choice questions on this topic.
Indications
Methocarbamol is a centrally-acting skeletal muscle relaxant (SMR) approved for the treatment of acute musculoskeletal pain.
Specific FDA indications for use are vague and have not been recently reviewed. Methocarbamol has been approved for muscle spasms since 1957.[1] The clinical efficacy of methocarbamol is recognized within the larger class of muscle relaxants.[2] As a treatment for involuntary skeletal muscle spasm, methocarbamol is considered an anti-spasmodic agent compared to anti-spastic agents like dantrolene and baclofen, which treat spasticity resulting from upper motor neuron disorders. Other commonly prescribed anti-spasmodic agents include cyclobenzaprine and carisoprodol. Tizanidine and diazepam have anti-spastic and anti-spasmodic properties.[3] These anti-spastic and anti-spasmodic medications have different mechanisms of action; for the scope of this review, we shall focus on methocarbamol.
Methocarbamol was discovered in the early 1950s and was approved for use in 1957.[1] In 1958, O’Doherty and Shields described methocarbamol as an effective treatment for muscle spasms observed in individuals with pyramidal spine lesions, such as those caused by herniated intervertebral discs.
[4] Concurrent with the work of O’Doherty and Shields, Forsyth described methocarbamol’s efficacy in a case series of one hundred patients with orthopedic conditions, including acute and chronic disc herniation and post-operative muscle spasm. In the published study, all but six patients had either a “moderate” or “pronounced” response in subjective relief of pain or spasm. No significant adverse effects were noted, and only nine patients reported “minor” adverse effects, including dizziness and nausea.[5]
Despite its common use today, there are few high-quality studies and no meta-analyses comparing methocarbamol to placebo or alternative agents for muscle spasms.[6] Today, clinical use is typically limited to the adjunctive treatment of acute pain of musculoskeletal origin; however, off-label use has been investigated for a range of painful conditions, including acute and chronic non-specific low-back pain, inflammatory arthritides, fibromyalgia, and myofascial pain, rib fractures, perioperative care of hip and knee replacements, and abdominal muscle cramps in patients with cirrhosis.
[7][8][9][10][11] Historically, methocarbamol had also been used to treat tetanus, a practice which today has been replaced by benzodiazepines.[12] Methocarbamol is not effective for treating contracture, rigidity, or spasticity that is believed to originate from upper motor neuron injury.
Mechanism of Action
The exact mechanism of action of methocarbamol remains unknown; similarly unknown is the relationship between musculoskeletal pain and muscle spasm.[8] In theory, involuntary muscle spasm may result from a protective reflex preventing movement that would otherwise cause injury. In some cases, muscle spasms themselves may become painful and debilitating.[4] This phenomenon, known as the “pain-spasm-pain cycle,” has not been confirmed in rigorous clinical and electrophysiologic studies.[8] Along with other muscle relaxants, the discovery and development of methocarbamol were based on animal studies that observed decreased muscle tone without concurrent depression of motor activity.
[13] It is thought that the relief provided by SMRs is the result of global central nervous system depression. One proposed mechanism is anticholinergic inhibition of the midbrain reticular activating system resulting in depressed polysynaptic reflexes and decreased muscle tone. This is also described as an indirect inhibition of the interneuronal junction of the spinal cord. Methocarbamol has no direct action at the motor nerve fiber, motor nerve end plate, or skeletal muscle contractility.[4]
Administration
Methocarbamol is administered commonly via the oral route. Oral methocarbamol is available in 500 mg and 750 mg tablets. Recommended daily dosing ranges from four to six grams daily in divided doses every six hours. The maximum recommended dose is six grams daily, and up to eight grams daily have been used. However, lower doses are often used in practice. For example, in a recent retrospective study of a reasonably sized cohort, the typical dose for a hospitalized patient was 500 mg orally every eight hours.
[9]
Intravenous (IV) and intramuscular (IM) formulations may also be used commonly in the postoperative setting.[14][15] one gram can be injected every eight hours by IM or IV route. The dose should not exceed three grams daily and should not be used for more than three consecutive days.
Pharmacokinetics
The onset of action of oral methocarbamol is 30 minutes. The drug is completely absorbed by the gastrointestinal tract and reaches peak plasma concentrations at two hours.[16] It has a variable half-life of one to two hours and is metabolized in the liver by dealkylation, hydroxylation, and glucuronidation. Methocarbamol is primarily excreted as an inactive metabolite in the urine. It is typically dosed every six hours based on observed pharmacokinetics. One study in hemodialysis patients observed no change in elimination time compared to control patients; however, renal clearance was reduced.[17] Clearance is also reduced in patients with cirrhosis; however, no specific dose adjustment is suggested.
In one study, a dosage of 500 mg given twice daily was well-tolerated by patients with cirrhosis.[11]
Specific Population
Renal Impairment: All major metabolites of methocarbamol are excreted in the urine. Similarly, some small amounts of unchanged methocarbamol are also excreted in the urine. IV dose is contraindicated in patients with renal impairment due to the presence of polyethylene glycol excipient. The oral dose should be used with caution for patients with mild to moderate kidney conditions. Patients who are on dialysis should also be using methocarbamol with caution.[17]
Hepatic Impairment: Methocarbamol is mainly metabolized via dealkylation, hydroxylation, and conjugation in the liver. However, there are no dose recommendations available in manufacturer labels.
Pregnant Women: It is considered pregnancy category C medicine. Some reports exist of fetal and congenital abnormalities following exposure to methocarbamol in pregnant women.
Therefore, it should not be used in women who may become pregnant or are pregnant, particularly in early pregnancy, until potential benefits outweigh the risk.[18]
Breastfeeding Women: There are no studies conducted to evaluate methocarbamol use in breastfeeding women. The manufacturer recommends exercising caution when methocarbamol is administered to a nursing woman.
Pediatric: Effectiveness and safety of methocarbamol in pediatric patients below the age of 16 have not been studied.
Adverse Effects
Severe adverse effects documented in the methocarbamol package insert include seizure, leukopenia, and cholestatic jaundice. The incidence of these severe effects is unknown, and no case reports appear on a literature review. According to the LiverTox resource governed by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), methocarbamol has not been linked to liver or kidney injury.[1]
According to drug monographs, there have been reports of seizures in individuals with a history of epilepsy after IV administration and cases of polysubstance toxicity; however, no published cases were available for review.
Drug monographs report neurologic adverse effects as more common, including sedation, followed by dizziness and headache. Other reported neurologic adverse effects include confusion, amnesia, falls, syncope, and diplopia.
Gastrointestinal side effects include dyspepsia, nausea, emesis, metallic taste, and cholestatic jaundice.
Methocarbamol may cause urine discoloration, which is not clinically significant; however, it may interfere with urine screening of 5-hydroxy indole acetic acid (5-HIAA) and vanillyl mandelic acid (VMA).
IV administration has been associated with phlebitis and injection site pain related to the extravasation of hypertonic solution.
Contraindications
According to the FDA, methocarbamol is contraindicated in individuals with a history of drug hypersensitivity to methocarbamol or component products.
Importantly, IV methocarbamol is contraindicated in renal impairment due to the presence of polyethylene glycol, which independently is associated with metabolic acidosis, renal injury, and hyperosmolarity.
[19]
There have been multiple studies evaluating the abuse potential of methocarbamol. Animal studies have shown low abuse potential when methocarbamol is compared to benzodiazepines and barbiturates.[20] However, multiple human studies have reported abuse potential.[21][22] Despite abuse concerns, a recent review of German pharmacovigilance data did not indicate abuse potential for methocarbamol; however, the authors noted that under-reporting of adverse effects was a limitation of the study, so the concern for abuse should remain. Methocarbamol should be used with caution in those prescribed multiple central nervous system (CNS) depressants, benzodiazepines, opioids, and those who have known substance use disorders.
Methocarbamol should not be used in patients with myasthenia gravis taking acetylcholinesterase inhibitors. This recommendation is in the package insert and based on a case report of an exacerbation of muscle weakness and fatigue associated with methocarbamol’s anticholinergic effects.
[23]
SMRs, including methocarbamol, are included in the Beers Criteria as medications that should be avoided in adults older than 65 years of age. They have been associated with a small but statistically significant increase in injury for elderly patients. This theoretical “injury” is based on retrospective case-control analyses evaluating patients who present to urgent care facilities, emergency rooms, and hospitals. The primary diagnoses of concern include fall, non-vertebral fracture, soft-tissue injury, and other cognitive or psycho-motor disruption. The absolute risk increase from methocarbamol calculated from the extant data is approximately 0.2%. All SMRs share anticholinergic properties that may contribute to sedation, falls, confusion, and polypharmacy in elderly patients, and methocarbamol is no exception.[24]
Methocarbamol is classified as Pregnancy Category C, as it has not been systematically studied in pregnant women. In addition, based on animal studies, methocarbamol is known to cross the placenta and is excreted in breast milk.
Therefore, it is not recommended for use in women who may become pregnant or who are breastfeeding.
Monitoring
The recommended monitoring of methocarbamol is to evaluate the clinical response and mitigate risk for the emergence of adverse effects. There is no need to check blood chemistry in follow-up, nor blood levels of the drug. Specific populations at risk for toxicity include those on multiple CNS depressants, patients with cirrhosis, renal impairment, substance use disorders, and, most importantly, the elderly.
Toxicity
Isolated methocarbamol overdose is rare and unlikely to be life-threatening in the absence of multiple drug exposures.[25] Based on limited data, toxicity symptoms may include nausea, sedation, seizures, coma, and death. Treatment is supportive.
Enhancing Healthcare Team Outcomes
SMRs, including methocarbamol, are commonly prescribed for non-specific musculoskeletal pain. In 2004, an estimated two million American adults took a muscle relaxant, the most common indication being low back pain.
[26] Low back pain was the leading cause of years lived with disability worldwide in 2016.[27] A specific nociceptive etiology of low back pain is often elusive. In such cases, symptoms result from multiple factors, including biomechanical pain generators, central and peripheral nociceptive processing, medical comorbidity, and psychosocial factors.[28] A biopsychosocial approach is encouraged when a specific etiology is not readily identified due to the complexity of factors contributing to low back pain. First-line recommendations are non-pharmacologic, including patient education, maintaining activity, and the use of heat and ice.[29] Pharmacologic treatments are an option for those with persistent symptoms but should be part of a multi-modal treatment plan that may include psychological and biomechanically oriented therapies.
Despite more than three million methocarbamol prescriptions yearly in the United States, there is limited high-quality data describing clinical efficacy.[1] Based mostly on dated, small case series and small randomized clinical trials (RCT), methocarbamol is superior to placebo for acute musculoskeletal pain and similar to other muscle relaxants.
[30] There is conflicting evidence as to whether methocarbamol is superior or provides any additive benefit to NSAIDs alone. In a 2018 RCT, Friedman et al. found that adding methocarbamol to naproxen did not improve outcomes at one week; however, their study was small. The same group also reported a similar lack of effect when methocarbamol was added to oxycodone-acetaminophen, cyclobenzaprine, corticosteroids, and diazepam.[31]
MDs, DOs, PAs, NPs, and physical therapists should be vigilant while prescribing methocarbamol in older patients, those at risk of polypharmacy, and those with a history of addiction. Clinicians should keep in mind that there is no high-quality evidence to suggest methocarbamol is more effective than NSAIDs for acute musculoskeletal pain. Nurses and pharmacists should verify methocarbamol is used only in select patients as part of multi-modal treatment with close monitoring of efficacy, adverse effects, and polypharmacy. Additionally, extensive randomized controlled trials are warranted to guide the clinical decision-making for a drug that appears to be a popular clinical tool for prescribers without solid evidence.:max_bytes(150000):strip_icc()/what-is-the-peripheral-nervous-system-2795465-FINAL-b69e1bb803654212a83d9e68eb4847d0.png)
Integrated and collaborative work of the healthcare team could bring the best possible outcomes for patients using methocarbamol. [Level 5]
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References
- 1.
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Jan 30, 2017. Methocarbamol. [PubMed: 31643609]
- 2.
van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM., Cochrane Back Review Group. Muscle relaxants for nonspecific low back pain: a systematic review within the framework of the cochrane collaboration. Spine (Phila Pa 1976). 2003 Sep 01;28(17):1978-92. [PubMed: 12973146]
- 3.
See S, Ginzburg R. Skeletal muscle relaxants. Pharmacotherapy. 2008 Feb;28(2):207-13. [PubMed: 18225966]
- 4.
O’DOHERTY DS, SHIELDS CD.
Methocarbamol; new agent in treatment of neurological and neuromuscular diseases. J Am Med Assoc. 1958 May 10;167(2):160-3. [PubMed: 13538683]- 5.
FORSYTH HF. Methocarbamol (robaxin) in orthopedic conditions; preliminary report of one hundred cases. J Am Med Assoc. 1958 May 10;167(2):163-8. [PubMed: 13538684]
- 6.
See S, Ginzburg R. Choosing a skeletal muscle relaxant. Am Fam Physician. 2008 Aug 01;78(3):365-70. [PubMed: 18711953]
- 7.
Richards BL, Whittle SL, van der Heijde DM, Buchbinder R. The efficacy and safety of muscle relaxants in inflammatory arthritis: a Cochrane systematic review. J Rheumatol Suppl. 2012 Sep;90:34-9. [PubMed: 22942327]
- 8.
Beebe FA, Barkin RL, Barkin S. A clinical and pharmacologic review of skeletal muscle relaxants for musculoskeletal conditions. Am J Ther. 2005 Mar-Apr;12(2):151-71. [PubMed: 15767833]
- 9.
Patanwala AE, Aljuhani O, Kopp BJ, Erstad BL.
Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures. Am J Surg. 2017 Oct;214(4):738-742. [PubMed: 28088301]- 10.
Looke TD, Kluth CT. Effect of preoperative intravenous methocarbamol and intravenous acetaminophen on opioid use after primary total hip and knee replacement. Orthopedics. 2013 Feb;36(2 Suppl):25-32. [PubMed: 23379573]
- 11.
Abd-Elsalam S, Arafa M, Elkadeem M, Elfert A, Soliman S, Elkhalawany W, Badawi R. Randomized-controlled trial of methocarbamol as a novel treatment for muscle cramps in cirrhotic patients. Eur J Gastroenterol Hepatol. 2019 Apr;31(4):499-502. [PubMed: 30444744]
- 12.
UTTERBACK RA, TENNEY PH. METHOCARBAMOL IN THE THERAPY OF TETANUS. Arch Neurol. 1963 Nov;9:555-60. [PubMed: 14057687]
- 13.
TRUITT EB, PATTERSON RB. Comparative hemolytic activity of mephenesin, guaiacol glycerol ether and methocarbamol in vitro and in vivo.
Proc Soc Exp Biol Med. 1957 Jul;95(3):422-4. [PubMed: 13453457]- 14.
Dent RW, Ervin DK. Relief of acute musculoskeletal symptoms with intravenous methocarbamol (robaxin injectable): a placebo-controlled study. Curr Ther Res Clin Exp. 1976 Nov;20(5):661-5. [PubMed: 825351]
- 15.
LEVENTEN EO, VACCARINO FP. Intravenous methocarbamol in 100 orthopedic patients. Curr Ther Res Clin Exp. 1960 Oct;2:497-500. [PubMed: 13761355]
- 16.
Elenbaas JK. Centrally acting oral skeletal muscle relaxants. Am J Hosp Pharm. 1980 Oct;37(10):1313-23. [PubMed: 6999895]
- 17.
Sica DA, Comstock TJ, Davis J, Manning L, Powell R, Melikian A, Wright G. Pharmacokinetics and protein binding of methocarbamol in renal insufficiency and normals. Eur J Clin Pharmacol. 1990;39(2):193-4. [PubMed: 2253675]
- 18.
Hall JG, Reed SD. Teratogens associated with congenital contractures in humans and in animals. Teratology. 1982 Apr;25(2):173-91.
[PubMed: 7101197]- 19.
Tayar J, Jabbour G, Saggi SJ. Severe hyperosmolar metabolic acidosis due to a large dose of intravenous lorazepam. N Engl J Med. 2002 Apr 18;346(16):1253-4. [PubMed: 11961161]
- 20.
Sannerud CA, Ator NA, Griffiths RR. Methocarbamol: evaluation of reinforcing and discriminative stimulus effects. Behav Pharmacol. 1991 Apr;2(2):143-150. [PubMed: 11224058]
- 21.
Gahr M, Freudenmann RW, Eller J, Schönfeldt-Lecuona C. Abuse liability of centrally acting non-opioid analgesics and muscle relaxants–a brief update based on a comparison of pharmacovigilance data and evidence from the literature. Int J Neuropsychopharmacol. 2014 Jun;17(6):957-9. [PubMed: 24552880]
- 22.
Preston KL, Wolf B, Guarino JJ, Griffiths RR. Subjective and behavioral effects of diphenhydramine, lorazepam and methocarbamol: evaluation of abuse liability. J Pharmacol Exp Ther. 1992 Aug;262(2):707-20. [PubMed: 1501118]
- 23.
Podrizki A. Methocarbamol and myasthenia gravis. JAMA. 1968 Sep 23;205(13):938. [PubMed: 5695627]
- 24.
Spence MM, Shin PJ, Lee EA, Gibbs NE. Risk of injury associated with skeletal muscle relaxant use in older adults. Ann Pharmacother. 2013 Jul-Aug;47(7-8):993-8. [PubMed: 23821610]
- 25.
Lebby TI, Dugger K, Lipscomb JW, Leikin JB. Skeletal muscle relaxant ingestion. Vet Hum Toxicol. 1990 Apr;32(2):133-5. [PubMed: 2327059]
- 26.
Dillon C, Paulose-Ram R, Hirsch R, Gu Q. Skeletal muscle relaxant use in the United States: data from the Third National Health and Nutrition Examination Survey (NHANES III). Spine (Phila Pa 1976). 2004 Apr 15;29(8):892-6. [PubMed: 15082991]
- 27.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
Lancet. 2017 Sep 16;390(10100):1211-1259. [PMC free article: PMC5605509] [PubMed: 28919117]- 28.
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, Smeets RJ, Underwood M., Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018 Jun 09;391(10137):2356-2367. [PubMed: 29573870]
- 29.
Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG., Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 09;391(10137):2368-2383. [PubMed: 29573872]
- 30.
Chou R, Peterson K, Helfand M. Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. J Pain Symptom Manage. 2004 Aug;28(2):140-75. [PubMed: 15276195]
- 31.
Friedman BW, Cisewski D, Irizarry E, Davitt M, Solorzano C, Nassery A, Pearlman S, White D, Gallagher EJ. A Randomized, Double-Blind, Placebo-Controlled Trial of Naproxen With or Without Orphenadrine or Methocarbamol for Acute Low Back Pain. Ann Emerg Med. 2018 Mar;71(3):348-356.e5. [PMC free article: PMC5820149] [PubMed: 29089169]
Methocarbamol; new agent in treatment of neurological and neuromuscular diseases. J Am Med Assoc. 1958 May 10;167(2):160-3. [PubMed: 13538683]
Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures. Am J Surg. 2017 Oct;214(4):738-742. [PubMed: 28088301]
Proc Soc Exp Biol Med. 1957 Jul;95(3):422-4. [PubMed: 13453457]
[PubMed: 7101197]
Lancet. 2017 Sep 16;390(10100):1211-1259. [PMC free article: PMC5605509] [PubMed: 28919117]
Disclosure: Jeffrey Sibrack declares no relevant financial relationships with ineligible companies.
Disclosure: Rachel Hammer declares no relevant financial relationships with ineligible companies.
📜 Instructions for use Riboxin 💊 Composition of Riboxin ✅ Use of Riboxin 📅 Storage conditions Riboxin ⏳ Expiration date Riboxin Save Search for analogues Product description Riboxin Based on the approved prescribing information and prepared for the 2011 electronic edition of the Vidal handbook, last updated: 2019. Marketing authorization holder: TATHIMPHARMPREPRATY JSC ATX code: C01EB (Other drugs for the treatment of heart diseases) Active substance: Rec.INN WHO registered Dosage form
Release form, packaging and composition |
08.01
Increases the energy balance of the myocardium, improves coronary circulation, prevents the consequences of intraoperative renal ischemia. It is directly involved in the metabolism of glucose and contributes to the activation of metabolism in conditions of hypoxia and in the absence of adenosine triphosphate.
| B15 | Acute hepatitis A |
| B16 | Acute hepatitis B |
| B17 | Other acute viral hepatitis |
| B18 | Chronic viral hepatitis |
E80. 1 | Porphyria cutaneous slow |
| I20 | Angina pectoris [angina pectoris] |
| I21 | Acute myocardial infarction |
| I49.8 | Other specified cardiac arrhythmias |
| K71 | Liver toxicity |
| K73 | Chronic hepatitis, not elsewhere classified |
| K74 | Fibrosis and cirrhosis of the liver |
| K76.0 | Fatty liver (liver degeneration), not elsewhere classified |
Dosage regimen
Assign to adults inside, before meals.
The daily dose when taken orally is 0.6-2.4 g. In the first days of treatment, the daily dose is 0.6-0.8 g (200 mg 3-4 times a day). In case of good tolerance, the dose is increased (for 2-3 days) to 1.2 g (0.4 g 3 times a day), if necessary, up to 2.4 g per day.
Course duration – from 4 weeks to 1.5-3 months.
In case of urocoproporphyria, the daily dose is 0.8 g (200 mg 4 times a day). The drug is taken daily for 1-3 months.
Side effect
Allergic reactions are possible in the form of urticaria, pruritus, skin hyperemia (drug withdrawal is required). Rarely, during treatment with the drug, the concentration of uric acid in the blood increases and exacerbation of gout (with prolonged use).
Contraindications for use
Hypersensitivity to the drug, gout, hyperuricemia. Fructose intolerance and glucose/galactose malabsorption syndrome or sucrase/isomaltase deficiency.
Precautions: renal insufficiency, diabetes mellitus.
Pregnancy and lactation
The safety of Riboxin during pregnancy and lactation has not been established. The use of the drug Riboxin is contraindicated during pregnancy. At the time of treatment with Riboxin, breastfeeding should be stopped.
Use in impaired renal function
Precautions: renal insufficiency.
Special instructions
During treatment with Riboxin, the concentration of uric acid in the blood and urine should be monitored.
Information for patients with diabetes mellitus: 1 tablet of the drug corresponds to 0.00641 bread units.
Does not affect the ability to drive vehicles and control mechanisms that require increased concentration.
Drug interactions
Immunosuppressants (azathioprine, antilympholin, cyclosporine, thymodepressin, etc.) reduce the effectiveness of Riboxin when used simultaneously.
Storage conditions of the drug Riboxin
In a dry, dark place at a temperature not exceeding 25°C.
Keep out of the reach of children.
Riboxin expiration date
Expiry date. 3 years. Do not use after the expiry date stated on the packaging.
Terms of sale
The drug is dispensed by prescription.
Keep
If you want to place a link to the description of this drug – use this code
Riboxin . Description of the drug in the reference book Vidal.
What is prescribed, analogs, composition, increases or decreases pressure
THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED. For the heart and blood vessels Angina pectoris
2 Riboxin: composition
The danger is that they are often asymptomatic and people become aware of problems too late. Everyone can remember the example of the sudden death of an “absolutely healthy” person from heart disease.
It is important to take care of your heart, to protect and maintain it, to be examined in a timely manner and, if necessary, treated. An integrated approach to the treatment of heart disease includes the elimination of symptoms, the fight against the cause and the improvement of the condition of the heart muscle. Today we are talking about the drug Riboxin, which doctors use to strengthen the myocardium in adverse conditions. We learn about the composition of the drug, side effects and contraindications, how it affects blood pressure and is comparable with Mildronate.
All products Riboxin
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Riboxin: composition
The drug contains the active ingredient inosine. It is the precursor of ATP, the main source of energy for all biochemical processes in the human body.
Riboxin improves tissue metabolism, provides them with energy and reduces hypoxia. Normalizes heart rate, increases the strength of myocardial contractions and relaxes it in diastole. Reduces blood viscosity and restores tissue – especially the myocardium and gastrointestinal mucosa. The main properties of the drug: it normalizes myocardial metabolism and reduces oxygen starvation of tissues.
Forms of release of Riboxin: tablets, capsules and solution for intravenous administration in ampoules. Most often, the drug is prescribed for the rehabilitation and prevention of seizures in coronary heart disease. A complete list of indications for use is indicated in the instructions for use.
How to take Riboxin?
Riboxin tablets are intended for long-term use – from one to three months. They are taken daily, the daily dose is divided into 3 doses. Start with a minimum daily dose of 600 mg. With good tolerance, the dose is gradually increased to a maximum of 2400 mg.
Before or after meals?
Tablets are taken orally 30 minutes before meals.
Riboxin: contraindications
Despite all the positive properties of the drug, Riboxin has contraindications:
- hypersensitivity to inosine and excipients
- gout, elevated blood uric acid
- pregnancy and lactation
- children under 18 years of age
Use with caution in patients with renal insufficiency. Riboxin is dispensed from pharmacies by prescription.
Riboxin: side effects
If the following side effects occur while taking Riboxin, stop taking the drug and contact your doctor:
- allergic reactions: itching, rash, urticaria, anaphylactic shock
- increase in the concentration of uric acid in the blood
- acute attacks of gout with prolonged use at high doses
Riboxin increases or decreases blood pressure
Riboxin has a moderate hypotensive effect.
It activates metabolism and stimulates the release of substances that dilate blood vessels. Riboxin is not used as a remedy for arterial hypertension.
Riboxin for incontinence
Riboxin is not indicated for the treatment of urinary incontinence. In this disease, other medicines are used.
Riboxin: analogues
Preparations that also contain the active ingredient inosine:
- Inosie-F – solution for intravenous administration
- Inosin-Eskom – solution for intravenous administration
- Riboxin Reneval – coated tablets
- Riboxin Avexima film-coated tablets
- Riboxin LekT – coated tablets
Indications for use are identical to Riboxin.
Mildronate or Riboxin: which is better
The active substance of Mildronate is meldonium. It is a metabolic agent that preserves the strength of the body. When it is taken, energy is generated in a low-cost way from glucose, not fat.
The oxidation of the latter requires more oxygen, so Mildronate helps the body during hypoxia.
Indications for the use of Mildronate differ from those of Riboxin:
- chronic heart failure
- cerebrovascular accident, stroke
- reduced performance
- mental and physical overload
- eye diseases
- withdrawal symptoms
A common indication for the two drugs is coronary heart disease (CHD). But only the attending physician can choose the treatment in this case. It takes into account the patient’s condition, concomitant diseases and contraindications. Both drugs are prohibited during pregnancy and lactation, as well as children under 18 years of age.
Summary
- Riboxin contains the active ingredient inosine.
- Contraindications to taking Riboxin are hypersensitivity to inosine and auxiliary components, gout, pregnancy, lactation, children under 18 years of age.
