Carisoprodol Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Carisoprodol is used short-term to treat muscle pain and discomfort. It is usually used along with rest, physical therapy, and other treatments. It works by helping to relax the muscles.

How to use Carisoprodol

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. This medication should only be used short-term (for 3 weeks or less) unless directed by your doctor.

If you suddenly stop using this medication, you may have withdrawal symptoms (such as stomach cramps, trouble sleeping, headache, nausea). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used carisoprodol for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.

Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.

Tell your doctor if your condition lasts after 2 to 3 weeks or if it gets worse.

Side Effects

Dizziness, drowsiness, or headache 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: confusion.

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 carisoprodol, tell your doctor or pharmacist if you are allergic to it; or to meprobamate, tybamate, or mebutamate; 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: a certain blood disorder (acute intermittent porphyria), kidney disease, liver disease, seizure, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol).

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness 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 drowsiness, or confusion. 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.

This medication passes into breast milk and may have undesirable effects on a nursing infant. 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 cyclobenzaprine, methocarbamol), 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.

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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, slow/shallow breathing, mental/mood changes (such as confusion, hallucinations), inability to move your legs/arms, shaky/unsteady movement, vision changes (such as blurred vision).

Do not share this medication with others. Sharing it is against the law.

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.

Images

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: SG 109

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: 111 logo

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: 2410 V

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: 5513 DAN

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 250 mg tablet

Color: whiteShape: roundImprint: NC 250

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: OP 35

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: D 31

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 250 mg tablet

Color: whiteShape: roundImprint: S 434

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 250 mg tablet

Color: whiteShape: roundImprint: I 43

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: 446

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 350 mg tablet

Color: whiteShape: roundImprint: CL 022

This medicine is a white, round, tablet imprinted with “SG 109”.

carisoprodol 250 mg tablet

Color: whiteShape: roundImprint: WP 5901

This medicine is a white, round, tablet imprinted with “SG 109”.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

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.

Carisoprodol – StatPearls – NCBI Bookshelf

Continuing Education Activity

Carisoprodol is an FDA-approved drug indicated for the relief of discomfort associated with acute, painful musculoskeletal conditions. Although marketed as a muscle relaxant, the parent compound is actually in the tranquilizer class of medications, with its primary metabolite meprobamate considered actually to be a benzodiazepine. This activity discusses the indications, mechanism of action, and contraindications for carisoprodol as a valuable agent to relax muscles after strains, sprains, and muscle injuries. This medication is intended to be used together with rest, physical therapy, and other measures. This activity highlights the mechanism of action, the potential benefits, the side effect profile, and other key factors (e.g., dosing, pharmacodynamics, pharmacokinetics, monitoring, relevant interactions) pertinent for healthcare professionals in managing patients with myofascial pain symptoms and related conditions.

Objectives:

• Identify the mechanism of action of carisoprodol and its primary metabolite, meprobamate.

• Describe the common potential adverse events or side effects associated with carisoprodol therapy.

• Review the potential toxicity of carisoprodol and its appropriate management.

• Explain why it is essential for the healthcare team to be aware of and up to date on the indications, interactions, adverse effects, and other pharmacodynamic and pharmacokinetic factors that can affect successful carisoprodol use in clinical care and lead to improved patient outcomes.

Access free multiple choice questions on this topic.

Indications

Carisoprodol is an FDA-approved drug indicated for the relief of discomfort associated with acute, painful musculoskeletal conditions.  It has approval for up to three weeks of use only. Carisoprodol is not recommended for use in patients under the age of 16 since this medication has not been evaluated in the pediatric population. In the United States, it is a schedule IV controlled substance. First approved for medical use in the United States in 1959, carisoprodol is available as a generic medication. It comes in tablet form and can be taken by mouth up to three times a day and once before bed. According to the package insert, carisoprodol is intended to be used together with rest, physical therapy, and other measures to relax muscles after strains, sprains, and muscle injuries.

Mechanism of Action

Per the package insert, the exact mechanism of action of carisoprodol in relieving discomfort associated with acute painful musculoskeletal conditions has not been clearly identified. It is believed to be a centrally acting skeletal muscle relaxant that does not directly relax skeletal muscles. The muscle relaxation effects induced by carisoprodol in animal studies are associated with altered interneuronal activity in the spinal cord and the descending reticular formation of the brain. Its primary metabolite, meprobamate, is believed to work at the GABA receptors similar to benzodiazepines and is believed to be responsible for carisoprodol’s therapeutic effects as well as its abuse potential. [1] Meprobamate is a benzodiazepine-type anxiolytic that also has sedative properties.    

Carisoprodol is metabolized in the liver primarily by the cytochrome P450 oxidase isozyme CYP2C19, and is excreted by the kidneys. The absolute bioavailability of carisoprodol remains undetermined. Carisoprodol’s primary metabolite is meprobamate, a known drug of abuse and dependence.[2][3][4] Meprobamate was classified as a schedule IV controlled substance in 1970 and is in the tranquilizer medication class, and its marketing was under several names. Per the package insert, carisoprodol, after oral ingestion, has a quick onset of action with the time to maximum plasma concentration being approximately 1.5 to 1.7 hours for the 250-milligram strength and the 350-milligram strength, respectively. The elimination half-life for carisoprodol is 1.7 to 2 hours, whereas the half-life for the meprobamate metabolite is approximately 10 hours.  The time to maximum plasma concentration for the meprobamate metabolite is approximately 3. 6 to 4.5 hours.    

Given the significantly prolonged half-life of meprobamate compared to the carisoprodol, there is a risk of meprobamate bio-accumulation following extended periods of carisoprodol administration.  Also, patients with reduced CYP2C19 activity are poor metabolizers of the carisoprodol resulting in up to a 4-fold increase in exposure to carisoprodol and a 50% reduced exposure to meprobamate.[5][6]

Carisoprodol is a racemic mixture, only slightly soluble in water but freely soluble in alcohol. The solubility of carisoprodol is practically independent of pH.  Furthermore, as per the package insert, taking this medication with fatty food did not appear to affect its pharmacokinetics.[7]

Administration

Carisoprodol is available in 250 mg and 350 mg tablet dosages taken by the mouth up to three times a day and once before bed. This medication is also available in various co-formulated forms: carisoprodol combined with acetaminophen and caffeine, carisoprodol combined with gamma-aminobutyric acid, and carisoprodol with acetylsalicylic acid and codeine.

Although the safety and pharmacokinetics of carisoprodol in patients with renal impairment have not undergone evaluation, caution is recommended since this medication’s metabolite is excreted renally.  Of note, carisoprodol is dialyzable by hemodialysis and peritoneal dialysis.[8] Carisoprodol gets metabolized by CYP2C19 in the liver. As per the package insert, caution is necessary if administered to patients with impaired hepatic function or reduced CYP2C19 activity since this could result in higher exposure to carisoprodol. Co-administration of CYP2C19 inhibitors could result in increased levels of carisoprodol and decreased levels of the meprobamate metabolite. Common CYP2C19-inhibitors include omeprazole, ticlopidine, fluoxetine, fluvoxamine, topiramate, sertraline, and tricyclic antidepressants. Conversely, co-administration of CYP2C19-inducers could result in decreased levels of carisoprodol and increased levels of meprobamate. Common CYP2C19-inducers include rifampin, carbamazepine, phenobarbital, aspirin, and St. John’s Wort.

Carisoprodol is pregnancy category C. However, animal studies indicate that carisoprodol adversely affected fetal growth and postnatal survival. Based on the limited post-marketing data, the primary metabolite meprobamate did not demonstrate any increased risk for particular congenital malformations.[1]  

Although carisoprodol prescribing appears to be declining to number 214 of the previous year down from number 181 of the top 300 commonly prescribed medications, it is still a commonly prescribed medication in the U.S., with over 3.4 million prescriptions in 2017. 

The efficacy, safety, and pharmacokinetics of carisoprodol have not been established in patients under the age of 16 or patients over the age of 65.

Adverse Effects

The most common side effects of carisoprodol include drowsiness, dizziness, and headache. According to the package insert, up to 17% of patients experienced sedation after taking carisoprodol compared to 6% of patients who received a placebo. This side effect can potentially impair the mental and physical abilities necessary to perform potentially hazardous work such as driving a vehicle or operating heavy machinery. There are post-marketing reports of motor vehicle accidents correlated with the use of carisoprodol. Since the sedative effects of CNS depressants may be additive, patients should be cautioned to avoid or minimize taking other CNS depressants such as alcohol, opioids, or benzodiazepines simultaneously and to take necessary precautions not to drive or engage in other potentially dangerous activities if experiencing sedation. 

Significant hypotension can also occur with carisoprodol overdose and is usually treated with supportive care and possibly dialysis.[8][9][10]

Dependence, withdrawal, and carisoprodol misuse have been reported with prolonged use, especially in patients with a history of addiction or when used in combination with other drugs with misuse potential.[1][11] Furthermore, withdrawal symptoms have been reported after abrupt discontinuation after prolonged use.  Therefore as per the package insert and labeling, it is recommended that carisoprodol not be used for more than two to three weeks to relieve acute musculoskeletal discomfort. The belief is that carisoprodol elicits barbiturate-like effects, where animal studies show that this medication can produce rewarding effects, like other drugs of abuse.[1] In addition to the potential for somnolence, a normal prescribed dosage of carisoprodol may result in short-lived mild to moderate euphoria or dysphoria due to carisoprodol’s potent anxiolytic effects. Carisoprodol, more so than meprobamate, may be responsible for the euphoria. Tolerance to the side effects of carisoprodol can develop and lessen over time.

The active metabolite meprobamate itself was a frequently misused drug in the 1950s and 1960s, and there have been reported overdoses.[3][6] With prolonged usage, carisoprodol and meprobamate can produce physical dependence of the barbiturate type and withdrawal symptoms similar to those of alcohol withdrawal. Like benzodiazepines, potential psychological dependence can result in withdrawal symptoms that persist for significantly longer periods, lasting months or even years. These symptoms may include anxiety and depression, long-term memory loss, chronic insomnia, social withdrawal, agitation and aggression, and other potential symptoms.[1][6][7] The severity of the symptoms appears to be magnified in patients with a history of substance misuse and patients concomitantly on other drugs with sedatives or benzodiazepine or opioid-like effects. The combination of carisoprodol with opioids and benzodiazepines has been referred to as “the Holy Trinity,” reportedly to increase the power of the “high.”[11] Because of its significant abuse potential due to its sedating, relaxant, and anxiolytic effects, in December of 2011, the drug enforcement agency classified carisoprodol as a schedule IV medication according to the Controlled Substance Act.

In March of 2007, Norwegian medical regulatory authorities conducted a review of carisoprodol, and the European Medicines Agency (EMEA) Committee for Medicinal Products for Human Use (CHMP) concluded that the benefits of medicines containing carisoprodol no longer outweigh their risks and that all marketing authorizations for carisoprodol be suspended throughout Europe.

Another potential significant reported adverse effect is seizures. In Indonesia, in September 2017, close to 100 people suffered seizures with at least one fatality when PCC, standing for “paracetamol-caffeine-carisoprodol,” was mixed into student’s drinks. 

Contraindications

Important contraindications listed in the package insert are acute intermittent porphyria as well as hypersensitivity reactions to a carbamate such as meprobamate. Patients with a sulfa allergy can develop a reaction after the carisoprodol is converted into meprobamate.[12]

Monitoring

No specific monitoring is necessary per the package insert. However, considering that this medication is metabolized in the liver and excluded through the kidney, the levels of carisoprodol and meprobamate can potentially increase if the patient has decreased liver function or renal insufficiency. Therefore dose or frequency adjustments may be indicated. Also, given the significant abuse potential of this medication and given that it is a controlled medication, performing appropriate monitoring such as periodic urine drug tests and pill counts should be considered. [13]

Toxicity

Since carisoprodol itself likely acts at the barbiturate site, a carisoprodol overdose itself is not directly reversible with flumazenil, a GABA-A receptor antagonist. However, the primary metabolite meprobamate, similar to benzodiazepines, does work on the GABA A receptor.[1] Therefore later in the course of an overdose, when there is potentially a significant amount of meprobamate, flumazenil can help reverse the effects of an overdose. Supportive care, including possibly charcoal,  gastric lavage, and dialysis, should be considered in overdose situations.[8]

Several case reports indicate that in overdose situations, there is direct cardiac toxicity.[5][9] Due to limited redistribution, maximum concentrations of carisoprodol appear in cardiac tissue.[9]

Enhancing Healthcare Team Outcomes

A good understanding of muscle relaxants in conjunction with the proper management of myofascial pain and muscle spasm can favorably impact a patient’s mobility, quality of life, safety,  and outcome after an acute painful muscular injury or strain. Carisoprodol indications include the relief of discomfort associated with acute, painful musculoskeletal conditions. This medication is recommended to be used together with rest, physical therapy, and other measures to relax muscles after strains, sprains, and muscle injuries.  It is also important for healthcare team members to be aware that this medication is a schedule IV controlled substance with abuse potential and, therefore, to assess a patient’s risk factors for substance abuse. Risk factors for substance abuse include a personal history of substance abuse, a first-degree relative with substance abuse problems, and environmental factors. To minimize the potential risks of drug dependence and abuse, it is not recommended to use carisoprodol for more than three weeks and is therefore approved for only up to three weeks of use.  In addition, due to potentially serious side effects such as sedation, seizures, and falls, this medication is not recommended to be used in pediatric patients under 16 years of age nor in elderly patients over the age of 65.  

In summary, healthcare professionals need to work together as an interprofessional team to thoroughly evaluate a patient and consider a patient’s risk factors, including a history of substance abuse and a history of medication noncompliance, to make informed decisions about the potential role of carisoprodol in their treatment. It is also essential for healthcare providers to be cognizant of the duration of treatment with this medication. The pharmacist should perform medication reconciliation and verify there are no interactions and that dosing is within proper limits, and let the prescriber know of any concerns. Nursing should counsel patients on possible adverse effects and monitor the patient’s usage to ensure there is no misuse and that therapy is effective, reporting any concerns to the prescribing clinician. Carisoprodol has been a commonly prescribed muscle relaxant for many years. To help improve patient outcomes when considering utilizing carisoprodol in a patient’s care, the interprofessional health care team members should be aware of the indications, potential interactions, potential adverse effects, pharmacodynamic variables, and pharmacokinetic factors that can affect the successful implementation and use of this medication. [Level 5]

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References

1.

Gonzalez LA, Gatch MB, Forster MJ, Dillon GH. Abuse Potential of Soma: the GABA(A) Receptor as a Target. Mol Cell Pharmacol. 2009 Jan 01;1(4):180-186. [PMC free article: PMC2858432] [PubMed: 20419052]

2.

KAMIN I, SHASKAN DA. Death due to massive overdose of meprobamate. Am J Psychiatry. 1959 Jun;115(12):1123-4. [PubMed: 13649976]

3.

Hollister LE. The pre-benzodiazepine era. J Psychoactive Drugs. 1983 Jan-Jun;15(1-2):9-13. [PubMed: 6350551]

4.

Allen MD, Greenblatt DJ, Noel BJ. Meprobamate overdosage: a continuing problem. Clin Toxicol. 1977 Dec;11(5):501-15. [PubMed: 608316]

5.

Kintz P, Tracqui A, Mangin P, Lugnier AA. Fatal meprobamate self-poisoning. Am J Forensic Med Pathol. 1988 Jun;9(2):139-40. [PubMed: 3381792]

6.

BERGER FM, KLETZKIN M, LUDWIG BJ, MARGOLIN S. The history, chemistry, and pharmacology of carisoprodol. Ann N Y Acad Sci. 1960 Mar 30;86:90-107. [PubMed: 13799302]

7.

Bramness JG, Furu K, Engeland A, Skurtveit S. Carisoprodol use and abuse in Norway: a pharmacoepidemiological study. Br J Clin Pharmacol. 2007 Aug;64(2):210-8. [PMC free article: PMC2000626] [PubMed: 17298482]

8.

Graae J, Ladefoged J. [Severe meprobamate poisoning treated by hemodialysis and peritoneal dialysis]. Nord Med. 1969 May 08;81(19):601-3. [PubMed: 5783967]

9.

Eeckhout E, Huyghens L, Loef B, Maes V, Sennesael J. Meprobamate poisoning, hypotension and the Swan-Ganz catheter. Intensive Care Med. 1988;14(4):437-8. [PubMed: 3403779]

10.

BLUMBERG AG, ROSETT HL, DOBROW A. Severe hypotensive reactions following meprobamate overdosage. Ann Intern Med. 1959 Sep;51:607-12. [PubMed: 13801701]

11.

Horsfall JT, Sprague JE. The Pharmacology and Toxicology of the ‘Holy Trinity’. Basic Clin Pharmacol Toxicol. 2017 Feb;120(2):115-119. [PubMed: 27550152]

12.

Pharmacology corner. J Addict Nurs. 2012 Dec;23(4):271-2. [PubMed: 24622497]

13.

Parente ST, Kim SS, Finch MD, Schloff LA, Rector TS, Seifeldin R, Haddox JD. Identifying controlled substance patterns of utilization requiring evaluation using administrative claims data. Am J Manag Care. 2004 Nov;10(11 Pt 1):783-90. [PubMed: 15623267]

Disclosure: Till Conermann declares no relevant financial relationships with ineligible companies.

Disclosure: Desirae Christian declares no relevant financial relationships with ineligible companies.

Carisoprodol oral tablet – Drink-Drink

Key features of carisoprodol

1. Carisoprodol oral tablets are available in generic and brand name formulations. Trade name: Soma .
2. Carisoprodol is only available as a tablet that you take by mouth.
3. Carisoprodol is used to treat muscle pain.

Important warnings

• Drowsiness: Carisoprodol may cause drowsiness. Do not drive or use dangerous machinery until you know how this drug affects you.
• Dependence: The use of carisoprodol may cause dependence (addiction). If this happens, abruptly stopping this medication may cause withdrawal symptoms. These symptoms may include trouble sleeping, vomiting, abdominal pain, headache, or shaking and muscle twitching. They may also include hallucinations (seeing or hearing things that are not real) or other mental problems. To prevent addiction, do not take this medicine for more than three weeks.
• Convulsions: Carisoprodol may cause convulsions. This risk is higher if it is used with multiple drugs that are misused or used at excessively high doses.

What is carisoprodol?

Carisoprodol is a prescription drug. It comes in the form of tablets that you take by mouth.

Carisoprodol is available as a brand name Soma . It is also available as a generic.

Generic drugs usually cost less. In some cases, they may not be available in all powers and shapes like the branded version.

Carisoprodol may be used as part of combination therapy. This means that you may need to take it with other medicines.

Why it is used

Carisoprodol is used for the short-term treatment of muscle pain. This drug should only be taken for two to three weeks.

How does it work?

Carisoprodol belongs to a class of drugs called muscle relaxants. A drug class is a group of drugs that work in a similar way. These drugs are often used to treat these conditions.

Carisoprodol is believed to work by preventing the nervous system from sending pain signals to the brain.

Carisoprodol side effects

Carisoprodol oral tablet may cause drowsiness. Do not drive or use dangerous machinery until you know how this drug affects you.

Carisoprodol may also cause other side effects.

More common side effects

More common side effects that may occur with carisoprodol include:

• Headache
• dizziness
• drowsiness expressed, they may go away within a few days or several weeks. If they get worse or don’t go away, talk to your doctor or pharmacist.

  Serious side effects

  Call your doctor right away if you have any serious side effects. Call 911 if your symptoms are life threatening or if you think you need emergency medical attention. Serious side effects and their symptoms may include the following:

  • heart problems, symptoms may include:
    • rapid heartbeat
    • low blood pressure, which may cause fainting
    • flushing of the face (sudden flushing)
  • problems with the nervous system, symptoms may include:
    • problems getting your muscles to move the way you want them to
    • feeling excited or irritable
    • greedy
    • unsteadiness
  • stomach problems, symptoms may include:
    • nausea
    • vomiting
    • abdominal pain (in the abdomen)
  • blood problems such as a decrease in white blood cells or other types of blood cells; these problems increase the risk of infection

  Carisoprodol may interact with other medicines.

  

  Carisoprodol oral tablet may interact with other medicines, vitamins or herbs you are taking. An interaction is when a substance changes how a drug works. This may harm or interfere with the drug.

  To avoid interactions, your doctor must carefully prescribe all of your medications. Be sure to tell your doctor about all medications, vitamins, or herbs you are taking. To find out how this drug may interact with other medicines you are taking, talk to your doctor or pharmacist.

  Examples of drugs that may interact with carisoprodol are listed below.

  Interactions that increase the risk of side effects

  • Side effects from other drugs: Taking carisoprodol with certain drugs increases the risk of side effects from these drugs. Examples of such drugs include:
    • Benzodiazepines such as alprazolam, diazepam or flurazepam.
      • Increased side effects may include drowsiness.
    • Opioids such as morphine, oxycodone, hydrocodone, or codeine.
      • Increased side effects may include drowsiness.
    • Tricyclic antidepressants such as amitriptyline, nortriptyline, doxepin or imipramine.
      • Increased side effects may include drowsiness.
    • Meprobamat.
      • Increased side effects may include drowsiness. This is because your body converts carisoprodol to meprobamate. This increases the amount of meprobamate in the body and increases its side effects.
  • Side effects of carisoprodol: Taking carisoprodol with certain medications increases the risk of side effects of carisoprodol. This is because the amount of carisoprodol in your body may be increased. Examples of such drugs include:
    • Drugs such as omeprazole or fluvoxamine.
      • If you are taking these drugs with carisoprodol, your doctor may monitor side effects more closely.

  Interactions that may make your medicines not work as well

  • When carisoprodol is used with certain medicines, it may not work to treat your condition. This is because the amount of carisoprodol in your body may be reduced. Examples of such drugs include:
    • Drugs such as St. John’s wort or rifampin.
      • If you are taking these drugs with carisoprodol, your doctor may increase your carisoprodol dosage.

  Carisoprodol Warnings

  This drug has several warnings.

  Allergy Prevention

  Carisoprodol may cause a severe allergic reaction. Symptoms may include:

  • difficulty breathing
  • swelling of the throat or tongue

  If you have an allergic reaction, call your doctor or local poison control center right away. If you have severe symptoms, call 911 or go to the nearest emergency room.

  Do not take this drug again if you have ever had an allergic reaction to it or to a drug called meprobamate. Repeated use may be fatal (cause death).

  Alcohol Interaction Warning

  Carisoprodol may cause drowsiness. Drinking drinks containing alcohol can increase drowsiness. If you drink alcohol, talk to your doctor about whether this drug is safe for you.

  Warnings for people with certain medical conditions

  For people with porphyria: Do not take carisoprodol. This may worsen your condition.

  For people with an enzyme (CYP2C19) that works slowly: The CYP2C19 enzyme helps your body process carisoprodol. The genetic mutation causes the enzyme to process the drug more slowly. As a result, you may have higher levels of carisoprodol in your body. This increases the risk of side effects. Your doctor may prescribe a lower dosage of this drug for you.

  For people with liver problems: This drug is processed in your body by your liver. If your liver is not working properly, your body may process this drug more slowly. This may cause more side effects. To prevent this, your doctor may prescribe you a lower dosage of this drug.

  For people with kidney problems: This drug is excreted by the kidneys. If your kidneys are not working properly, your body may excrete this drug more slowly. This can increase the amount of the drug in the body and cause more side effects. To prevent this, your doctor may prescribe you a lower dosage of this drug.

  Warnings for other groups

  For pregnant women: Carisoprodol is a category C pregnancy drug. This means two things:

  1. Animal studies have shown adverse effects on the fetus when the drug is taken by the mother.
  2. There have not been enough human studies to be sure how the drug may affect the fetus.

  Talk to your doctor if you are pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

  Call your doctor if you become pregnant while taking this drug.

  For lactating women: Carisoprodol may pass into breast milk and cause side effects in a breast-fed infant. This drug may also decrease the amount of milk your body produces.

  Talk to your doctor if you are breastfeeding. You may need to decide whether to stop breastfeeding or stop taking this medication.

  For the elderly: This medicine has not been studied in adults over 65 years of age. It should not be used in people in this age group.

  For children: This drug has not been studied in children under 17 years of age. It should not be used in children in this age group.

  How to take carisoprodol

  All possible dosages and dosage forms cannot be included here. Your dosage, dosage form, and how often you take the drug will depend on:

  • Your age
  • The condition being treated
  • How bad is your condition
  • Other medical conditions you have
  • How do you respond to the first dose

  Forms and strengths

  Generic: Carisoprodol

  • Form: oral tablet
  • Strengths: 250mg, 350mg

  Brand: Soma

  • Shape: oral tablet
  • Strengths: 250mg, 350mg

  Muscle pain dosage

  Adult dosage (age 17 to 64)

  • Typical dosage: 250–350 mg 1,400 once a day and at bedtime. This is a total of four times a day (XNUMX mg/day).

  Pediatric dosage (ages 0 to 16 years)

  • The use of this drug in children under 17 years of age has not been studied. It should not be used in children in this age group.

  Senior dosage (age 65 and over)

  • This medicine has not been studied in adults over 65 years of age. It should not be used in people in this age group.

  Take as directed

  Carisoprodol is used for short term treatment. It comes with serious risks if you don’t take it as prescribed.

  If you suddenly stop taking a drug or don’t take it at all: If you do not take this drug, your muscle pain may continue or get worse. If you stop taking this drug suddenly, you may experience withdrawal symptoms. They may include trouble sleeping, vomiting, abdominal pain, headache, or trembling and muscle twitching. They may also include hallucinations (seeing or hearing things that are not real) or other mental problems.

  If you miss doses or don’t take your medicine as scheduled: Your medicine may not work or stop working completely. For this drug to work well, there must be a certain amount in your body at all times.

  If you take too much: You may have dangerous levels of the drug in your body. This risk is higher if this medicine is used with several drugs that are used incorrectly or are taken in excessively high doses. Overdose symptoms of this drug may include:

  • low blood pressure
  • rapid heartbeat
  • shortness of breath
  • seizures
  • delusions (believing something is not true)
  • hallucinations (seeing or hearing unreal things)
  • unusual excitement
  • vision problems
  • muscle stiffness and incoordination
  • coma
  • death

  9000 2 If you think you have taken too much of this drug, call your doctor or to your local poison control center. If you have severe symptoms, call 911 or go to the nearest emergency room right away.

  What to do if you miss an appointment: Take the dose as soon as you remember. But if you only remember a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This can lead to dangerous side effects.

  How to find out if the drug will work: You need to relieve muscle pain.

  Important considerations when taking carisoprodol

  Keep these considerations in mind if your doctor prescribes carisoprodol for you.

  General

  • Take this drug at the time your doctor tells you to.
  • You can take carisoprodol with or without food. Taking it with food can help reduce indigestion.
  • The tablet may be cut or crushed.

  Memory

  • Store carisoprodol at room temperature, 68°F to 77°F (20°C to 25°C).
  • Keep this medication away from light.
  • Do not store this medicine in damp or damp places such as bathrooms.
  • Keep this medicine in a tightly closed container.

  Refills

  The prescription for this medicine is refillable. You do not need a new prescription to refill this medicine. Your doctor will write down the number of additives allowed in your prescription.

  Travel

  If you are traveling with medication:

  • Carry your medication with you at all times. During the flight, never put it in your checked baggage. Keep it in your hand luggage.
  • Don’t worry about the X-ray machines at the airport. They cannot harm your medicine.
  • You may need to show airport staff the pharmacy label for your medications. Always carry the original box with the prescription label with you.
  • Do not put this medicine in the glove compartment of your car or leave it in your car. Avoid this in very hot or very cold weather.

  Clinical monitoring

  You and your doctor need to monitor certain health problems. This may help you stay safe while taking this drug. These problems include:

  • Kidney and liver function. Blood tests can check how well your kidneys and liver are working. If your kidneys or liver are not working properly, your doctor may lower the dosage of this drug.
  • Misuse or dependence. This drug may cause dependence (dependence). Call your doctor if you feel like you are using too much carisoprodol or that you need it to get through the day.

  Availability

  Not every pharmacy stocks this drug. When filling out your prescription, be sure to call ahead to make sure they have it.

  Hidden costs

  You may need to have blood tests to check kidney and liver function while taking this drug. The cost of these tests will depend on your insurance.

  Insurance

  Many insurance companies require prior authorization to take this drug. This means that your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

  Are there alternatives?

  There are other medicines available to treat your condition. Some may suit you better than others. Talk to your doctor about other drug options that may help you.

  List of Substances

  90. Carisoprodol

  Sources:

  – Mathias B. Forrester, Carisoprodol abuse in Texas, 1998–2003, J Med Toxicol. 2006 Mar; 2(1): 8–13. doi: 10.1007/BF03161006

  – Reeves, R. R., Pinkofsky, H. B., & Carter, O. S. (1997). Carisoprodol: A drug of continued abuse. Mayank Gupta, Case Report: Carisoprodol Abuse in Adolescence, Cureus 12(11): e11525, DOI: 10.7759/ cureus.11525

  Additional sources:

  https://www.drugsdata.org/view.php?id=9454

  Active ingredient: Carisoprodol

  Nomenclature name: 2-[(Carbamoyloxy)methyl]-2 -methylpentyl propan-2-ylcarbamate

  Molecular formula: C12h34N2O4

  Molecular weight: 260.33

  Initiator/Territorial unit: USA

  Russian Federation: Carisoprodol has not been controlled.

  Republic of Belarus: control over the circulation of Carisoprodol has not been established.

  Substance control status shown corresponds to the date the alert was created.

  Carisoprodol, a uniquely structured psychoactive drug, a muscle relaxant sold under the trade name Soma, is used to treat musculoskeletal pain following sprains and muscle injuries. Refers to GABAergic drugs (neurotransmitter of GABA receptors). Carisoprodol is a modification of meprobamate, the “classic” controlled substance. Unlike meprobamate, it has better muscle relaxation properties, it actually acts as a “prodrug”. A significant proportion of carisoprodol is metabolized to meprobamate, which after administration reaches higher peak plasma levels than carisoprodol itself. This largely explains the high abuse potential of carisoprodol.

  Carisoprodol, like meprobamate, can cause physical dependence similar to barbiturate after periods of prolonged use. The combination of carisoprodol with opioids and benzodiazepines is referred to as the “Holy Trinity” because it is reported to increase the strength and duration of euphoria.