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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Cyclobenzaprine, a chemical closely related to the antidepressant amitriptyline, is a centrally acting skeletal muscle relaxant with antidepressant activity. It is indicated for use as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions. In pharmaceutical products, cyclobenzaprine is employed as cyclobenzaprine hydrochloride (CAS number 6202-23-9, EC number 228-264-4, molecular formula C20H22ClN) (1).
Medications That May Be Useful in the Management of Patients with Chronic Intractable Pain
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
Cyclobenzaprine can be used as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute painful muscle conditions. A dose of 10–40 mg/day appears to be a useful adjunct in the management of the fibrositis (fibromyalgia) syndrome.
Medication for Pain
Published in Harold G. Koenig, Chronic Pain, 2013
Cyclobenzaprine (Flexeril) and methocarbamol (Robaxin) are medicines that help to relax tense muscles and thereby ease pain. Muscles may be tense because of psychological stress, a response to inflammation, or the body’s response to pain itself. Whatever the cause, if muscles contract and tighten up, this reduces blood flow to the muscles—causing ischemia (lack of oxygen) that results in pain and inflammation. It is easy for a vicious cycle to develop, leading to more and more pain as muscles become more and more tense. Cyclobenzaprine and similar drugs help to interrupt this vicious cycle, increasing blood flow to muscles and reducing pain and inflammation. Sometimes very low doses of these medications are effective. For example, I have found that one-fourth of a 10 mg cyclobenzaprine at night helps to relieve my pain and keep me functional. Because my body will tend to get used to this small dose, I periodically need to give it a “drug holiday.” This means doing without the drug for a week or ten days, allowing my body to become sensitive to it again.
Early stage IgD multiple myeloma in a 50-year-old man
Published in Baylor University Medical Center Proceedings, 2020
C. Lake Littlejohn, Andrew Whiteley, Marvin J. Stone
The patient had no family history of malignancy or blood disorders. His social history was unremarkable. He was employed as a cafeteria manager. Home medications included lisinopril and recent prescriptions for cyclobenzaprine and ibuprofen. Physical exam revealed an obese middle-aged man lying in bed with a traction splint applied to his right lower extremity. Laboratory studies showed a hemoglobin of 13.6 g/dL, serum creatinine of 0.9 mg/dL, and calcium of 9.2 mg/dL. Blood glucose was mildly elevated, but other laboratory tests, including a complete blood count and comprehensive metabolic panel, revealed values within normal limits. Plain films revealed an acute minimally comminuted fracture of the proximal right femur diaphysis (Figure 1). Computed tomography scan of the right lower extremity showed irregularity of the margins and small adjacent osseous fragments consistent with a pathologic fracture. A focal soft tissue mass was identified within the marrow cavity.
Conservative management of severe serotonin syndrome with coma, myoclonus, and crossed-extensor reflex complicated by hepatic encephalopathy
Published in Baylor University Medical Center Proceedings, 2018
Vignesh Ramachandran, Belicia Ding, Rollin George, Matthew Novakovic
The patient's elevated ammonia level at presentation (82 µmol/L) led to consideration of hepatic encephalopathy. The correlation of hyperammonemia and hepatic encephalopathy has been questioned because it is the level of ammonia in the cerebrospinal fluid that is the determinant of hepatic encephalopathy.9 Nevertheless, increased levels of ammonia in the serum have been shown to be a predictor of hepatic encephalopathy.10 Worsening symptoms over 24 hours despite aggressive lactulose treatment and bowel movements prompted investigation of other causes. The patient's medication list revealed 3 drugs that may precipitate SS and worsen SS symptoms when taken in combination. Fluoxetine, a selective serotonin reuptake inhibitor, and its metabolite norfluoxetine were most likely the major cause of the patient's prolonged SS course, because they have the longest half-lives (1 week and 2.5 weeks, respectively) when taken for prolonged periods of time.11 Aripiprazole is an atypical antipsychotic that acts as partial agonist at 5-HT1A receptor and antagonist at 5-HT2A receptor. Cyclobenzaprine has tricyclic properties and interacts with pro-serotonergic drugs to cause SS.12 Aripiprazole and cyclobenzaprine have shorter half-lives (72 and 32 hours, respectively). As such, a synergistic effect was likely due to the different serotonergic pathways implicated. Thus, despite normal doses, the combination induced SS.12,13
Prescribing patterns for treating common complications of spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2023
Shikha Gupta, Mary Ann McColl, Karen Smith, Alexander McColl
The second most commonly treated condition among people with SCI was muscle spasms, for which 73 prescriptions were issued to 58 participants (54% of the sample). The most commonly prescribed groups of medications were anti-spasmodics for central nervous system (particularly baclofen), making up 63% (46/73) of the prescriptions issued for this condition. Other commonly prescribed medications under this therapeutic class included tizanidine, intrathecal baclofen, diazepam, dantrium, and botulinum neurotoxin – all prescribed to less than 10% of patients treated for spasms. Apart from anti-spasmodics, participants were also prescribed general muscle relaxants or anxiolytics which commonly included lorazepam and cyclobenzaprine such as Flexeril.