Category:

• Muscle relaxant

  Description:

• Centrally acting skeletal muscle relaxant

Indications:

• Skeletal muscle spasms associated with acute, painful musculoskeletal conditions

• Tetanus: neuromuscular manifestations

  Contraindications:

• Do not administer IV to patients with renal dysfunction due to presence of polyethylene glycol 300 in parenteral formulation.

Precautions:

• Pregnancy category C

• Do not administer injection rate of 3mL per minute.

• Do not exceed a total of 3 grams per day for greater than 3 consecutive days, except in tetanus.

• Use injectable form cautiously in epileptic patients.

  Adverse Reactions (Side Effects):

• Parenteral (associated with rapid IV administration):

  • Cardiovascular: syncope, hypotension, bradycardia

  • CNS: drowsiness, lightheadedness, vertigo, headache

  • Dermatologic: urticaria, pruritis, rash, flushing

  • Ophthalmic: blurred vision, conjunctivitis

  • Misc: metallic taste, GI upset

• Oral:

  • lightheadedness, dizziness, drowsiness, nausea, urticaria, rash, headache, fever, blurred vision

Dosage:

• Administered orally (tablets) and IV or IM injection

• Oral:

  • Adult (for first 48-072 hours, recommended dose is 6 grams per day):

  • Initial: 1.5 grams qid

  • Maintenance: 1 gram qid, 75omg q4h or 1.5 grams tid

• Parenteral:

  • do not exceed 3 grams for 3 consecutive days

  • usual dose is 1 gram

  • IV: max rate of 3mL per minute

  • IM: do not inject over 5mL into each gluteal region

• Tetanus:

  • Adults: 1-2 grams directly into IV tubing

  • Children: 15mg/kg, may repeat