Hello again Jimen,
Muscle Relaxants in General:
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?Skeletal muscle relaxants are used to relax certain muscles in your
body and relieve the stiffness, pain, and discomfort caused by
strains, sprains, or other injury to your muscles. However, these
medicines do not take the place of rest, exercise or physical therapy,
or other treatment that your doctor may recommend for your medical
problem.?
Please read this entire page, as it describes side effects of commonly
used muscle relaxants. None are without side effects, and it is
impossible to determine if you will suffer side effects or not. Most
side effects are transient, and can be monitored.
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202523.html
Side Effects of Muscle Relaxants
=================================
"All muscle relaxants are associated with side effects, and you should
be monitored carefully while taking any type of this medication. The
most common side effects include dry mouth, drowsiness, and
constipation. As with benzodiazepines, muscle relaxants can also be
habit forming. Muscle relaxants should not be taken for extended
periods of time unless under the direction of a health care
professional.?
?Fibromyalgia muscle relaxants have proven to be very effective in
treating muscle pain. In one study performed on cyclobenzaprine,
fibromyalgia sufferers reported an increased ability to sleep and a
decrease in their pain symptoms after using the drug for three months.
Studies on orphenadrine citrate produced similar results. However,
some muscle relaxants do not reduce the amount of muscle spasms that
occur with fibromyalgia. Often, tinzanidine is prescribed to those who
suffer from muscle spasms along with their pain.?
http://www.fibromyalgia-symptoms.org/fibromyalgia_muscle_relaxants.html
Baclofen
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?If you are taking more than 30 mg daily, do not stop taking this
medication suddenly. Stopping high doses of this medication abruptly
can cause convulsions, hallucinations, increases in muscle spasms or
cramping, mental changes, or unusual nervousness or restlessness.
Consult your physician about how to reduce the dosage gradually before
stopping the medication completely.?
Possible Side Effects
Side effects that typically go away as your body adjusts to the
medication and do not require medical attention unless they continue
for several weeks or are bothersome: drowsiness or unusual tiredness*;
increased weakness*; dizziness or lightheadedness; confusion; unusual
constipation*; new or unusual bladder symptoms*; trouble sleeping;
unusual unsteadiness or clumsiness*.
Unusual side effects that require immediate medical attention:
fainting; hallucinations; severe mood changes; skin rash or itching.?
?Since it may be difficult to distinguish between certain common
symptoms of MS and some side effects of baclofen, be sure to consult
your health care professional if an abrupt change of this type
occurs.?
http://www.nationalmssociety.org/Meds-Baclofen.asp
Clonazepam
===========
?Response from Omar Khan, MD
Associate Professor of Neurology and Medical Director, Multiple
Sclerosis Clinic, Wayne State University, Detroit, Michigan
I assume the term "regular" muscle relaxants and analgesia implies
that drugs such as baclofen, tizanidine, cyclobenzaprine, and diazepam
have been used. Other agents that can help relieve painful muscle
spasms include carbamazepine, gabapentin, tiagabine, carisoprodol, and
dantrolene. Of these, carbamazepine may be the most effective, or some
of the newer epilepsy drugs that have a structure similar to
carbamazepine. The use of these latter drugs for treating muscle
spasms would be considered "off-label."
http://www.medscape.com/viewarticle/448407
http://www.nationalmssociety.org/Meds-Clonazepam.asp
?Clonazepam is a benzodiazepine that belongs to the group of
medications called central nervous system (CNS) depressants, which
slow down the nervous system. Although clonazepam is used for a
variety of medical conditions, it is used in multiple sclerosis
primarily for the treatment of tremor, pain, and spasticity.?
?Possible Side Effects
Side effects that may go away during treatment as your body adjusts to
the medication and do not require medical attention unless they
continue for several weeks or are bothersome: drowsiness or tiredness;
clumsiness or unsteadiness*; dizziness or lightheadedness; slurred
speech*; abdominal cramps or pain; blurred vision or other changes in
vision*; changes in sexual drive or performance*; gastrointestinal
changes, including constipation* or diarrhea; dryness of mouth; fast
or pounding heartbeat; muscle spasm*; trouble with urination*;
trembling.·?
http://www.nationalmssociety.org/Meds-Clonazepam.asp
Valium
======
?Possible Side Effects
Side effects that may go away during treatment as your body adjusts to
the medication and do not require medical attention unless they
continue for several weeks or are bothersome: clumsiness or
unsteadiness*; dizziness or lightheadedness; slurred speech*;
abdominal cramps or pain; blurred vision or other changes in vision*;
changes in sexual drive or performance*; constipation*; diarrhea;
dryness of mouth; fast or pounding heartbeat; muscle spasm*; trouble
with urination*; trembling*; unusual tiredness or weakness*.?
?Since it may be difficult to distinguish between certain common
symptoms of MS and some side effects of diazepam, be sure to consult
your health care professional if an abrupt change of this type
occurs.?
http://www.nationalmssociety.org/Meds-Diazepam.asp
Tizanidine
==========
?Tizanidine is used in multiple sclerosis to treat the increased
muscle tone associated with spasticity. While it does not provide a
cure for the problem, it is designed to relieve the spasms, cramping,
and tightness of muscles.
In order to minimize unwanted side effects with this medication, your
physician will start you on a low dose and gradually raise it until a
well-tolerated and effective level is reached.
Common side effects that may go away as your body adjusts to the
medication and do not require medical attention unless they continue
for more than two weeks or are bothersome: dryness of mouth;
sleepiness or sedation; weakness*, fatigue*, and or tiredness*;
dizziness or lightheadedness, especially when getting up from a
sitting or lying position; increase in muscle spasms, cramps, or
tightness; back pain.?
http://www.nationalmssociety.org/Meds-Tizanidine_md.asp
?Tizanidine
Tizanidine also works by blocking nerve impulses that are sent from
the nerve endings in your body to your brain. Marketed under the name
Zanaflex, tizanidine is particularly helpful in reducing fibromyalgia
muscle spasms. Few other muscle relaxants work well for this purpose.
Tizanidine works to increase muscle tone, thereby reducing muscle
weakness and spasm.
Tizanidine should not be taken if you have liver or kidney disease or
are currently taking oral contraceptives.?
http://www.fibromyalgia-symptoms.org/fibromyalgia_muscle_relaxants.html
Flexeril
========
?Flexeril. (Cyclobenzaprine) is a centrally acting skeletal muscle
relaxant medication which is prescribed to relieve muscle spasms from
injuries such as pulls, strains or sprains. Because cyclobenzaprine's
duration of action is 4 to 6 hours it usually needs to be taken 3
times a day. Some studies have suggested that a lower dosage of 5 mg.
3 times a day may be as effective as 10 mg. 3 times a day, and that it
produces less sedation.?
http://www.remedyfind.com/rm-513-Flexeril.asp
http://www.healingwell.com/library/ms/moorhead2.asp
Dolobid
========
?Listed below are the adverse reactions reported in the 1,314 of
these patients who received treatment in studies of two weeks or
longer. Five hundred thirteen patients were treated for at least 24
weeks, 255 patients were treated for at least 48 weeks, and 46
patients were treated for 96 weeks. In general, the adverse reactions
listed below were 2 to 14 times less frequent in the 1,113 patients
who received short-term treatment for mild to moderate pain.
Incidence Greater Than 1%
Gastrointestinal: The most frequent types of adverse reactions
occurring with diflunisal are gastrointestinal, these include nausea*,
vomiting, dyspepsia*, gastrointestinal pain*, diarrhea*, constipation,
and flatulence.
Psychiatric: Somnolence, insomnia.
Central Nervous System: Dizziness.
Special Senses: Tinnitus.
Incidence Less Than 1 in 100
The following adverse reactions, occurring less frequently than 1 in
100, were reported in clinical trials or since the drug was marketed.
The probability exists of a causal relationship between diflunisal and
these adverse reactions.
Dermatologic: Erythema multiforme, exfoliative dermatitis,
Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria,
pruritus, sweating, dry mucous membranes, stomatitis,
photosensitivity.
Gastrointestinal: Peptic ulcer, gastrointestinal bleeding, anorexia,
eructation, gastrointestinal perforation, gastritis. Liver function
abnormalities; jaundice, sometimes with fever; cholestasis; hepatitis.
Hematologic: Thrombocytopenia; agranulocytosis; hemolytic anemia.
Genitourinary: Dysuria; renal impairment, including renal failure;
interstitial nephritis; hematuria; proteinuria.
Psychiatric: Nervousness, depression, hallucinations, confusion, disorientation.
Central Nervous System: Vertigo; light-headedness; paresthesias.
Special Senses: Transient visual disturbances including blurred vision.
http://www.rxlist.com/cgi/generic3/diflunisal_ad.htm
?Dolobid, a nonsteroidal anti-inflammatory drug, is used to treat mild
to moderate pain and relieve the inflammation, swelling, stiffness,
and joint pain associated with rheumatoid arthritis and osteoarthritis
(the most common form of arthritis).?
?Side effects cannot be anticipated. If any develop or change in
intensity, inform your doctor as soon as possible. Only your doctor
can determine if it is safe for you to continue taking Dolobid.
· More common side effects may include:
Abdominal pain, constipation, diarrhea, dizziness, fatigue, gas,
headache, inability to sleep, indigestion, nausea, rash, ringing in
ears, sleepiness, vomiting
http://www.healthsquare.com/newrx/DOL1145.HTM
A list of commonly used drugs and links to further information
http://browse.drugs.com/cond-multiple_sclerosis.html
More drug info:
http://ms.about.com/od/spasticity/a/SpasticityMeds.htm
?Medications
Knowing tremor may be worsened by stress or anxiety, medications which
have a calming effect are sometimes prescribed. Hydroxyzine (Atarax®,
Vistaril®) is a tranquilizer and antihistamine that reduces a tremor
by relaxing the individual and calming stress which may have provoked
the tremor.
Clonazepam (Klonopin®) works similarly to hydroxyzine. Care must be
taken by the physician, however, to prescribe a dose which is
effective but not so strong as to sedate the patient excessively. This
drug can cause tolerance and dependency.
Propranolol (Inderal®) is a beta blocker ? an agent which blocks the
nerve flow along certain nerves known as "beta fibers." It is
typically given for high blood pressure or angina. Propranolol is
usually effective in treating only physiologic tremors. Doses should
be started low and gradually increased until an optimal level is
reached.
Amantadine (Symmetrel®) helps to reduce shaking for some individuals.
This medication also has antiviral properties and is sometimes
prescribed for people with MS to alleviate fatigue.
Baclofen (Lioresal®) is a drug often taken by people with MS to treat
spasticity. It also helps to slow tremor, but the dosage must be
carefully watched as baclofen produces weakness as a side effect.
A drug normally used to fight tuberculosis, isoniazid (INH) with
pyridoxine, is also helpful in controlling severe gross tremors which
are posture related. Unfortunately, large doses of isoniazid are
needed to be effective, and this can result in liver toxicity. Given
the danger, this medication should only be used in extreme cases, and
liver function must be evaluated regularly.
Other drugs that may be used to treat tremor include primidone
(Mysoline®), and acetazolamide (Diamox®). Primidone is an
anticonvulsant and acetazolamide is a diuretic (water pill). Both have
properties which may reduce some tremors.?
(Also drugs for pain found on this page)
http://www.msaa.com/publications/managing_symptoms/p_06_weakness.html
http://www.msmoms.com/medications.htm
?As with the majority of MS symptoms, spasticity appears to result
from changes in the flow of nerve impulses, in this case along the
spinal cord. Spasticity can be transient or may last indefinitely.
Discomfort with spasticity ranges from an occasional tightness,
achiness, pulling, or restless sensation to strong pain resulting from
severe spasms. Spasticity is one of the most common symptoms of MS.
Typical treatments for spasticity include exercise, physical therapy,
mechanical devices (such as an ankle brace or "spreaders" for the
fingers), medication, baclofen pump implant, and nerve-blocking
procedures (in severe instances). In addition to any pain relief,
treatments offer the potential for increased coordination, easier
movement, and less fatigue as a result of less effort involved in
movement.
A successful exercise program, emphasizing stretching and range of
motion, in conjunction with proper medication (if necessary), will
normally decrease the symptoms of spasticity and potentially prevent
the development of more severe conditions. Spasticity frequently leads
to contractures (joint immobility), which can cause an increased risk
of infection as well as pressure sores as a result of limited
movement. Severe muscle spasms are also possible.?
?Chlordiazepoxide (Librium®), as does diazepam, improves mobility by
reducing stiffness. Sensitivity, lethargy, and sleepiness are common
side effects. Cyclobenzaprine (Flexeril®) is another drug which may
help limb spasms, but more often acts upon back spasms. Under a
doctor's guidance, both of these drugs may be given in conjunction
with other antispasticity medications.
Carbamazepine (Tegretol®) is an anticonvulsant drug that can help
control tonic or paroxysmal spasms. Cortisone is also effective but
can only be used on a short-term basis.
Many of the drugs used to relieve spasticity can become less effective
over time as people become "more tolerant" to them. When this occurs,
the drug can either be increased, or discontinued and then restarted
at a later date when the treatment may be effective again.
When pain from spasticity and spasms is caused by tendon strains,
joint injuries, or pulled muscles, anti-inflammatory drugs are
sometimes prescribed. These may include ibuprofen (Motrin®, Advil®,
Nuprin®), naproxen (Naprosyn®, Anaprox®), piroxicam (Feldene®), and
diflunisal (Dolobid®).?
http://www.msaa.com/publications/managing_symptoms/p_05_surgery.html
Again, I hope you find relief!
Sincerely, Crabcakes
Search Terms
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Muscle relaxers
muscle relaxants + few side effects
Muscle relaxers + MS |
