Cyclobenzaprine, Orphenadrine and Tizanidine

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Muscle relaxants such as orphenadrine are used to help relieve the stiffness, pain, and discomfort caused by sprains and strains of the muscles in the neck, back, or other areas of the body. Your doctor may prescribe additional treatments such as appropriate rest, exercise, or physical therapy to help your stiff muscles. Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur.

Side Effects

Centrally-acting muscle relaxants include cyclobenzaprine, methocarbamol, metaxalone, chlorzoxazone, tizanidine, baclofen, carisoprodol, and orphenadrine. There are two broad categories of muscle relaxers (benzodiazepines and skeletal muscle relaxants), each of which acts on the nervous system in different ways. The drugs are usually not prescribed as the primary treatment of musculoskeletal pain but are rather reserved for when conservative treatments fail to provide relief.

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Both cyclobenzaprine and orphenadrine work primarily on central nervous system to provide skeletal muscle relaxation. On the other hand, a meta-analysis suggested that orphenadrine seems more effective than placebo at relieving pain related to muscle spasms. It’s typically considered when first-line treatments fail or aren’t tolerated by patients. Orphenadrine has robust data supporting its use as an adjunctive treatment alongside physical therapy and rest for symptomatic relief. Nonetheless, due to its unique pharmacology, Norflex may be an ideal choice for patients who did not respond well to other muscle relaxants or have specific needs such as avoiding common side effects like sedation. Now, skeletal muscle relaxants can further be divided into centrally-acting and direct-acting muscle relaxants.

Muscle relaxers can be very effective for the treatment of severe muscle, joint, back, or neck pain. With that said, they are not intended for long-term use and should only be taken as prescribed. Muscle relaxers are sometimes prescribed for people with osteoarthritis pain and other types of musculoskeletal pain. They are available by prescription only and intended for short-term use.

The dose of this medicine will be different for different patients. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. Orphenadrine acts in the central nervous system (CNS) to produce its muscle relaxant effects.


Isometheptene compounds (Midrin) and the butalbital compounds comprise the second-line medications. It is important to avoid overuse of analgesics, which has been found to contribute to worsening headaches in children and adolescents [45,46]. If analgesics are used, they should be used only for severe headaches, not every headache. Combination analgesics, antiemetics, DHE, and triptans should be avoided. The importance of a psychological evaluation and implementation of appropriate psychotherapy cannot be emphasized enough, particularly in the management of tension-type headaches. Once oral doses have been initiated and titrated to a satisfactory level, the analgesic effect needs to be sustained by minimizing fluctuations in blood levels and the variable effects of dosing schedules.

Tell patients that they should not suddenly discontinue Zanaflex, because rebound hypertension and tachycardia may occur. Both Flexeril and Norflex, along with most other muscle relaxant medications, may cause drowsiness or lightheadedness. If you experience these symptoms excessively or if they persist, please seek immediate medical attention. The one possible side effect common to all muscle relaxers is dizziness and drowsiness, although some cause greater drowsiness than others.

  • Abortive medications for children less than 11 years old are used for sporadic tension-type headaches and include limited amounts of acetaminophen, ibuprofen, or caffeine.
  • Some people find that taking an OTC pain reliever and muscle relaxant together provides maximum benefit, especially at night, to help with sleep problems and reduce daytime drowsiness.
  • There is limited research as to which muscle relaxers work „better“ than others.
  • There are no adequate studies in women for determining infant risk when using this medication during breastfeeding.
  • Clonazepam might be particularly useful in patients with myoclonic dystonia.

Drinking alcohol can be especially dangerous when taking muscle relaxers. Alcohol increases the sedative effects of the drugs and, in some cases, can lead to severe respiratory depression and death. Meanwhile, skeletal muscle relaxers like Dantrium, Flexeril, Lorzone, Robaxin, Skelaxin, Soma, and Zanaflex may need to be used with caution in people with preexisting liver or kidney disease. 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.

Are there any potential serious side effects for Flexeril?

Zanaflex is used to treat muscle tightness and cramping caused by conditions such as multiple sclerosis or spinal injury. Cannabis extract is believed to have dual muscle relaxant properties, i.e., both local and central effects. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records.