Question for those of you who are on Flexeril. Can you please share your dosage with me and how many times a day you take it?

My doctor wrote it for 5mg 2x day. That doesn't seem to be doing anything. I saw on here that at least one person was at 10mg 3x day.

I am also on Fentanyl patch 50mcg,

Ultram ER, Lyrica, Wellbutrin, Chlordizepoxide, and Zoloft.

Thanks!

A 15-mg dose of cyclobenzaprine in capsule form.
Credit: National Institutes of Health.

Cyclobenzaprine hydrochloride (a prescription-only medication known as Flexeril) is a central nervous system muscle relaxant designed to relieve pain and discomfort related to muscle spasms, sprains and other muscle injuries. It is usually used in conjunction with rest, physical therapy and other measures.

Cyclobenzaprine is not designed for long-term use, and patients should follow the regimen provided by their physician, said Dr. Kiran Patel, pain management specialist at Lenox Hill Hospital. "It's a muscle relaxant that can help with a muscle spam or the sensation of tightness," Patel told Live Science. 

Cyclobenzaprine is often prescribed to people who have acute back injuries, including when people report having muscle spasms or significant tightness in their back, or when the back feels like it's locked, she said. It's also prescribed to treat for muscle strains. 

Taking cyclobenzaprine

Cyclobenzaprine is a skeletal muscle relaxant that works by increasing the release of the chemical norepinephrine from central nervous structures in the brain, Patel said. 

It can be taken as either a tablet or an extended release capsule (brand name Amrix). The regular tablet’s usual dosage is two to four times a day, while the extended release capsule is generally taken one to two times a day. The tablets, intended for short-term use, come in 5, 7.5, and 10 mg doses. The usual starting dose, according to the Drug Enforcement Administration, is 5 mg three times a day. The maximum recommended dose is 10 mg three times a day.

If stomach upset occurs, take it with food to reduce stomach irritation, Patel said.

According to the Food and Drug Administration (FDA), patients should avoid use of monoamine oxidase (MAO) inhibitors within 14 days of cyclobenzaprine use. These include Marplan, Nardil, Parnate and Matulane. Seizures and even death have occurred in patients who have cyclobenzaprine or other structurally similar tricyclic antidepressants with MAO inhibitor drugs.

Who shouldn't take it

The FDA recommends cautious use of cyclobenzaprine in patients with a history of urinary retention and glaucoma or other eye problems. There is no evidence to suggest that the drug causes any issues for pregnant mothers (according to studies done on mice, rats and rabbits), but there have yet to be any adequate and well-controlled studies in pregnant women. As a result, the FDA cautions use during pregnancy only if clearly needed. For nursing mothers, it is unknown if cyclobenzaprine is excreted in human milk. However, because it is closely related to tricyclic antidepressants, which are excreted in human milk, the FDA cautions against breastfeeding if using cyclobenzaprine.

"It's not known if this medicine can be found in breast milk, and because of that we don't want to take any chances," Patel said. 

A 10-mg dose of cyclobenzaprine in tablet form.
Credit: National Institutes of Health.

Cyclobenzaprine has not been tested in pediatric patients younger than 15 years of age. The elderly may be at a higher risk for adverse events, including hallucinations and confusion, cardiac events and drug interactions. According to the FDA, the plasma concentration of cyclobenzaprine is increased in the elderly, so the drug should be prescribed only if clearly needed. Initiation should begin with a 5 mg dose and slowly increased, under the careful eye of a doctor.

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