Cyclobenzaprine and naproxen versus naproxen alone in the treatment of acute low back pain and muscle spasm
Main Outcomes and Measures The primary outcome was improvement in RMDQ between ED discharge and 1 week later. Skeletal muscle relaxant that acts centrally and reduces motor activity of tonic somatic origins influencing both alpha and gamma motor neurons. “These findings do not support the use of these additional medications in this setting,” the authors write. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness.
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Furthermore, the magnitude of benefit was modest, with a number needed to treat of nearly 6 for moderate or severe pain, which is balanced by a number needed to harm of nearly 5. Although we cannot exclude the possibility of a modest benefit of the opioid combination in a select subgroup of patients, our data do not support providing oxycodone/acetaminophen in addition to naproxen for all ED patients with acute LBP. There are multiple medications available to treat low back pain in the acute setting. Despite the common use of these medications, the evidence for opioids in the treatment of acute low back pain is very limitedReference Deyo, Von Korff and Duhrkoop 3 . Additionally, existing data comparing the combination of NSAIDs plus muscle relaxants with NSAIDS plus placebo has been conflictingReference Berry and Hutchinson 4
– Reference Pareek, Chandurkar and Chandanwale 8 . Among patients with acute, nontraumatic, nonradicular LBP presenting to an ED, adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone did not improve functional outcomes or pain at 7 days.
If you notice any other effects, check with your healthcare professional. Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more. You are encouraged to report negative side effects of prescription drugs to the FDA.
Cyclobenzaprine is structurally similar to tricyclic antidepressants (TCAs) and has similar anticholinergic side effects such as sedation, dizziness, tachycardia, arrhythmias and may worsen heart failure, cardiac conduction abnormalities, and benign prostatic hyperplasia [29r]. Elderly patients seem to tolerate cyclobenzaprine less and may develop hallucinations as well as significant anticholinergic side effects, such as sedation. The use of significant lower dosing schedules in elderly patients may be prudent. The most common adverse reactions to cyclobenzaprine are somnolence, dry mucous membranes, dizziness, and confusion. Less commonly, tachycardia, dysarthria, disorientation, and hallucinations have been reported .
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It is structurally similar to the tricyclic antidepressants and adverse effects similar to those seen with the tricyclic antidepressants are therefore to be expected. This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Check with your doctor before taking any of the above while you are using this medicine. Cyclobenzaprine labeling suggests that concomitant use with tramadol may place patients at higher risk for developing seizures.19 Attendant use of cyclobenzaprine with monoamine oxidase inhibitors or use within 14 days after their discontinuation is contraindicated. It can also enhance the effects of agents with CNS depressant activity.
Fourth, we did not determine whether participants were using NSAIDs at the time of enrollment, thus limiting this study’s generalizability. Design, Setting, and Participants This randomized, double-blind, 3-group study was conducted at one urban ED in the Bronx, New York City. Patients who presented with nontraumatic, nonradicular LBP of 2 weeks’ duration or less were eligible for enrollment upon ED discharge if they had a score greater than 5 on the Roland-Morris Disability Questionnaire (RMDQ). The RMDQ is a 24-item questionnaire commonly used to measure LBP and related functional impairment on which 0 indicates no functional impairment and 24 indicates maximum impairment. Beginning in April 2012, a total of 2588 patients were approached for enrollment. Of the 323 deemed eligible for participation, 107 were randomized to receive placebo and 108 each to cyclobenzaprine and to oxycodone/acetaminophen.
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Three months after the emergency department visit, regardless of study group, opioid use for LBP was uncommon, with fewer than 3 percent of patients reporting use of an opioid within the previous 72 hours. Many ED patients had already taken NSAIDs for LBP before arriving to the ED. Some patients may have taken insufficient doses at incorrect intervals and could be helped by optimization of their NSAID regimen.
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However, this medicine does not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem. Cyclobenzaprine acts on the central nervous system (CNS) to produce its muscle relaxant effects. Its actions on the CNS may also cause some of this medicine’s side effects. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
- However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.
- Use of a medication taper may be warranted for chronic-use patients.
- This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
- Additional data for the exploratory outcomes of pain intensity at one week follow-up and resumption of usual activities at three month follow-up are reported in eTable 2 in Supplement 2.
- Importance Low back pain (LBP) is responsible for more than 2.5 million visits to US emergency departments (EDs) annually.
So we can profoundly understand the winner is your perspective towards medicine. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Ask your healthcare professional how you should dispose of any medicine you do not use. If you cannot swallow the capsule whole, you may open the capsule and sprinkle the contents over one tablespoon of applesauce. Rinse the mouth to make sure all of the medicine have been swallowed.
What are the side effects of cyclobenzaprine and naproxen?
Our main objective is to spread scientifically backed information to the users visiting our website without promoting a specific brand or product. If you miss a dose baclofen flexeril of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.