Carisoprodol
- Atc Codes:M03BA02
- CAS Codes:78-44-4
- PHARMGKB ID:78-44-4
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Toxicological Effects
- Caution and personalized dose adjustment in patients with the following genotypes
- Substrate of
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Denmark: Somadril; Greece: Artifar.
North America
USA: Carisoprodol, Soma.
Latin America
Argentina: Listaflex; Mexico: Somacid.
Drug combinations
Carisoprodol and Acetaminophen
Carisoprodol and Aspirin
Carisoprodol and Naproxen
Carisoprodol and Piroxicam
Carisoprodol, Aspirin, and Codeine
Carisoprodol, Dipyrone, and Piroxicam
Carisoprodol, Dexamethasone, and Piroxicam
Carisoprodol, Dexamethasone, Hydroxocobalamin (Vitamin B~12a~), Piroxicam, and Pyridoxine (Vitamin B~6~)
Chemistry
Carisoprodol: C~12~H~24~N~2~O~4~. Mw: 260.33. (±)-2-Methyl-2-propyl-1,3-propanediol carbamate isopropylcarbamate. CAS-78-44-4.
Pharmacologic Category
Centrally-Acting Skeletal Muscle Relaxants. (ATC-Code: M03BA02).
Mechanism of action
Carisoprodol is a centrally-acting skeletal muscle relaxant. Precise mechanism not yet clear, but many effects have been ascribed to its central depressant actions. In animals, carisoprodol blocks interneuronal activity and depresses polysynaptic neuron transmission in the spinal cord and reticular formation of the brain. It is also metabolized to meprobamate, which has anxiolytic and sedative effects. Most authorities attribute the beneficial effects of carisoprodol to its sedative properties.
Therapeutic use
Short-term (2-3 weeks) relief of skeletal muscle pain. Treatment of muscle spasms and pain associated with acute temporomandibular joint pain. Carisoprodol is used as an adjunct to rest, physical therapy, analgesics, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The drug is ineffective in the treatment of skeletal muscle hyperactivity secondary to chronic neurologic disorders, such as cerebral palsy, and other dyskinesias.
Pregnancy and lactiation implications
Animal data suggest that carisoprodol crosses placenta and adverse events have been observed in animal studies. Limited postmarketing data with meprobamate (the active metabolite) demonstrate a possible risk for congenital malformations. Use only if benefit outweighs risk. Use with caution during lactation.
Unlabeled use
Contraindications
Not recommended for use in the elderly. Hypersensitivity to carisoprodol, meprobamate, or any component of the formulation. Acute intermittent porphyria.
Warnings and precautions
May cause CNS depression. Drowsiness is common. May produce paradoxical CNS stimulation. Idiosyncratic reactions (severe weakness, transient quadriplegia, euphoria, or temporary vision loss) may occur following the initial dose. Has been associated with seizures in patients with and without seizure history. Use with caution in history of drug abuse or acute alcoholism (potential for drug dependency). Tolerance, psychological and physical dependence may occur with prolonged use. Withdrawal symptoms reported after abrupt cessation of prolonged use. Safety not established in hepatic/renal impairment (caution). Carisoprodol should be used with caution in reduced functional alleles of CYP2C19. May rarely cause leukopenia or aplastic anemia. Some formulations may contain sodium metabisulfite, which can cause allergic-type reactions, including anaphylaxis and life-threatening or less severe asthmatic episodes, in certain susceptible individuals. Carisoprodol is contraindicated in acute intermittent porphyria and in patients who have previously demonstrated allergic or idiosyncratic reactions to carisoprodol or related compounds such as meprobamate, mebutamate, or tybamate.