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Skelaxin vs Flexeril
Introduction
For patients experiencing musculoskeletal conditions or injuries, certain medications that relax the muscles can significantly improve comfort and mobility. Skelaxin (metaxalone) and Flexeril (cyclobenzaprine) are two such drugs commonly prescribed for muscle spasms. Each affects different mechanisms in the body to relieve muscle tension, yet both have muscle-relaxant effects.
Skelaxin works by blocking nerve impulses in the brain that lead to muscle pain sensation, although its exact mechanism of action is not fully understood. It has a short half-life and is usually taken three or four times daily.
Flexeril acts primarily as a centrally acting skeletal muscle relaxant, believed to work through the central nervous system rather than directly on skeletal muscles. Usually advised for short-term use (up to 2-3 weeks), it's typically administered less frequently – around three times per day due to its longer half-life compared with Skelaxin.
Skelaxin vs Flexeril Side By Side
| Attribute | Skelaxin | Flexeril |
|---|---|---|
| Brand Name | Skelaxin | Flexeril |
| Contraindications | Should not be taken with alcohol or drugs causing drowsiness. Watch for signs of liver issues like persistent nausea/vomiting, loss of appetite, stomach/abdominal pain, yellowing eyes/skin. | Should not be taken with alcohol or drugs causing drowsiness. Increased risk for serotonin syndrome when combined with other medications. |
| Cost | The price of 30 tablets of Skelaxin (800 mg) averages around $320, or generic metaxalone costs ranging from $1.50 to over $5 per day depending on the pack size. | The price for 30 tablets of Flexeril (10 mg) is approximately $100, or generic cyclobenzaprine costs as low as about $.50/day to about $2/day. |
| Generic Name | Metaxalone | Cyclobenzaprine |
| Most Serious Side Effect | Signs of an allergic reaction, liver problems, serious nervous system reaction, rapid heartbeat and shortness of breath, feeling faint. | Severe allergic or skin reaction, sudden chest pain or difficulty breathing, rapid heart rate or palpitations, confusion or hallucinations, severe drowsiness leading to unconsciousness, unusual weakness. |
| Severe Drug Interactions | Increased risk of drowsiness or dizziness when combined with other sedatives, potential for shallow breathing. | Potential drug interactions and increased risk for serotonin syndrome when combined with other medications. |
| Typical Dose | 800-3200 mg/day, typically taken as an 800 mg tablet three to four times a day. | 5 mg three times a day, can be increased to 10 mg three times per day. Total daily dosage should not exceed 30 mg. |
What is Skelaxin?
Metaxalone (the generic name for Skelaxin) and Cyclobenzaprine (generic for Flexeril), are both muscle relaxants that help relieve pain, stiffness or discomfort caused by strains, sprains or other muscle injuries. These drugs work differently in the body than a typical antispasmodic medication.
Metaxalone was first approved by the FDA in 1962. It is believed to inhibit nerve signals in the brain that contribute to muscular contractions, but its exact mechanism of action isn't entirely known. Metaxalone is used to treat acute musculoskeletal pain and has less potential for abuse compared to other similar drugs.
On the other hand, Cyclobenzaprine acts centrally within the brainstem or spinal cord rather than directly on skeletal muscles. Approved by FDA in 1977, Flexeril primarily reduces muscle tone without affecting voluntary movement. However, it can cause more side effects such as dizziness and dry mouth due its stronger sedative properties when compared with Skelaxin.
What conditions is Skelaxin approved to treat?
Skelaxin and Flexeril are both approved for the treatment of muscle spasms associated with acute, painful musculoskeletal conditions:
- Skelaxin (metaxalone) is often used as an adjunct to rest, physical therapy, and other measures for the relief of discomforts associated with acute, painful musculoskeletal conditions.
- Flexeril (cyclobenzaprine) is also intended to be used alongside rest and physical therapy. It treats muscle spasms caused by muscular injuries or sprains but it can also be prescribed off-label for fibromyalgia pain.
How does Skelaxin help with these illnesses?
Skelaxin (metaxalone) works to relieve pain and discomfort caused by strains, sprains, and other muscle injuries. It is thought that it does this by affecting the communication between nerves in parts of the brain that control the sensation of pain and in the spinal cord. This modulation can reduce or block signals of pain sent from irritated or injured muscles to your brain, thereby alleviating discomfort.
On the other hand, Flexeril (cyclobenzaprine) also helps with relief from muscle spasms associated with acute musculoskeletal conditions. Its exact mechanism is not completely understood but it's believed that it mainly acts at the brain stem level rather than directly on skeletal muscles. In simpler terms, Flexeril appears to reduce tonic somatic motor activity influencing both gamma- and alpha-motor systems.
Both drugs are used as adjuncts to rest, physical therapy, and other measures for relieving discomfort from acute musculoskeletal conditions but they have different mechanisms of action which might make one more suitable for certain patients over another.
What is Flexeril?
Flexeril, or cyclobenzaprine by its generic name, is a muscle relaxant commonly used to treat skeletal muscle conditions such as pain and stiffness. It functions primarily on the central nervous system to produce its muscle relaxant effects, rather than directly targeting skeletal muscles. Approved by the FDA in 1977, Flexeril works by blocking nerve impulses (or pain sensations) that are sent to your brain.
As opposed to Skelaxin (metaxalone), Flexeril does not significantly depress the central nervous system. This means that it generally has fewer side effects related to sedation and depression of respiration. However, it can still cause drowsiness and dry mouth in some patients which are common side-effects for this class of medication but less so compared with others like Skelaxin.
The effectiveness of Flexeril combined with its relatively milder side-effect profile makes it an excellent option for many individuals suffering from painful musculoskeletal conditions who may not respond well or tolerate other medications such as metaxalone.
What conditions is Flexeril approved to treat?
Flexeril, also known as cyclobenzaprine, is a muscle relaxant that's primarily used to alleviate symptoms such as muscle spasms and pain associated with acute musculoskeletal conditions. Some of the approved uses for Flexeril include:
- Short-term relief (up to 2 to 3 weeks) of acute, painful musculoskeletal conditions.
- It can be beneficial in managing certain types of backache and neck stiffness caused by motor vehicle accidents or other forms of trauma.
Remember: While effective, Flexeril should only be used on a short-term basis and combined with rest and physical therapy to achieve maximum benefits.
How does Flexeril help with these illnesses?
Flexeril, also known by its generic name Cyclobenzaprine, functions as a muscle relaxant and operates via the central nervous system to provide relief from spasms, sprains and strains. Much like norepinephrine's role in memory recall and focus, Flexeril works by blocking nerve impulses sent to your brain that trigger feelings of pain. Unlike Skelaxin though, it has sedative effects which can often cause drowsiness or sleepiness among patients. As such, it is typically prescribed for short-term use (two to three weeks) when a patient needs immediate relief from acute musculoskeletal conditions. While not affecting serotonin levels directly like SSRI antidepressants (such as Prozac), Flexeril is sometimes used in conjunction with physical therapy and rest for comprehensive care.
How effective are both Skelaxin and Flexeril?
Both metaxalone (Skelaxin) and cyclobenzaprine (Flexeril) have established histories of success in treating muscle spasms, with Flexeril initially approved by the FDA a few years before Skelaxin. Since they act on different mechanisms, they may be prescribed under different circumstances. The effectiveness of metaxalone and cyclobenzaprine in alleviating muscular discomfort was directly studied in several clinical trials; both drugs exhibited similar efficacy in reducing symptoms associated with musculoskeletal conditions as well as favorable safety profiles.
A 2003 review demonstrated that metaxalone is effective at relieving acute painful musculoskeletal conditions starting from the first week of treatment and its side effect profile is generally mild, most commonly causing drowsiness. It's also noted for being well-tolerated even among elderly populations due to its low potential for drug interactions. Metaxalone has gained considerable use as a muscle relaxant across various medical disciplines due to these factors.
A 2016 meta-analysis indicated that cyclobenzaprine seems to be more effective than placebo in treating muscle spasm related pain, showcasing similar efficacy to other common muscle relaxants. However, it should be noted that cyclobenzaprine is usually considered after other non-pharmacological treatments have failed or are not suitable due to certain patient factors. While significant research involving co-prescription with NSAIDs exists supporting its role in managing musculoskeletal pain, data confirming its long-term efficacy beyond two weeks of usage remains less robust than short term usage evidence. Nonetheless, owing mainly to its pharmacology which includes sedative properties besides skeletal muscle relaxation, cyclobenzaprine may serve as an optimal treatment choice among patients who did not respond adequately to initial interventions or those who need additional symptomatic relief during bedtime.
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At what dose is Skelaxin typically prescribed?
Oral dosages of Skelaxin generally range from 800-3200 mg/day, typically taken as an 800 mg tablet three to four times a day. However, studies suggest that the lower-end dosage of 1600mg/day (taken as two doses) is often sufficient for managing acute painful musculoskeletal conditions in adults. For Flexeril, on the other hand, the typical adult dose starts from 5 mg three times per day and may be increased to a maximum of 10 mg three times per day based on patient response and tolerance. It's important to note that neither Skelaxin nor Flexeril are recommended for use in pediatric patients under the age of twelve or adolescents. Both drugs should be used only for short periods up to two or three weeks.
At what dose is Flexeril typically prescribed?
Flexeril therapy usually commences with a dosage of 5 mg three times a day. If necessary, the dose can be increased to 10 mg three times per day after initial evaluation. The total daily dosage should not exceed 30 mg divided into three doses and spaced approximately 8 hours apart. This regimen may be evaluated if there is no response to treatment at the initial dose after a few weeks. Keep in mind that Flexeril is typically used for short-term relief from acute muscle injuries; it's generally not recommended for long-term use. As always, any changes in medication or dosages should only be made under the direction of your healthcare provider.
What are the most common side effects for Skelaxin?
Common side effects of Skelaxin include:
- Drowsiness, dizziness, headache
- Irritability or nervousness
- Nausea, vomiting, upset stomach
- Constipation or diarrhea
- Decreased appetite
- Difficulty keeping balance (this could lead to falls)
- Skin rash or itching
- Unusual fatigue and general weakness
On the other hand, Flexeril can also cause similar side effects such as:
-Dry mouth
-Drowsiness/sleepiness/fatigue
-Nervousness
-Stomach pain/discomfort/dyspepsia
-Concentration issues
-Unintentional shaking/tremor
-Muscle weakness.
Both drugs may also potentially impact libido and cause abnormal dreams. Always consult your doctor if you experience any unusual or severe symptoms after taking these medications.
Are there any potential serious side effects for Skelaxin?
While the occurrence of severe side effects is relatively rare with Skelaxin, you should be aware of the following potential reactions:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face or throat
- Any signs pointing to liver problems including loss of appetite, stomach pain (upper right part), fatigue, itching, dark urine, clay-colored stools or jaundice (yellowing of skin or eyes)
- Symptoms suggesting a serious nervous system reaction like fever, chills or sore throat
- Rapid heartbeat and shortness of breath
- Feeling faint
If any symptoms related to serotonin syndrome occur – confusion, hallucination, seizure; extreme changes in blood pressure; increased heart rate; fever; excessive sweating; shivering or shaking. Please stop using Skelaxin immediately and seek medical attention.
What are the most common side effects for Flexeril?
While both Skelaxin and Flexeril are muscle relaxants, they have slightly different side effects. Here's a look at some of the common side effects associated with Flexeril:
- Dry mouth or throat
- Fatigue or drowsiness
- Headache
- Dizziness
- Nausea, constipation, stomach upset
- Blurred vision
- Difficulty urinating
- Nervousness or confusion
Some people may also experience faster heart rate while on this medication. It is unlikely but possible that you could experience more severe reactions such as rash, weight changes, sleep problems like insomnia, and even agitation. As always consult your doctor if any adverse symptoms persist.
Are there any potential serious side effects for Flexeril?
While Flexeril is generally well-tolerated, it can occasionally lead to serious side effects. If you experience any of the following symptoms, seek immediate medical attention:
- Signs of a severe allergic or skin reaction such as hives, itching, fever, swollen glands, difficulty breathing or swelling in your face or throat
- Sudden chest pain or difficulty breathing
- Rapid heart rate or palpitations
- Confusion or hallucinations
- Severe drowsiness that may lead to unconsciousness
- Unusual weakness or inability to move one side of the body It's also crucial not to combine Flexeril with other medications without first consulting your healthcare provider due to potential drug interactions and increased risk for serotonin syndrome.
Contraindications for Skelaxin and Flexeril?
Both Skelaxin and Flexeril, as with most muscle relaxants, may intensify symptoms of dizziness or drowsiness in some people. If you notice your symptoms worsening or an increase in fatigue or lethargy after taking these medications, please seek immediate medical attention.
Neither Skelaxin nor Flexeril should be taken if you are consuming alcohol or using other drugs that cause drowsiness such as sleeping pills, narcotic pain relievers, cough suppressants, antihistamines (medications for allergies), anti-seizure drugs etc. Always inform your physician about all the medications you are currently taking; mixing sedatives can lead to increased sleepiness and potentially dangerous respiratory problems such as shallow breathing.
Also note that both Skelaxin and Flexeril have a potential risk for liver damage. Pay attention to signs of liver issues like persistent nausea/vomiting, loss of appetite, stomach/abdominal pain, yellowing eyes/skin. Seek immediate medical help if any of these occur.
How much do Skelaxin and Flexeril cost?
For the brand-name versions of these drugs:
- The price of 30 tablets of Skelaxin (800 mg) averages around $320, which works out to roughly $10.67/day.
- The price for 30 tablets of Flexeril (10 mg) is approximately $100, working out to about $3.33/day.
Hence, if you are taking a single daily dose, then brand-name Flexeril is less expensive on a per-day treatment basis than Skelaxin. However, it's important to remember that cost should not be your primary consideration when choosing between these two medications; effectiveness and side-effects also matter significantly.
In terms of generic versions - metaxalone for Skelaxin and cyclobenzaprine for Flexeril - costs are considerably lower:
- Metaxalone (800 mg tablets) is available in packs from 20 up to several hundred with approximate costs ranging from $1.50 to over $5 per day depending on the size of the pack purchased.
- Cyclobenzaprine can be found in packs starting from 15 capsules up to multiples hundreds (10mg), with prices as low as about $.50/day if buying large upfront quantities or typically not exceeding about $2/day otherwise.
Popularity of Skelaxin and Flexeril
Metaxalone, also known by the brand name Skelaxin, was prescribed to an estimated 1.2 million people in the United States in 2020. Metaxalone is a muscle relaxant used to treat skeletal muscle conditions such as pain or injury and accounts for roughly 8% of prescriptions within its drug class. While not classified as a benzodiazepine or another broad class of muscle relaxants, it has seen steady use over the past decade.
Cyclobenzaprine, including branded versions such as Flexeril, was prescribed to about 16 million individuals in America in 2020. Cyclobenzaprine constitutes approximately 45% of muscle relaxant prescriptions and just under 12% of overall neuromuscular prescriptions within the country. The prevalence of cyclobenzaprine has remained consistent over recent years despite generic alternatives becoming more widely available.
Conclusion
Both Skelaxin (metaxalone) and Flexeril (cyclobenzaprine) have long track records of usage in patients with muscle spasms, and are supported by numerous clinical studies indicating that they are more effective than placebo treatments. In some cases, these drugs may be used together, but this should always be under the careful supervision of a physician as combining them can increase the risk of side effects. Due to their different mechanisms of action, Skelaxin primarily acts as a muscle relaxant while Flexeril works on both muscles and nerves; they tend to be prescribed under different circumstances. Flexeril is often considered a first-line treatment option for acute musculoskeletal conditions whereas Skelaxin might typically be considered an alternative choice or adjunct therapy.
Both medications are available in generic form which can offer significant cost savings especially for patients who must pay out-of-pocket. Both metaxalone and cyclobenzaprine may require an adjustment period meaning that full relief from symptoms may not be immediate.
The side effect profile is similar between the two drugs, both being well-tolerated generally but with cyclobenzaprine having greater anticholinergic side effects including dry mouth and urinary retention compared to metaxalone. For both drugs, patients must closely monitor their reactions due to potential drowsiness or dizziness risk when starting treatment.
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Refrences
- Harden, R. N., & Argoff, C. (2000, November 1). A review of three commonly prescribed skeletal muscle relaxants. Journal of Back and Musculoskeletal Rehabilitation. IOS Press.http://doi.org/10.3233/bmr-2000-152-303
- Cook, T. J., Edwards, S., Gyemah, C., Shah, M., Shah, I., & Fox, T. (2004, September). Variability in Tablet Fragment Weights When Splitting Unscored Cyclobenzaprine 10mg Tablets. Journal of the American Pharmacists Association. Elsevier BV.http://doi.org/10.1331/1544-3191.44.5.583.cook
- Singh, K., Senatorov, I. S., Cheshmehkani, A., Karmokar, P. F., & Moniri, N. H. (2022, January 6). The Skeletal Muscle Relaxer Cyclobenzaprine Is a Potent Non-Competitive Antagonist of Histamine H1 Receptors. Journal of Pharmacology and Experimental Therapeutics. American Society for Pharmacology & Experimental Therapeutics (ASPET).http://doi.org/10.1124/jpet.121.000998