Muscle Relaxers: A List of Prescription Medications

Medically reviewed by Zara Risoldi Cochrane, PharmD, MS, FASCP on June 22, 2017Written by University of Illinois at Chicago, Drug Information Group

Introduction

Muscle relaxers, or muscle relaxants, are medications used to treat muscle spasms or muscle spasticity.

Muscle spasms or cramps are sudden, involuntary contractions of a muscle or group of muscles. They can be caused by too much muscle strain and lead to pain. They’re associated with conditions such as lower back pain, neck pain, and fibromyalgia.

Muscle spasticity, on the other hand, is a continuous muscle spasm that causes stiffness, rigidity, or tightness that can interfere with normal walking, talking, or movement. Muscle spasticity is caused by injury to parts of the brain or spinal cord involved with movement. Conditions that can cause muscle spasticity include multiple sclerosis (MS), cerebral palsy, and amyotrophic lateral sclerosis (ALS).

Prescription drugs can help relieve the pain and discomfort from muscle spasms or spasticity. In addition, certain over-the-counter medications may be used to treat aches and pains associated with muscle spasms.

Prescription medications

Prescription medications are divided into two groups: antispasmodics and antispastics. Antispasmodics are used to treat muscle spasms, and antispastics are used to treat muscle spasticity. Some antispasmodics, such as tizanidine, can be used to treat muscle spasticity. However, antispastics should not be used to treat muscle spasms.

Antispasmodics: Centrally acting skeletal muscle relaxants (SMRs)

Centrally acting SMRs are used in addition to rest and physical therapy to help relieve muscle spasms. They’re thought to work by causing a sedative effect or by preventing your nerves from sending pain signals to your brain.

You should only use these muscle relaxants for up to 2 or 3 weeks. The safety of longer-term use is not yet known.

While antispasmodics can be used to treat muscle spasms, they have not been shown to work better than nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. In addition, they have more side effects than NSAIDs or acetaminophen.

The more common side effects of centrally acting SMRs include:

  • drowsiness
  • dizziness
  • headache
  • nervousness
  • reddish-purple or orange urine
  • lowered blood pressure upon standing

You should talk to your doctor about the benefits and risks of these medications for the treatment of your muscle spasms.

List of centrally acting SMRs

Generic nameBrand nameFormGeneric available
carisoprodol Somatabletyes
carisoprodol/aspirin not availabletabletyes
carisoprodol/aspirin/codeinenot availabletabletyes
chlorzoxazoneParafon Forte, Lorzonetabletyes
cyclobenzaprineFexmid, Flexeril, Amrixtablet, extended-release capsuletablet only
metaxaloneSkelaxin, Metaxalltabletyes
methocarbamolRobaxintabletyes
orphenadrineNorflexextended-release tabletyes
tizanidineZanaflextablet, capsuleyes

Antispastics

Antispastics are used to treat muscle spasticity. They should not be used to treat muscle spasms. These drugs include:

Baclofen: Baclofen (Lioresal) is used to relieve spasticity caused by MS. It’s not fully understood how it works, but it seems to block nerve signals from the spinal cord that cause muscles to spasm. Side effects can include drowsiness, dizziness, weakness, and fatigue.

Dantrolene: Dantrolene (Dantrium) is used to treat muscle spasms caused by spinal cord injury, stroke, cerebral palsy, or MS. It works by acting directly on the skeletal muscle to relax the muscle spasm. Side effects can include drowsiness, dizziness, lightheadedness, and fatigue.

Diazepam: Diazepam (Valium) is used to relieve muscle spasms caused by inflammation, trauma, or muscle spasticity. It works by increasing the activity of a certain neurotransmitter to decrease the occurrence of muscle spasms. Diazepam is a sedative. Side effects can include drowsiness, fatigue, and muscle weakness.

List of antispastics

Generic nameBrand nameFormGeneric available
baclofenLioresal, Gablofen, Lioresaltablet, injectionyes
dantroleneDantriumtabletyes
diazepamValiumoral suspension, tablet, injectionyes

Warnings for prescription muscle relaxants

Muscle relaxants such as carisoprodol and diazepam can be habit forming. Be sure to take your medication exactly as prescribed by your doctor.

Muscle relaxants can also cause withdrawal symptoms, such as seizures or hallucinations (sensing things that aren’t real). Do not suddenly stop taking your medication, especially if you’ve been taking it for a long time.

Also, muscle relaxants depress your central nervous system (CNS), making it hard to pay attention or stay awake. While taking a muscle relaxant, avoid activities that require mental alertness or coordination, such as driving or using heavy machinery.

You should not take muscle relaxants with:

  • alcohol
  • CNS depressant drugs, such as opioids or psychotropics
  • sleeping medications
  • herbal supplements such as St. John’s wort

Talk to your doctor about how you can safely use muscle relaxants if you:

  • are older than 65 years
  • have a mental health problem or brain disorder
  • have liver problems

Off-label medications for spasticity

Doctors can use certain medications to treat spasticity even when the drugs are not approved for that purpose by the U.S. Food and Drug Association (FDA). This is called off-label drug use. The following drugs are not actually muscle relaxants, but they can still help relieve symptoms of spasticity.

Benzodiazepines

Benzodiazepines are sedatives that can help relax muscles. They work by increasing the effects of certain neurotransmitters, which are chemicals that relay messages between your brain cells.

Examples of benzodiazepines include:

Side effects of benzodiazepines can include drowsiness and problems with balance and memory. These drugs can also be habit forming.

Clonidine

Clonidine (Kapvay) is thought to work by preventing your nerves from sending pain signals to your brain or by causing a sedative effect.

Clonidine should not be used with other muscle relaxants. Taking it with similar drugs increases your risk of side effects. For instance, taking clonidine with tizanidine can cause very low blood pressure.

Clonidine is available in brand-name and generic versions.

Gabapentin

Gabapentin (Neurontin) is an anticonvulsant drug typically used to relieve seizures. It’s not fully known how gabapentin works to relieve muscle spasticity. Gabapentin is available in brand-name and generic versions.

Over-the-counter options for muscle spasms

OTC treatment is recommended as first-line therapy for muscle spasms caused by conditions such as acute lower back pain or tension headache. This means you should try OTC treatments before prescription medications.

OTC treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or a combination of both. Your doctor or pharmacist can help you choose an OTC treatment.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs work by blocking your body from making certain substances that cause inflammation and pain. NSAIDs are available in generic and brand-name versions. They’re typically sold over the counter. Stronger versions are available by prescription.

NSAIDs come as oral tablets, capsules, or suspensions. They also come as chewable tablets for children. Side effects of these drugs can include upset stomach and dizziness.

Examples of NSAIDs include:

Acetaminophen

Acetaminophen (Tylenol) is thought to work by blocking your body from making certain substances that cause pain. Acetaminophen is available in generic and brand-name versions. It comes as immediate-release and extended release oral tablets and capsules, orally disintegrating tablets, chewable tablets, and oral solutions.

The more common side effects of acetaminophen can include nausea and upset stomach.

When to call your doctor

You can often manage your muscle spasm or spasticity symptoms on your own, but in some cases, you may need medical advice or care. Be sure to call your doctor if you:

  • have spasticity for the first time and don’t know the cause
  • notice the spasticity is getting more severe, happening more often, or making tasks difficult
  • have severe and frequent muscle spasms
  • notice deformity of the parts of your body affected by muscle spasms
  • have side effects from your muscle relaxant
  • have a “frozen joint” due to contracture that decreases your range of motion or causes pressure sores
  • have increasing discomfort or pain

Talk with your doctor

It’s important to treat both spasticity and muscle spasms. Severe, long-term spasticity can lead to muscle contracture, which can decrease your range of motion or leave the affected joints permanently bent. And muscle spasms can not only be uncomfortable, they can also be a sign of an underlying medical problem.

Your muscle spasms or spasticity are likely treatable with rest, physical therapy, medications, or all of the above. Work with your doctor to put together a care plan that can ease your pain and get you moving comfortably again.

Q&A

Q:

Can cannabis be used to treat muscle spasticity or spasm?

A:

Yes, in some cases.

Cannabis, more commonly known as marijuana, is legal in certain states for medicinal uses. Muscle spasm is one of the health conditions that cannabis is used to treat. It helps relieve muscle spasms by reducing pain and inflammation.

Cannabis has also been used to treat muscle spasticity due to multiple sclerosis (MS). In many research trials, cannabis has been shown to be effective alone and in combination with other treatments for reducing muscle spasticity symptoms. However, there’s limited information available on the use of cannabis for muscle spasticity that’s not associated with MS.

If you’re being treated for MS and still have muscle spasms or spasticity, adding cannabis may help. Talk to your doctor about whether it’s a good option for you.

You should keep certain factors in mind. The more common side effects of cannabis include dizziness, vomiting, urinary tract infections, and a relapse of MS. Also, limited information is available about drug interactions and other usage warnings.

The Healthline Editorial Team Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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