Patient should avoid activities requiring mental alertness or coordination until drug effects arerealized.
Drug may color urine brown, black, or green.
This drug may cause flushing, dyspepsia, nausea, vomiting, dizziness, headache, nystagmus,somnolence, vertigo, blurred vision, conjunctivitis, nervousness, bradyarrhythmia, syncope, leukopenia. The intravenous formulation may also cause seizures.
Instruct patient to report signs/symptoms of hypotension or severe sedation.
Instruct patient to take a missed oral dose if it is remembered within 1 h of dose time, but if it ismore than 1 h late, patient should skip the missed dose.
Musculoskeletal pain: initial, 1500 mg ORALLY 4 times a day for 48-72 hr
Musculoskeletal pain: maintenance, 750 mg ORALLY every 4 hr OR 1500 mg ORALLY 3 times aday OR 1000 mg ORALLY 4 times a day
Musculoskeletal pain: 10 mL (1000 mg) IV (max infusion rate of 300 mg/min) for moderate tosevere symptoms; may require additional 10 mL every 8 hours (max dose 3000 mg/day for 3 days); if condition persists, a like course may be repeated after a 48 hr drug-free interval
Musculoskeletal pain: up to 10 mL (1000 mg) (5 mL into each gluteal region) IM every 8 hr asneeded (max dose 3000 mg/day for 3 days); if necessary, a like course may be repeated after a 48 hr drug-free interval
Spasm - Tetanus: initial, 10-20 mL (1000-2000 mg) IV (max infusion rate of 300 mg/min), anadditional 10-20 mL may be added to the infusion bottle (max initial dose 30 mL)
Spasm - Tetanus: maintenance, repeat IV dosage every 6 hr until conditions allow for theinsertion of a nasogastric tube. Crushed methocarbamol tablets suspended in water or saline may then be given through this tube. Total oral doses up to 24 g/day may be required
liver disease: use lower initial doses and increase gradually as needed and tolerated
renal impairment: use lower initial doses and increase gradually as needed and tolerated
Musculoskeletal pain: Adult: yes
Musculoskeletal pain: Pediatric: no
Spasm - Tetanus: Adult: yes
Spasm - Tetanus: Pediatric: yes (injectable only)
safety and effectiveness of oral dosage forms in pediatric patients have not been established • Spasm - Tetanus: 15 mg/kg IV or 500 mg/m(2) every 6 hr as needed (max dose 1.8 g/m(2) for 3 consecutive days)
Thomson: Infant risk is minimal.
Hypersensitivity to methocarbamol or to any of the injection components
Known or suspected renal pathology (polyethylene glycol 300 (PEG 300) is present inmethocarbamol vials for injection and is potentially toxic)
Epilepsy (seizures have occurred with intravenous injection)
Mental alertness or physical coordination may be impaired
Transient central nervous system depression may occur
Methacarbamol is a CNS depressant with sedative and musculoskeletal relaxant activities. Itlacks direct action on the contractile mechanism of striated muscle, the motor endplate or the nerve fiber. The mechanism of action remains unknown and presumed to be due to general CNS depression .
1.1 h +/- 0.27 h (mean)
conjugation, dealkylation, and hydroxylation
Protein binding: 46% to 50%
Renal: all metabolites, small amount unchanged
Dialyzable: unknown (hemodialysis)
elderly: 1.5 h +/- 0.4 h (mean)
Protein binding: (elderly), 41% to 43%
Protein binding: (cirrhosis), approximately 40% to 45%
renal impairment: 1.2 h +/- 0.6 h (mean)
cirrhosis: 3.38 h +/- 1.62 h (mean)
SKELETAL MUSCLE RELAXANTS - CENTRAL ACTING: TOXICITY: Fatal poisonings are rare;lethality varies by agent. CARISOPRODOL: CHILD - 700 mg caused CNS and respiratory depression in a toddler; 3.5 grams of carisoprodol in a 5 year-old resulted in death; ADULT - 8.4 to 9.5 grams produced CNS depression, tachycardia and ataxia; 14.7 grams resulted in seizures and coma. CHLORMEZANONE: ADULT - Coma, mild hypotension and anticholinergic effects reported after ingestions of 7 to 11 grams. CHLORZOXAZONE: ADULT - 5 grams of chlorzoxazone resulted in no adverse effects. METAXALONE: An adult female with MS ingested 90 grams and developed severe muscular rigidity and CNS depression; following intensive support the patient returned to neurologic baseline. THERAPEUTIC DOSE: Varies by agent. CARISOPRODOL: ADULT and CHILDREN 12 years of age and older - Disorder of musculoskeletal system: 350 mg orally 3 times a day and at bedtime. CHLORZOXAZONE: ADULT - Musculoskeletal pain: 500 to 750 mg orally 3 to 4 times daily. METAXALONE: ADULT and CHILDREN 13 years of age or older - Musculoskeletal pain: 800 mg orally 3 to 4 times a day.
SKELETAL MUSCLE RELAXANTS - CENTRAL ACTING: Decontamination: Activated charcoal.Ipecac contraindicated.
SKELETAL MUSCLE RELAXANTS - CENTRAL ACTING: Hypotensive episode: IV 0.9% NaCl10-20 ml/kg, dopamine or norepinephrine.
SKELETAL MUSCLE RELAXANTS - CENTRAL ACTING: Seizure: IV barbiturates,benzodiazepines.
SKELETAL MUSCLE RELAXANTS - CENTRAL ACTING: Monitoring of patient: CNS function,VS with cardiac monitoring as indicated, fluid status, and electrolytes.
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