carisoprodol (Rx)

Brand and Other Names:Soma
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet: Schedule IV

  • 250mg
  • 350mg

Musculoskeletal Conditions

250-350 mg q8hr and HS; not to exceed 2-3 weeks; taper slowly (over 14 days) in patients with history of long term use to avoid withdrawal symptoms, including insomnia, anxiety, or irritability

Dosing Modifications

Renal impairment: Caution; not studied

Hepatic impairment: Caution; not studied

Dosage Forms & Strengths

tablet: Schedule IV

  • 250mg
  • 350mg

Musculoskeletal Conditions

<16 years: Not recommended

>16 years: 250-350 mg q8hr and HS; not to exceed 2-3 weeks; taper slowly (over 14 days) in patients with history of long term use to avoid withdrawal symptoms, including insomnia, anxiety, or irritability

Not drug of choice in elderly, owing to risk of orthostatic hypotension and CNS depression

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Interactions

Interaction Checker

and carisoprodol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Drowsiness (13-17%)

            1-10%

            Dizziness (7-8%)

            Headache (3-5%)

            Frequency Not Defined

            Orthostatic hypotension

            Syncope

            Tachycardia

            Agitation

            Irritability

            Depression

            Allergic/idiosyncratic reactions (pruritus, rash, dizziness, etc)

            Epigastric distress

            N/V

            Facial flushing

            Weakness

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            Warnings

            Contraindications

            Hypersensitivity to carisoprodol, meprobamate, mebutamate, tybamate

            History of acute intermittent porphyria

            Cautions

            Caution in hepatic/renal impairment

            May cause CNS depression; use caution when performing tasks which require mental alertness (eg, operating heavy machinery); sedating effects potentiated when used with other CNS-depressant drugs or ethanol

            Severe weakness may occur

            Seizures reported with its use in patients with or without seizure history

            Risk of allergic reactions

            Use caution in patients with history of drug abuse or acute alcoholism; drug dependency may occur and withdrawal symptoms experienced with abrupt cessation, especially with long-term use; limit use to 2-3 weeks

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            Pregnancy & Lactation

            Pregnancy

            Data over many decades of use of drug in pregnancy have not identified drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes; data on meprobamate, the primary metabolite of carisoprodol, do not show consistent association between maternal use and increased risk of major birth defects

            Animal data

            • In a published animal reproduction study, pregnant mice administered carisoprodol orally at 2.6- and 4.1-times maximum recommended human dose of 1400 mg per day [350 mg QID] based on body surface area comparison) from gestation through weaning resulted in reduced fetal weights, postnatal weight gain, and postnatal survival

            Lactation

            Data from published literature report that carisoprodol and its metabolite, meprobamate, are present in breastmilk; there are no data on effect on milk production; there is one report of sedation in an infant who was breastfed by a mother taking carisoprodol; because there have been no consistent reports of adverse events in breastfed infants over decades of use, the developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant or from underlying maternal condition; infants exposed to drug through breast milk should be monitored for sedation

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Not clearly known; may block interneural activity and depress polysynaptic neuron transmission

            Absorption

            Onset: 30 min

            Duration: 4-6 hr

            Peak plasma time: 1.5-2 hr

            Metabolism

            Metabolized by liver microsomal enzymes (CYP2C19)

            Elimination

            Half-life: 2 hr; meprobamate (8 hr)

            Dialyzable: Yes (HD, PD)

            Excretion: Urine

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.