carisoprodol (isomeprobamate)

Drug Name

Generic Name : carisoprodol (isomeprobamate)
Brand Name: Soma
Classification: Centrally acting skeletal muscle relaxant
Pregnancy Category NR

Dosage & Route

Oral

• Adjunct in the short-term symptomatic treatment of painful muscle spasm associated with musculoskeletal conditions
• Adult: 350 mg 3-4 times daily for up to 2-3 wk.
• Elderly: Half of the usual dose.

Therapeutic actions

• Carisoprodol blocks interneuronal synaptic activity in the descending reticular formation and spinal cord resulting in skeletal muscle relaxation.
  • Duration: 4-6 hrs.
  • Absorption: Absorbed from the GIT (oral); peak plasma concentrations after 30 min.
  • Distribution: Enters breast milk (significant amounts).
  • Metabolism: Hepatic; yields meprobamate.
  • Excretion: Via urine (as metabolites).

Indications

• Relief of discomfort associated with acute, painful musculoskeletal conditions as an adjunct to rest, physical therapy, and other measures

Adverse effects

• Dizziness, drowsiness, nausea, epigastric distress, tachycardia, orthostatic hypotension, Hypersensitivity reactions, rash.
• Potentially Fatal: Idiosyncratic reaction (rare).

Contraindications

• Acute intermittent porphyria, hypersensitivity. Lactation.

Nursing considerations

Assessment

• History: Allergic or idiosyncratic reactions to carisoprodol, meprobamate; acute intermittent porphyria, suspected porphyria; lactation
• Physical: T; skin color, lesions; orientation, affect; P, BP, orthostatic BP; bowel sounds, liver evaluation; LFTs, renal function tests, CBC

Interventions

• WARNING: Monitor patient for potentially serious idiosyncratic reactions—most likely with first few doses.
• Reduce dose with hepatic impairment.
• Provide safety measures if CNS effects occur.
• Drug may be habit forming. Monitor patient.

Teaching points

• Take this drug exactly as prescribed; do not take a higher dosage; take with food if GI upset occurs.
• Avoid alcohol, sleep-inducing, or over-the-counter drugs; these could cause dangerous effects; if you feel you need one of these preparations, consult your health care provider.
• You may experience these side effects: Drowsiness, dizziness, vertigo (avoid driving or activities that require alertness); dizziness when you get up or climb stairs (avoid sudden changes in position, use caution climbing stairs); nausea (take drug with food; eat frequent small meals); insomnia, headache, depression (transient effects).
• Report rash, severe nausea, dizziness, insomnia, fever, difficulty breathing.

Posted in: Pharmacology