Last updated: October 6, 2014

Trade Names:  Soma

Drug Class: Skeletal muscle relaxant

Tablet: 250-, 350 mg
Compound tablet: Carisoprodol 200 mg and aspirin 325 mg

Dose: Adults: 250 mg to 350 mg two to four times daily;
Recommended maximum duration of use is 2-3 weeks

Indications: Short term treatment of painful muscle spasm; useful in some patients with fibromyalgia

Mechanism of Action: Unknown; has a sedative effect and may modify pain perception

Contraindications: Hypersensitivity to carisoprodol or meprobamate; acute intermittent porphyria

Precautions: Use caution in renal or hepatic dysfunction. Avoid in elderly. Abuse potential. Operating machinery or driving under the effects of the drug are hazardous. Seizures.

Pregnancy Risk: C

Adverse Effects
Common: Drowsiness
Uncommon: Allergy, anaphylaxis, psychologic dependence and drug abuse, flushing, rash, nausea, fever, paradoxical stimulation, tremor, hematologic abnormalities, withdrawal symptoms after discontinuation of chronic therapy, seizures

Drug Interactions
CNS depressants: Increased CNS depression

Patient Instructions: Avoid alcohol. It may cause drowsiness.

Comments: Potential for abuse has resulted in it being removed from the market in several countries. Nighttime sedative effect is sometimes useful in improving sleep and pain control in fibromyalgia.

Clinical Pharmacology: Rapid oral absorption, hepatic metabolism via CYP2C19  to meprobamate (anxiolytic) that has a half-life of 10 hours, renal excretion. CYP2C19 poor  metabolizers and patients receiving CYP2C19 inhibitors such as omeprazole may have higher concentrations of carisoprodol and lower concentrations of meprobamate.

Cost: $$

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