Cyclobenzaprine


Description

Cyclobenzaprine, a centrally-acting muscle relaxant, was first synthesized in 1961[

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Pharmacology

Indication

Cyclobenzaprine is indicated as a short-term (2-3 weeks) adjunct therapy, along with rest and physic... Read more

Pharmacodynamic

Cyclobenzaprine is a skeletal muscle relaxant that works on areas of the brainstem to reduce skeleta... Read more

Mechanism of action

The exact mechanism of action of cyclobenzaprine has not been fully elucidated in humans, and much o... Read more

Absorption

The oral bioavailability of cyclobenzaprine has been estimated to be between 0.33 and 0.55.[ Read more

Protein binding

Cyclobenzaprine is approximately 93% protein bound in plasma.[ Read more

Volume of distribution

The volume of distribution of cyclobenzaprine is approximately 146 L.[ Read more

Clearance

The approximate plasma clearance of cyclobenzaprine is 0.7 L/min.[ Read more

Half life

The effective half-life of cyclobenzaprine in young healthy subjects is approximately 18 hours.[ Read more

Route of elimination

After administration of a radio-labeled dose of cyclobenzaprine, 38-51% of radioactivity was excrete... Read more

Toxicity

The oral LD50 of cyclobenzaprine in mice and rats is 338 mg/kg and 425 mg/kg, respectivel... Read more


Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Drowsiness US
  • Kind: experimental
    • Percent: 16-39%
  • Varying Reports
    Drowsiness US
  • Kind: experimental
    • Percent: 29-38%
  • Kind: placebo
    • Percent: 10%
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 21-32%
  • Kind: placebo
    • Percent: 7%
  • Clinical Trial
    Dry Mouth US
  • Kind: experimental
    • Percent: 7-27%
  • Varying Reports
    Dizziness US
  • Kind: experimental
    • Percent: 3-11%
  • Varying Reports
    Headache US
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 8%
  • Clinical Trial
    Fatigue US
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Pharyngitis US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Upper Respiratory Infection US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Nervousness US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Dizziness US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Diarrhea US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Mental acuity decreased US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Irritability US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Nausea US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Acid Regurgitation US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Constipation US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Abdominal Pain US
  • Kind: experimental
    • Percent: 1-3%
  • Clinical Trial
    Headache US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Nervousness US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Confusion US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Unpleasant taste US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Blurred vision US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Nausea US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Constipation US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Dyspepsia US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Fatigue/tiredness US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Asthenia US
  • Kind: experimental
    • Percent: 1-3%
  • Varying Reports
    Muscle twitching US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Convulsions US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Hypertonia US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Tremors US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Dysarthria US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Vertigo US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Ataxia US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Seizures US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Local weakness US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Rash US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Urticaria US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Facial edema US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Pruritus US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Anaphylaxis US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Angioedema US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Jaundice and cholestasis US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Abnormal liver function and rare reports of hepatitis US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Flatulence US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Edema of the Tongue US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Thirst US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Gastritis US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial
    Anorexia US
  • Kind: experimental
    • Percent: <1%
  • Post Marketing Clinical Trial

    Contraindications

    • Route:
      • Oral
    • Hypersensitivity:
      • true
    • Regions: US
    • Route:
      • Oral
    • Time Period: During MAO-I therapy or within 14 days after their discontinuation
    • Regions: US
    • With Categories Coadmin:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Arrhythmias
        • Drugbank Id: DBCOND0031410
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Acute recovery phase of myocardial infarction
        • Drugbank Id: DBCOND0107607
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Conduction Disturbances
        • Drugbank Id: DBCOND0071211
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Heart Block
        • Drugbank Id: DBCOND0032425
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Hyperthyroidism
        • Drugbank Id: DBCOND0009048
    • Route:
      • Oral
    • Regions: US
    • Patient Conditions:
        • Name: Congestive Heart Failure
        • Drugbank Id: DBCOND0029751

    Food Interactions

    • Avoid alcohol.
    • Take with food to reduce irritation.

    Interactions

    Type in a drug name to check for interaction with Cyclobenzaprine

    The metabolism of Cyclobenzaprine can be decreased when combined with (R)-warfarin.
    The metabolism of Cyclobenzaprine can be decreased when combined with (S)-Warfarin.
    Cyclobenzaprine may decrease the hypoglycemic activities of 2,4-thiazolidinedione.
    The risk or severity of CNS depression can be increased when 2,5-Dimethoxy-4-ethylthioamphetamine is combined with Cyclobenzaprine.
    The metabolism of Cyclobenzaprine can be decreased when combined with 3,5-diiodothyropropionic acid.
    The risk or severity of CNS depression can be increased when 4-Bromo-2,5-dimethoxyamphetamine is combined with Cyclobenzaprine.
    The risk or severity of hypertension can be increased when Cyclobenzaprine is combined with 4-Bromo-2,5-dimethoxyphenethylamine.
    The metabolism of 4-hydroxycoumarin can be decreased when combined with Cyclobenzaprine.
    The risk or severity of CNS depression can be increased when Cyclobenzaprine is combined with 4-Methoxyamphetamine.
    The metabolism of Cyclobenzaprine can be decreased when combined with 5-androstenedione.
    The risk or severity of CNS depression can be increased when Cyclobenzaprine is combined with 5-methoxy-N,N-dimethyltryptamine.
    The metabolism of Cyclobenzaprine can be decreased when combined with 6-Deoxyerythronolide B.
    The metabolism of Cyclobenzaprine can be decreased when combined with 6-O-benzylguanine.
    The metabolism of Cyclobenzaprine can be decreased when combined with 7-ethyl-10-hydroxycamptothecin.
    The risk or severity of CNS depression can be increased when Cyclobenzaprine is combined with 7-Nitroindazole.
    Cyclobenzaprine may increase the serotonergic activities of 7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline.
    The metabolism of 8-azaguanine can be decreased when combined with Cyclobenzaprine.
    The metabolism of 8-chlorotheophylline can be decreased when combined with Cyclobenzaprine.
    The metabolism of Cyclobenzaprine can be decreased when combined with 9-aminocamptothecin.
    The metabolism of 9-Deazaguanine can be decreased when combined with Cyclobenzaprine.

    References

    • 1 . Wang RW, Liu L, Cheng H: Identification of human liver cytochrome P450 isoforms involved in the in vitro metabolism of cyclobenzaprine. Drug Metab Dispos. 1996 Jul;24(7):786-91. [PubMed: 8818577]
    • 2 . Lu D, Xie Q, Wu B: N-glucuronidation catalyzed by UGT1A4 and UGT2B10 in human liver microsomes: Assay optimization and substrate identification. J Pharm Biomed Anal. 2017 Oct 25;145:692-703. doi: 10.1016/j.jpba.2017.07.037. Epub 2017 Aug 4. [PubMed: 28803208]
    • 3 . Kobayashi H, Hasegawa Y, Ono H: Cyclobenzaprine, a centrally acting muscle relaxant, acts on descending serotonergic systems. Eur J Pharmacol. 1996 Sep 5;311(1):29-35. [PubMed: 8884233]
    • 4 . Honda M, Nishida T, Ono H: Tricyclic analogs cyclobenzaprine, amitriptyline and cyproheptadine inhibit the spinal reflex transmission through 5-HT(2) receptors. Eur J Pharmacol. 2003 Jan 1;458(1-2):91-9. [PubMed: 12498911]
    • 5 . Mestres J, Seifert SA, Oprea TI: Linking pharmacology to clinical reports: cyclobenzaprine and its possible association with serotonin syndrome. Clin Pharmacol Ther. 2011 Nov;90(5):662-5. doi: 10.1038/clpt.2011.177. Epub 2011 Oct 5. [PubMed: 21975349]
    • 6 . Hutchinson MR, Loram LC, Zhang Y, Shridhar M, Rezvani N, Berkelhammer D, Phipps S, Foster PS, Landgraf K, Falke JJ, Rice KC, Maier SF, Yin H, Watkins LR: Evidence that tricyclic small molecules may possess toll-like receptor and myeloid differentiation protein 2 activity. Neuroscience. 2010 Jun 30;168(2):551-63. doi: 10.1016/j.neuroscience.2010.03.067. Epub 2010 Apr 8. [PubMed: 20381591]
    • 7 . Obach RS, Huynh P, Allen MC, Beedham C: Human liver aldehyde oxidase: inhibition by 239 drugs. J Clin Pharmacol. 2004 Jan;44(1):7-19. [PubMed: 14681337]
    • 8 . Winchell GA, King JD, Chavez-Eng CM, Constanzer ML, Korn SH: Cyclobenzaprine pharmacokinetics, including the effects of age, gender, and hepatic insufficiency. J Clin Pharmacol. 2002 Jan;42(1):61-9. doi: 10.1177/0091270002042001007. [PubMed: 11808825]
    • 9 . Calandre EP, Rico-Villademoros F, Slim M: An update on pharmacotherapy for the treatment of fibromyalgia. Expert Opin Pharmacother. 2015 Jun;16(9):1347-68. doi: 10.1517/14656566.2015.1047343. [PubMed: 26001183]
    • 10 . Cimolai N: Cyclobenzaprine: a new look at an old pharmacological agent. Expert Rev Clin Pharmacol. 2009 May;2(3):255-63. doi: 10.1586/ecp.09.5. [PubMed: 24410704]
    • 11 . Brioschi TM, Schramm SG, Kano EK, Koono EE, Ching TH, Serra CH, Porta V: Pharmacokinetics and bioequivalence evaluation of cyclobenzaprine tablets. Biomed Res Int. 2013;2013:281392. doi: 10.1155/2013/281392. Epub 2013 Sep 16. [PubMed: 24151591]
    • 12 . Baig MH, Rahman S, Rabbani G, Imran M, Ahmad K, Choi I: Multi-Spectroscopic Characterization of Human Serum Albumin Binding with Cyclobenzaprine Hydrochloride: Insights from Biophysical and In Silico Approaches. Int J Mol Sci. 2019 Feb 3;20(3). pii: ijms20030662. doi: 10.3390/ijms20030662. [PubMed: 30717459]
    • 13 . Hucker HB, Stauffer SC, Balletto AJ, White SD, Zacchei AG, Arison BH: Physiological disposition and metabolism of cyclobenzaprine in the rat, dog, rhesus monkey, and man. Drug Metab Dispos. 1978 Nov-Dec;6(6):659-72. [PubMed: 33029]
    • 14 . CaymenChem: Cyclobenzaprine hydrochloride MSDS [Link]
    • 15 . FDA Approved Drugs: Cyclobenzaprine [Link]
    • 16 . DPD Approved Drugs: Cyclobenzaprine [Link]

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