Comparison of naproxen with cyclobenzaprine, oxycodone-acetaminophen, and placebo for the treatment of acute low back pain Canadian Journal of Emergency Medicine

Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products.

• The only salient difference is that Valium has a higher potential to cause drug dependency than Flexeril.
• The primary outcome was improvement on the RMDQ between ED discharge and the 7-day telephone follow-up.
• In this study, we saw no difference in outcomes between those randomized to receive naproxen + placebo vs those randomized to receive naproxen + oxycodone/acetaminophen.
• In the US — Call your doctor for medical advice about side effects.
• Cyclobenzaprine is the most heavily studied and has been shown to be effective for various musculoskeletal conditions.

The sedative properties of tizanidine and cyclobenzaprine may benefit patients with insomnia caused by severe muscle spasms. Methocarbamol and metaxalone are less sedating, although effectiveness evidence is limited. Adverse effects, particularly dizziness and drowsiness, are consistently reported flexeril and lexapro reddit with all skeletal muscle relaxants. The potential adverse effects should be communicated clearly to the patient. Because of limited comparable effectiveness data, choice of agent should be based on side-effect profile, patient preference, abuse potential, and possible drug interactions.

Muscle relaxant or opioid combined with NSAID does not improve low back pain

Taking the medication every six hours may increase pain control at the risk of increased side effects. Finally, this study was performed in a select patient population with atraumatic back pain without radicular symptoms within an urban population with typically poor follow-up. The researchers found that neither naproxen combined with oxycodone/acetaminophen nor naproxen combined with cyclobenzaprine provided better pain relief or better improvement in functional outcomes than naproxen combined with placebo. Measures of pain, functional impairment, and use of health care resources were not different between the study groups at 7 days or at 3 months after the emergency department visit. Among patients with acute, atraumatic low back without radicular symptoms, adding oxycodone/acetaminophen or cyclobenzaprine to naproxen alone did not improve functional outcomes or pain at seven days or three months. Additionally, there was a significant rate of side effects and 24% of patients still had back pain at three months.

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Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Appropriate studies have not been performed on the relationship of age to the effects of cyclobenzaprine extended-release capsules in the pediatric population. «These findings do not support the use of these additional medications in this setting,» the authors write. Please list any fees and grants from, employment by, consultancy for, shared ownership in or any close relationship with, at any time over the preceding 36 months, any organisation whose interests may be affected by the publication of the response.

Conclusions and Relevance Among patients with acute, nontraumatic, nonradicular LBP presenting to the ED, adding cyclobenzaprine or oxycodone/acetaminophen to naproxen alone did not improve functional outcomes or pain at 1-week follow-up. These findings do not support use of these additional medications in this setting. Consider treating patients with acute low back pain with naproxen only, as adding cyclobenzaprine or oxycodone/acetaminophen to scheduled naproxen does not improve functional assessment at 7 days or 3 months and increases adverse effects. The primary outcome was change in the RMDQ between ED discharge and a phone call 7 days later, with a 5-point improvement in the RMDQ considered clinically significant.

Side Effects

Use of a medication taper may be warranted for chronic-use patients. This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Check with your doctor before taking any of the above while you are using this medicine.

Cyclobenzaprine is best used in short-term treatment but may be used intermittently or long-term for chronic pain. Drug interactions may change how your medications work or increase your risk for serious side effects. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.

What are the side effects of cyclobenzaprine and naproxen?

It is also true that corticosteroids20 and acetaminophen21 are not beneficial for patients with nonradicular LBP. Whether cyclobenzaprine is superior to other drugs for the management of acute myofascial strain is unclear and it usually adds more side effects with little therapeutic gain (Turturro et al 2003). For neck pain, however, mixed results are obtained (Peloso et al 2005). There are no extensive studies on the use of cyclobenzaprine in the management of painful orofacial musculoskeletal conditions. A recent study on patients with orofacial myofascial pain compared the effect of adding therapy with clonazepam, cyclobenzaprine or placebo to a universally applied self-care and patient education programme (Herman et al 2002).

Do not use it later for another condition unless your doctor directs you to do so. Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. If you notice other effects not listed above, contact your doctor or pharmacist. Drowsiness, dizziness, dry mouth, constipation, or tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

The usual starting dose is 5 mg at night time, which can be increased to 10 mg after 5 to 7 days unless the child has difficulties awakening in the morning. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.