Carisoprodol which also goes by its brand name Soma is a powerful muscle relaxant used to treat musculoskeletal pain. The intensity of its rapid action gives users a high, euphoric feeling known as a soma high feeling.
Because of its sedating nature, Soma can sometimes be addicting. If Soma is consumed in high doses, it can intensify its effects and result in the patient feeling the same after-effects that doing drugs causes and become addicted.
Here are eight effective alternatives for carisoprodol that serve the same purpose with varying functions and effects:

Methocarbamol

Brand name: Robaxin

Methocarbamol is one of the alternate medications prescribed in place of Soma. It is used as a muscle relaxant.

It is used along with physical therapy to treat musculoskeletal conditions.

Common Side effects:

  • Mood swings
  • Heartburn
  • Indigestion
  • Belching (burping)
  • Insomnia
  • Stomach pain
  • Nausea

Side effects to look out for:

  • Chest pain
  • Black or tarry stool
  • Dark urine
  • Diarrhea
  • Changes in skin color
  • Hives developing on body parts
  • Puffiness in the face
  • Ulcers or sores forming in mouth or lips
  • Vomiting blood

   Precautions:

  • This drug should not be used in early pregnancy and breastfeeding. It may harm an unborn baby.
  •  Patients with a history of seizures, kidney diseases, or myasthenia gravis should let their doctor know before intaking.
  • Do not consume medication with alcohol as it may cause serious side effects.
  • Avoid driving or doing anything that requires you to be alert as drug impairs and delays your thinking and actions.
  •  Do not use methocarbamol if you are allergic to it.

Dosage:

  • Take the dosage strictly as prescribed by your doctor or physician.
  • Methocarbamol is consumed by either taking tablets orally or through an injection.
  • Oral: these are taken by mouth. The initial dose is 1500 mg; it should be taken four times daily. Which is later reduced after 2 to 3 days. 
  • Injection: this is injected into a muscle. They are not administered subcutaneously only for IV (intravenous) and IM (intramuscular) administration.

For IM: 500 mg into each gluteal region
For IV: inject undiluted iv into the vein at a rate of 300 mg /minute

Cyclobenzaprine

Brand names: Flexeril, Amrix, Fexmid

Cyclobenzaprine is an alternative for Soma for muscle relaxation.

It is used to minister muscle spasms and help reduce pain caused by any sprain or injuries.

Common side effects:

  • Fatigue
  • Xerostomia (dry mouth)
  • Nausea
  • Headache
  • Drowsiness
  • Constipation
  • Confusion or nervousness
  • bloating
  • Blurry vision

Side effects to look out for:

  •  hallucinations
  •  Eyes or skin yellowing
  • Irregular heartbeats
  • Seizure
  • Hives/skin rash
  • Depression
  •  Vomiting

Precautions:

  • For pregnant females, this drug should only be used if it is extremely necessary, so clarify with your doctor then proceed for consumption.
  • As this drug is associated with tricyclic antidepressants, it has a tendency to be excreted in human milk, so caution is required.
  • Avoid alcohol.
  • Causes confusion and drowsiness, so participating in risky activities is not advised.

Inform your doctor know if you have any of the following:

1. thyroid disease
2. heart diseases
3. liver disease
4. glaucoma
5. victim of heart attack
6. enlarged prostate
7. trouble with urination

Do not consume if you are allergic to it or have

Dosage:

Medically recommended dose of cyclobenzaprine is 5 or 10 mg thrice daily for IR tablets (Immediate Release tablets are formulated to dissolve or disintegrate after swallowing.)
OR
15 or 30 mg once daily consuming extended-release tablets (extended-release tablets are formulated so that the medication dissolves slowly over time, this causes fewer side effects to taking place in the body)

Metaxalone

Brand name: Skelaxin, Metaxall

Metaxalone works as a skeletal muscle relaxant. It takes effect by blocking nerve impulses in the brain. It is prescribed for muscle pain caused by injury, sprain, and fibromyalgia. It consists of sedative properties.

Common Side effects:

  • Constipation
  • Drowsiness
  • Feeling nervous
  • Nausea
  • Vomiting
  • Feeling anxious

Side effects to look out for:

  • Anxiety
  • Stomach, back, leg ache
  • Nosebleeds
  • Black, tarry stool
  • Bleeding gums
  • Diarrhea
  • Puffy face
  • Hives
  • Loss of appetite
  • Twitching
  • Vomiting blood
  • Chest pain

Precautions:

There is no data provided regarding the safety of pregnant or breastfeeding women consuming metaxalone. Ingesting is not recommended.

  • Not to be consumed with alcohol.
  • Not to be consumed with Central Nervous System (CNS) Depressants. It might increase the sedative effect on the body.
  • Patients suffering from liver damage should be careful
  • Nursing/ breastfeeding mothers should not consume as drugs are prone to be excreted in breast milk.
  • Look out for signs of Serotonin Syndrome(SS).

Signs include:

  • Agitation
  • Hypertonia
  • Clonus
  • Diaphoresis
  • Hyperreflexia

Dosage:

The suggested standard dose is intaking one 800 mg tablet 3 to 4 times daily.

Tizanidine

Brand name: Zanaflex

Tizanidine falls under the category of central alpha-2-adrenergic agonists. Can be used to reduce muscle spasm related to spinal injury as well as pain caused due to muscle spasm.

Common side effects:

  • Asthenia (unusual weakness)
  • Bradycardia (slow heart rate)
  • Burning sensation during urinating
  • Nausea
  • Vomiting
  • Xerostomia (dry mouth due to medication)
  • Fever
  • Lightheaded
  • Constipation
  • Sore throat

Side effects to look out for:

  • Kidney stones.
  • Hallucinations
  • Itchy skin
  •  Severe sleepiness
  • Skin, lips, fingernails turning faint blue

Precautions:

  • Medication is expected to be excreted in breast milk, so breastfeeding and nursing women are not suggested to consume Zanaflex.
  • There is no practical research data about pregnant women so not ingesting is better to avoid risks to health.
  • Drinking alcohol is not advised.
  • Partaking in operating machinery, driving etc is risky and should be avoided to not cause bodily harm.
  • Tizanidine causes allergies in patients like urticaria (hives) and anaphylaxis.
  •  Patients suffering from renal impairment should be careful.
  • Patients suffering from hepatic impairment should be careful.

Dosage:

  • Capsules can also be consumed by opening and sprinkling it in food.
  • Medication is available in tablet as well as capsule form.
  • A starting dose of 2 mg to be taken thrice in 24 hours.
  • Dosage can be increased steadily from 2 mg to 4 mg.
  • Total daily dose should never exceed the limit of 36 mg.

Baclofen

Brand name: Kemstro, Gablofen, Lioresal

Baclofen, also known as Lioresal, is a skeletal muscle relaxant that is effective in treating muscle pain and spasms.it is prescribed for spinal cord diseases and sclerosis and for flexor spasms, concomitant pain, clonus, and muscular rigidity.

Common side effects:

  • Insomnia
  • Nausea
  • Headache
  • Frequent urination
  • Weakness
  • Drowsiness

Side effects to look out for:

  • Seizure
  • Swelling in face or throat
  • Fever
  • Hallucinations
  • Shortness of breath
  • Hives
  • Tingling or numbness in limbs

Precautions:

  • Causes withdrawal symptoms.
  • Practicing activities which require motor control, alertness, and balance should be avoided when under the influence of medication.
  • Patients suffering from renal impairment should be careful. 
  • May increase risk of ovarian cyst.
  • Pregnant or nursing women should NOT consume. Consuming baclofen during pregnancy will harm the offspring’s mental state.
  • Not appropriate consumption for below 12-year-olds.

Inform your physician know if you are suffering from any of the following:
1. Mental illnesses
2. Epilepsy (stroke)
3. Nervous system disorder
4. Kidney disease

Dosage:

  • The medication is provided in tablet form as well as in a solution.
  • Recommended dose for the solution is 5ml thrice a day for three days day (not more than 80 mg in a day that is 20 mg 4 times a day.)
  • Recommended dose for tablet is 5 mg thrice a day (not more than 80 mg in a day that is 20 mg 4 times in a day.)

Oxazepam and Diazepam

Brand name: Serax and Valium respectively

Oxazepam and diazepam both belong in the benzodiazepine class of drugs. Drugs that fall under the benzodiazepine class are a group of nervous system depressants. They are prescribed for the treatment of conditions such as anxiety, seizures, insomnia, panic attacks as well as spasms. They work as sedatives by inducing calm effects.

Common side effects:

  • Menstrual changes
  • Increased interest in sexual intercourse
  • Decreased interest in sexual intercourse
  • Excessive salivation
  • Diplopia (seeing double)
  • Constipation

Side effects to look out for:

  • hallucinations
  • side or lower back pain
  • nightmares
  • vomiting blood
  • seizures
  • agitation
  • dark urine
  • black, tarry stool
  • trouble concentrating
  • irregular breathing
  • fast heartbeat

Precautions:

  • Benzodiazepine use is advised to be avoided for childbearing females. Benzodiazepine puts the child at risk for withdrawal symptoms. It causes birth defects
  • Drug gets excreted in breast milk. Thus, consumption during the breastfeeding phase is NOT recommended.
    Should not be consumed with the combination of alcohol or grapefruit/ grapefruit juice.
  • Practicing activities which require motor control, alertness, and balance should be avoided when under the influence of medication.
  • Increase suicidal thoughts
    Withdrawal symptoms may occur after prolonged use of medication.

Not suitable for people with the following:

  • History of substance abuse
  • Respiratory conditions
  • Glaucoma
  • Liver diseases
  • Kidney diseases

Dosage:
Misuse of these drugs can result in overdose, addiction and even death.

For Oxazepam:

  • Standard dose for users is 10 mg to 15 mg tablets orally 3 or 4 times daily.
  • Increased dose for users is 15 mg to 30 mg orally 3 or 4 times daily.
    For Diazepam:
  • Oral: 2 to 10 mg taken orally 3 or 4 times a day
  • Parenteral: 2 to 5 mg IV / IM in 3 to 4 hours
    Or 5 to 10 mg IV / IM in 3 to 4 hours.
    Depending on the severity of the condition.

Chlorzoxazone

Brand name: Paraflex, Lorzone
Chlorzoxazone is a muscle relaxant used to treat skeletal muscle conditions like pain, muscle spasms, and injury.

Common side effects:

  • Nausea
  • Drowsiness
  • Vomiting
  • Headache

Side effects to look out for:

  • Skin rash
  • Nausea
  • Dark urine
  • Yellowing of eyes and skin
  • Fever
  • Fatigue
  • Anorexia

Precautions:

  • There is no practical research data about the safety of pregnant women when consuming chlorzoxazone. Therefore should only consume if the physician advises so.
  • Should not be consumed with alcohol.
  • Patients with a history of drug allergies should be cautious about intake.

Dosage:
The standard dose is 375 mg tablet 3 or 4 times a day
For better results, the dosage can be increased from one to two tablets (750 mg) 3 or 4 times a day.

Orphenadrine

Brand name: Norflex, Invagesic Orphenadrine is a skeletal muscle relaxant.
Orphenadrine is generally prescribed for the treatment of symptoms of muscle spasms as well as for other conditions such as migraines. Its inducing effects are similar to Carisoprodol effects known for producing euphoric feelings in the mind.

Common side effects:

  • Anxiety
  • Itchy skin
  • Numbness around mouth, hands or feet
  • Dilated pupils
  • Muscle weakness
  • Trembling body
  • Confusion

Side effects to look out for:

  • Chest pain
  • Laboured breathing
  •  Hives
  • Sores or ulcers in the mouth
  • Fever
  •  Hallucinations
  • Headache
  • Nausea
  • Glaucoma
  •  Abdominal pain
  •  Vomiting

Precautions:

  • Orphenadrine should be prescribed to pregnant women only if
  • Desperately required.
  • Practicing activities which require motor control, alertness and balance should be avoided when under the influence of medication.

Patients suffering from the following conditions should be careful with this medication:

1. Tachycardia
2. Coronary insufficiency
3. Cardiac arrhythmia
4. Cardiac decompensation

Contraindicated in patients with the following:
1. Glaucoma
2. Pyloric stenosis
3. Stenosing peptic ulcers
4. (BPH) Benign prostate enlargement
5. Myasthenia gravis
6. Cardio spasm

Dosage:·

  • Orphenadrine medication is available in tablet form as well as in injections.
  • Tablets: Orphenadrine 100 mg extended-release tablets should be taken orally twice a day (100 mg 2 times a day)
  •  Injection: Orphenadrine 60 mg IV or IM parenteral injections to be injected every 12 hours (60 mg IV/IM every 12 hours)

References

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