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The Risks of Cyclobenzaprine Overdose

Cyclobenzaprine is a medication known as a skeletal muscle relaxant that is often prescribed to help relax muscles and ease pain due to sprains, strain, and other muscle-related issues. The brand names for cyclobenzaprine are Amrix and Fexmid. It was also available under the brand name Flexeril in the past. 

Cyclobenzaprine is usually prescribed as a short-term treatment along with physical therapy and rest. It acts on the central nervous system (CNS) to help the muscles feel relaxed. It’s available in several forms including a tablet, an extended release capsule, and as a suspension. 

Some off-label uses for cyclobenzaprine include tension headaches and migraines, insomnia, tinnitus and pain and muscle spasms caused by fibromyalgia. 

Precautions

Many medications may interact with cyclobenzaprine. Be sure to let your doctor know about any other prescription medications, drugs, or supplements you are taking. Don’t make any changes to your dosage or dosing schedule without speaking with your doctor first.

Some medical conditions may affect cyclobenzaprine use. Let your doctor know if you have any medical conditions, especially heart problems, hyperthyroidism, glaucoma, a history of urinary trouble, and liver disease. 

Although addiction to cyclobenzaprine isn’t as common as addiction to some other drugs, it can still occur. Overdose may also occur. Taking too much cyclobenzaprine can result in an overdose, which can be dangerous or even deadly. It’s important to follow prescription instructions carefully. 

How Much Cyclobenzaprine Causes an Overdose?

The standard dosage for cyclobenzaprine will vary depending on the form of the medication and whether the patient is an adult or a child. For adults and children 15 years old and older, in most cases, the dose for an extended-release capsule will be between 15 mg (milligrams) to 30 mg per day. 

For tablets, the dose for adults and children over 15 years old is usually 10 mg taken three times a day, with a maximum dose of 60 mg per day. Dosages for children under 15 years old must be established by your healthcare professional. Taking more than the recommended dosage of cyclobenzaprine may result in an overdose.

It’s best to avoid drinking alcohol or other drugs that depress the central nervous system, including:

  • Benzodiazepines like Valium and Xanax and other sedatives
  • Antihistamines
  • Sleep medications
  • Tranquilizers
  • Prescription pain medications
  • Seizure medication or barbiturates
  • Additional muscle relaxers
  • Anesthetics including anesthetics for dental procedures

Drinking alcohol or taking other CNS depressants can increase the chances of dangerous side effects or overdose.  

How to Recognize a Cyclobenzaprine Overdose

Several signs and symptoms can indicate a cyclobenzaprine overdose. Cyclobenzaprine affects the central nervous system (CNS). Taking more than the prescribed dose may result in some very serious, and potentially deadly, symptoms.

If you think someone has overdosed on cyclobenzaprine, call 911 or get emergency medical help right away. 

Symptoms of a cyclobenzaprine overdose may include:

  • Agitation
  • Change in body temperature
  • Confusion
  • Dizziness
  • Drowsiness
  • Rapid or irregular heartbeat
  • Trouble with speech or movement
  • Nausea
  • Vomiting
  • Hallucinations
  • Tremors
  • Loss of consciousness
  • Heart attack (rare)
  • Seizures (rare)

Dangers of a Cyclobenzaprine Overdose

If you observe someone who has overdosed on cyclobenzaprine, call 911 immediately. 

A cyclobenzaprine overdose can be dangerous and even deadly. Taking too much baclofen can cause an irregular heartbeat, vomiting, hallucinations, seizures, or even death. 

It’s very important to take only the prescribed dose provided by your doctor. If you have any questions about your prescription or dosage, contact your doctor. Don’t make any changes in your dosage without talking with your doctor first. 

Also, always be sure that this medication and any other medications, drugs, or supplements are out of the reach of children. In fact, accidental overdose is a leading cause of death for children ages 6 months to 5 years old. 

Have the local poison control center information handy if you have small children in your household or locate one by dialing 800-222-1222 or accessing the American Association of Poison Control Centers (www.aapcc.org). 

What to Do While Waiting for the Paramedics

After you call 911, stay with the victim and remain calm. Make sure they are breathing and help them stay conscious.

First, quickly remove any objects from around the victim. If they have a seizure, clearing the space will help limit the possibility of injury. 

Make sure you check on the victim’s breathing. Once you have cleared the space around them, tilt their head back. This keeps the airway open. If their breathing becomes shallow or they stop breathing, then tilt their head back and gently lift their chin. Close their nostrils shut, and then seal your mouth over their lips.

After you have sealed your mouth over theirs, quickly blow two breaths into their mouth. At each 5-second mark, give them a long breath. 

Do not give any beverages or food to the victim. This could cause them to choke.

Make sure they stay awake. 

Don’t move the victim or put them in the shower. This could cause shock.

Medical Treatment for a Cyclobenzaprine Overdose

Cyclobenzaprine overdose treatment will vary depending on the amount of the overdose. The larger the overdose and the more serious the symptoms, the longer and more intense the treatment will be. 

The victim may require CPR if they are not breathing. If they continue to have trouble breathing or have an irregular heartbeat, then oxygen and defibrillation may also be necessary. 

A medication known as syrup of ipecac may be administered to induce vomiting. If this is not successful or doesn’t result in the removal of enough of the medication, the medical team may use a procedure called gastric lavage (“stomach pumping”) to mechanically remove the remaining medication from the stomach. 

Activated charcoal may also be used to help limit how much of the medication is absorbed into the bloodstream. The drug binds to the charcoal and then is eliminated through the stool.  

If the overdose is severe, a breathing tube may be inserted into the patient’s throat, and they may be monitored in the ICU for a few days. They may also require a medical detox and treatment for cyclobenzaprine withdrawal symptoms if they have been taking larger doses of the drug for a longer period. 

The medical staff will continue to monitor the patient’s physical and mental health. Before discharge from the hospital, a psychiatric evaluation may be given, especially if the overdose was due to a suicide attempt.

Conclusion

If you or someone you love has a prescription for cyclobenzaprine (also known as the brand names Amrix or Fexmid), be sure to follow the dosing instructions carefully. If your condition changes, contact your doctor. Be sure you know how to recognize the signs and symptoms of a cyclobenzaprine overdose. If you witness someone who has overdosed on cyclobenzaprine, call 911 right away. Stay with the victim until help arrives and make sure they stay awake and remain breathing.

Sources

Chabria, S. (2006, July 17) Rhabdomyolysis: A Manifestation of Cyclobenzaprine Toxicity. In Journal of Occupational Medicine and Toxicology. Retrieved from https://www.ncbi.nlm.nih.gov/

Cyclobenzaprine. from https://medlineplus.gov/druginfo/meds/a682514.html

Flexeril. Retrieved from https://www.rxlist.com

Drug Overdose. Retrieved from https://www.webmd.com

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