Med of the Month: Carisoprodol

Carisoprodol is a muscle relaxant sometimes used short-term to relieve acute muscle spasms. While it can help reduce discomfort from muscle-related dental pain, it's typically prescribed cautiously due to its potential for sedation and dependence. Dentists may collaborate with physicians if muscle relaxants are needed as part of a broader pain management plan. Here's what every dental provider should know about carisoprodol:

Generic Name: Carisoprodol

Brand Name(s): Soma

Pronunciation: kar eye soe PROE dole

About this drug:

• Carisoprodol is a muscle relaxant used short-term to treat muscle pain, spasms, and stiffness.

• It is not approved for use in children under 16 years of age without the advice of a doctor.

Dentistry-related tidbits:

• This medication is highly regulated because it is abused and often illegally combined with a street drug. Familiarize yourself with the dose directions before prescribing this muscle relaxant or prescribe a different muscle relaxant. 

• This medication should be tapered and not abruptly stopped if the patient is taking it for > 7 days.

• Avoid prescribing this medication if a patient is also taking an opioid, benzodiazepine, anticonvulsants like gabapentin or pregabalin, or other sedating medications to avoid an increased risk of respiratory or central nervous system depression, and potentially even death.

• Advise patients to avoid over-the-counter medications that may be sedating such as antihistamines (e.g. Benadryl) to avoid additive sedating side effects.

• Do not prescribe carisoprodol if the patient has epilepsy to avoid an increase in seizures.

• Combining antifungals such as fluconazole and voriconazole with carisoprodol may increase carisoprodol levels.

• Combining the penicillin antibiotic dicloxacillin with carisoprodol may decrease carisoprodol levels. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.

Fun facts:

• It is unknown how carisoprodol works but it can cause sedation and alter pain perception by interrupting neuronal communication.

• Remind a patient to avoid using marijuana and alcohol as this combination may increase the risk of CNS depression and diminished psychomotor function.

• This medication causes drowsiness, dizziness, and hypotension. Advise patients not to drive, operate machinery, or engage in sports while taking this medication until they know how this medication affects them.

• Combining this medication with an opioid and a benzodiazepine is referred to as the “Holy Trinity”  as it can create a desirable high.

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