General

Pronunciation
kar-i-SOP-roe-dole

Trade Name(s)

• Soma

• Vanadom

Pregnancy Category
Category Unknown

Ther. class.
skeletal muscle relaxants
(centrally acting)

Indications

Adjunct to rest and physical therapy in the treatment of muscle spasm associated with acute painful musculoskeletal conditions

Action

Skeletal muscle relaxation, probably due to CNS depression.

Therapeutic Effect(s):
Skeletal muscle relaxation

Pharmacokinetics

Absorption: Well absorbed after oral administration

Distribution: Crosses the placenta; high concentrations in breast milk

Metabolism and Excretion: Mostly metabolized by the liver

Half-life: 8 hr

TIME/ACTION PROFILE (skeletal muscle relaxation)

ROUTE	ONSET	PEAK	DURATION
PO	30 min	unknown	4–6 hr

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity to carisoprodol or to meprobamate

• Porphyria or suspected porphyria

Use Cautiously in:

• Severe liver or kidney disease

• OB: Lactation: Pedi: Safety not established for pregnant women, breastfeeding infants or children <16 yr

• Geri: Poorly tolerated due to anticholinergic effects. Appears on Beers list

Adverse Reactions/Side Effects

CNS: dizziness, drowsiness, agitation, ataxia, depression, headache, insomnia, irritability, syncope.

Resp: asthma attacks.

CV: hypotension, tachycardia.

GI: epigastric distress, hiccups, nausea, vomiting.

Derm: flushing, rashes.

Hemat: eosinophilia, leukopenia.

Misc: ANAPHYLACTIC SHOCK, fever, psychological dependence, severe idiosyncratic reaction.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Drug-Drug
Additive CNS depression with other CNS depressants including alcohol, antihistamines, opioid analgesics, and sedative/hypnotics

Drug-Natural Products
Concomitant use of kava-kava, valerian, skullcap, chamomile, or hops can increase CNS depression

Route/Dosage

• PO (Adults >=16 yrs): 250–350 mg 4 times daily for no >2–3 wks.

Availability

• Tablets: 250 mg, 350 mg

• In combination with: aspirin (Soma compound) and codeine. See combination drugs

Assessment

• Assess patient for pain, muscle stiffness, and range of motion before and periodically throughout therapy

• Observe patient for idiosyncratic symptoms that may appear within minutes or hours of administration during the first dose. Symptoms include extreme weakness, quadriplegia, dizziness, ataxia, dysarthria, visual disturbances, agitation, euphoria, confusion, and disorientation. Usually subsides over several hours

• Geri: Assess geriatric patients for anticholinergic effects (sedation and weakness).

Potential Nursing Diagnoses

• Acute pain (Indications)

• Impaired bed mobility (Indications)

• Risk for injury (Side Effects)

Implementation

• Do not confuse Soma with Soma Compound

» Provide safety measures as indicated. Supervise ambulation and transfer of patients

• PO: Administer with food to minimize GI irritation. Give dose at bedtime

Patient/Family Teaching

• Instruct patient to take medication as directed. Missed doses should be taken within 1 hr; if not, omit and return to regular dosing schedule. Do not double doses

• Encourage patient to comply with additional therapies prescribed for muscle spasm (rest, physical therapy, heat, etc.)

• May cause dizziness or drowsiness. Advise patient to avoid driving or other activities requiring alertness until response to drug is known

• Instruct patient to change positions slowly to minimize orthostatic hypotension

• Advise patient to avoid concurrent use of alcohol and other CNS depressants while taking this medication

• Instruct patient to notify health care professional if signs of allergy (rash, hives, swelling of tongue or lips, dyspnea) or idiosyncratic reaction occur

Evaluation/Desired Outcomes

Decreased musculoskeletal pain and muscle spasticity

» Increased range of motion

carisoprodol is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

To find other Davis's Drug Guide topics, please login or purchase a subscription.