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Muscle Relaxers: Methocarbamol vs. Cyclobenzaprine

cartoon man with shoulder pain

Skeletal muscle relaxants are prescription medications commonly used to treat muscle pain and muscle spasms. If you have back pain or have suffered a strain or sprain, your healthcare provider may offer you a skeletal muscle relaxant such as methocarbamol (Robaxin) or cyclobenzaprine (Fexmid, Amrix). 

Please continue reading to learn about the similarities and differences between methocarbamol and cyclobenzaprine, including how they work, their side effects, drug interactions, cost, and more. 

What is Robaxin?

Robaxin is the brand name of the generic medication called methocarbamol. It was developed in the 1960s to treat pain and provide relief from muscle spasms. While its exact mechanism of action remains unclear, scientists believe Robaxin can help with pain and discomfort caused by musculoskeletal conditions by blocking the pain signals that are sent to the brain. It is also believed that Robaxin relaxes the muscle by having depressive effects on the central nervous system.

Robaxin is available as an oral tablet of 500 mg or 750 mg. The other dosage form of this medicine is an injection solution into a muscle or into a vein. Robaxin needs to be taken three to four times a day to provide relief from muscle pain and muscle spasms.

What is Flexeril?

Flexeril (generic name cyclobenzaprine) was developed in the 1970s. Flexeril works on the central nervous system to reduce motor activity or muscle contractions, thus, relieving muscle spasms. 

Note: The brand name Flexeril is discontinued; cyclobenzaprine is its generic and available with a prescription. In addition to the generic cyclobenzaprine, two brand-name medications are available, Fexmid (immediate release) and Amrix (extended-release). The extended-release tablet (Amrix) needs to be taken only once a day. 

Are methocarbamol and cyclobenzaprine the same?

No, methocarbamol and cyclobenzaprine are not the same. Both drugs are skeletal muscle relaxants or antispasmodic agents, but they contain different active ingredients. Methocarbamol typically needs to be taken up to 4 times a day, whereas cyclobenzaprine extended-release capsules offer the convenience of once-a-day dosing. Keep in mind that regular cyclobenzaprine tablets may require dosing of up to 3 times a day.

What is the difference between cyclobenzaprine and methocarbamol?

Methocarbamol (Robaxin) and cyclobenzaprine (Fexmid, Amrix) are FDA-approved skeletal muscle relaxants. They are used to treat muscle spasms and muscle pain such as neck pain and lower back pain. Other uses of these medications include the treatment of severe muscle spasms associated with musculoskeletal conditions like tetanus. In addition, Flexeril is also used to treat fibromyalgia, a condition characterized by chronic pain all over the body. 

Another difference between methocarbamol and cyclobenzaprine is that methocarbamol must be taken 3-4 times a day, whereas, in addition to the regular oral tablets, cyclobenzaprine is also available in an extended-release dosage form that only needs to be taken once a day.

Methocarbamol can be used for long or short-term treatment as advised by a doctor. On the other hand, cyclobenzaprine is generally not prescribed for longer than two or three weeks. 

What muscle relaxer is better? Which muscle relaxer is the strongest?

Studies have compared cyclobenzaprine, methocarbamol, and other skeletal muscle relaxants and found that they are equally effective in treating acute musculoskeletal conditions. Cyclobenzaprine is one of the most studied skeletal muscle relaxants, with solid evidence and systematic reviews supporting its effectiveness.

You should discuss the treatment options with your doctor. While all the medicines are effective, one specific muscle relaxant might work better than others for you. 

If you have muscle spasms or muscle pain and plan to take skeletal muscle relaxants, please work with your healthcare provider to find the one that works best for you. Keep in mind that along with medications for short-term alleviation of pain and discomfort, rest and physical therapy can help with long-term pain relief and function.

Is Robaxin, Fexmid, or Amrix better? 

As mentioned above, there is not a significant difference between Robaxin, Fexmid, Amrix, and other muscle relaxants in terms of efficacy in treating acute low back pain, other musculoskeletal pain, and muscle spasms. However, one drug might be more effective for you than another. 

Some people prefer Fexmid and Amrix over Robaxin because it is dosed once a day rather than 3 to 4 times a day. On the other hand, they can cause more adverse effects such as dry mouth and drowsiness. 

What are the common side effects of cyclobenzaprine vs. methocarbamol?

Drug comparisons between cyclobenzaprine and methocarbamol in terms of side effects do not reveal many differences. Both medications can cause adverse effects such as dizziness, drowsiness, headache, nausea, and fatigue. Cyclobenzaprine tends to cause more drowsiness than methocarbamol. Also, cyclobenzaprine can cause dry mouth because it has anticholinergic effects. 

In a small number of people, cyclobenzaprine and methocarbamol can cause more serious adverse effects such as allergic reactions with severe rash, swelling, and trouble breathing. If you experience these adverse effects, please seek emergency medical attention.

What are some precautions while taking skeletal muscle relaxants?

Skeletal muscle relaxants like cyclobenzaprine and methocarbamol can cause dizziness and drowsiness. Therefore, you should wait and see how these medications affect you before driving a motor vehicle or operating machinery. 

Also, methocarbamol and cyclobenzaprine are not recommended in pregnant women, elderly adults, and young children. 

Stopping muscle relaxants suddenly can lead to withdrawal symptoms. These drugs have mild abuse potential, meaning there is a risk of developing a physical dependence on muscle relaxants if they are not used at the recommended dose (taking higher doses or taking the medication more frequently than prescribed by your healthcare provider). Anyone with a history of substance abuse should mention this medical history to their doctor. 

It’s important to thoroughly inform your doctor about all of your medical conditions because muscle relaxants might not be suitable for certain diseases and conditions.

What are the possible drug interactions of cyclobenzaprine or methocarbamol?

Both cyclobenzaprine and methocarbamol have depressive effects on the central nervous system and can interact with other drugs that have a similar effect, such as benzodiazepines, opiate pain medications, and antidepressants. When these drugs interact, it can worsen side effects like drowsiness and dizziness.

Always give your healthcare professional a complete list of your medications, including prescription drugs, over-the-counter medicines, and dietary supplements to reduce the risk of a dangerous drug interaction between a muscle relaxant and one of your other medicines.

Which is cheaper - cyclobenzaprine or methocarbamol?

Generic methocarbamol is around $6.25 for 30 tablets of the 500mg dose with a BuzzRx drug discount card. Brand name Robaxin is approximately $95 for 30 tablets of the 750mg dose with a BuzzRx savings card. Generic cyclobenzaprine may be under $0.50 for 30 tablets of the 10mg dose through the BuzzRx discount program. 

Even if you have insurance, the prices of Robaxin, Fexmid, Amrix, and other muscle relaxants may be cheaper through the BuzzRx discount program. You can get your BuzzRx card for free and start saving on muscle relaxants at a participating pharmacy near you right away. 

References:

  1. https://medlineplus.gov/druginfo/meds/a682579.html
  2. https://medlineplus.gov/druginfo/meds/a682514.html