Which medications in the drug class Skeletal muscle relaxants are used in the treatment of Osteoarthritis?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Skeletal muscle relaxants

The use of certain skeletal muscle relaxants have been shown to be helpful in osteoarthritis.

Carisoprodol (Soma)

Short-acting medication that may have depressant effects at spinal cord level.

Skeletal muscle relaxants have modest short-term benefit as adjunctive therapy for nociceptive pain associated with muscle strains and, used intermittently, for diffuse and certain regional chronic pain syndromes. Long-term improvement over placebo has not been established.

Dantrolene (Dantium, Revonto)

Acts peripherally at muscle fiber rather than at neural level; reduces muscle action potential–induced release of calcium and also affects intrafusal and extrafusal fibers and spindle sensitivity. Has no action on smooth or cardiac muscle tissue. Induces release of Ca++ into sarcoplasmic reticulum, subsequently decreasing the force of excitation coupling. Only drug that intervenes at a muscular level. Preferred for the cerebral form of spasticity. Less likely to cause lethargy or cognitive changes like baclofen or diazepam.

May reduce painful cramping and detrimental muscle tightening.

Can be administered PO/IV. IV form is much more expensive and should be reserved for patients unable to take oral medications. Most patients respond to 400 mg/day or less. Eliminated in the urine and bile.

Baclofen (Lioresal)

Muscle relaxant (central), presynaptic GABA-B receptor agonist that may induce hyperpolarization of afferent terminals and inhibit both monosynaptic and polysynaptic reflexes at spinal level. Lessens flexor spasticity and hyperactive stretch reflexes of upper motor neuron origin. Eliminated through renal excretion.

Well absorbed, with average oral bioavailability of 60% and mean elimination half-life of 12 h; steady state reached within 5 d with multiple dose administration; metabolism occurs in liver (P 450-dependent glucuronidation and hydroxylation); 6 major and a few minor metabolites produced.


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