The Safety and Efficacy of Methocarbamol as a Muscle Relaxant with Analgesic Action: Analysis of Current Data

Authors

  • Hyungjin Jung SJ Pharma Co., Ltd., Korea, Republic of
  • HanKook Chae AJU Pharm. Co., Ltd., Korea, Republic of

DOI:

https://doi.org/10.20535/ibb.2019.3.4.183336

Keywords:

Methocarbamol, Pain, Myelorelaxant, Safety, Efficacy

Abstract

Background. The causes of musculoskeletal pain are various diseases of the musculoskeletal system, including osteoporosis, osteochondrosis, arthritis, bone tumors, myalgia, etc. Despite the progress of pharmacology and modern clinical medicine, the problem of pain therapy remains an urgent medical and social problem. One of the preparations of choice for such patients is methocarbomol, a central-acting muscle relaxant whose effect is caused by a general depressant effect on the central nervous system.

Objective. The aim of the work is a critical analysis of current scientific data on the safety and efficacy of the use of methocarbamol as a muscle relaxant mediating analgesic action.

Methods. Analysis and systematization of current scientific data on clinical study of safety and efficacy of methocarbamol preparations in various pathologies.

Results. The results of controlled and uncontrolled clinical trials on the efficacy of methocarbamol have been analyzed, as well as a critical evaluation of data on clinical safety studies.

Conclusions. Methocarbamol is characterized by a favorable safety profile when administered either orally or in injectable form. The incidence of side effects does not exceed that of other commonly used myelorelaxants. Methocarbamol has proven to be an effective and safe drug for use as a supplement to exercise regimen (muscle rest), physiotherapy and other activities to ease the discomfort associated with acute musculoskeletal disorders.

References

Pincus T, Castrejon I, Yazici Y, Gibson KA, Bergman MJ, Block JA. Osteoarthritis is as severe as rheumatoid arthritis: evidence over 40 years according to the same measure in each disease. Clin Exp Rheumatol. 2019;37 Suppl 120(5):7-17.

Cleveland RJ, Nelson AE, Callahan LF. Knee and hip osteoarthritis as predictors of premature death: a review of the evidence. Clin Exp Rheumatol. 2019;37 Suppl 120(5):24-30.

Dizdarevic A, Farah F, Ding J, Shah S, Bryan A, Kahn M, et al. A comprehensive review of analgesia and pain modalities in hip fracture pathogenesis. Curr Pain Headache Rep. 2019;23(10):72. DOI: 10.1007/s11916-019-0814-9

Aguiar ARSA, Ribeiro-Samora GA, Pereira LSM, Godinho LB, Assis MG. Disability in older adults with acute low back pain: the study Back Complaints in the Elderly – (Brazil). Braz J Phys Ther. 2017;21(5):365-71. DOI: 10.1016/j.bjpt.2017.06.008

Pertsev IM, Khalavka MV, Tamm TI, Datsenko OB, Balanovich MM. Diseases of the musculoskeletal system. Osteochondrosis: prevention, diagnosis, treatment. Apteka [Internet]. 2017 [cited 2017 Feb 17];6(1077). Available from: https://www.apteka.ua/article/401532

Lizneva D, Yuen T, Sun L, Kim S, Atabiekov I, Munshi LB, et al. Emerging concepts in the epidemiology, pathophysiology, and clinical care of osteoporosis across the menopausal transition. Matrix Biol. 2018;71-72:70-81. DOI: 10.1016/j.matbio.2018.05.001

Yu F, Xia W. The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporos. 2019;14(1):32. DOI: 10.1007/s11657-018-0549-y

Moon DK. Epidemiology, cause, and anatomy of osteonecrosis of the foot and ankle. Foot Ankle Clin. 2019;24(1):1-16. DOI: 10.1016/j.fcl.2018.10.001

Olstad K, Shea KG, Cannamela PC, Polousky JD, Ekman S, Ytrehus B, et al. Juvenile osteochondritis dissecans of the knee is a result of failure of the blood supply to growth cartilage and osteochondrosis. Osteoarthritis Cartilage. 2018;26(12):1691-8. DOI: 10.1016/j.joca.2018.06.019

Stewart S, Carroll M, Brenton-Rule A, Keys M, Bell L, Dalbeth N, et al. Region-specific foot pain and plantar pressure in people with rheumatoid arthritis: A cross-sectional study. Clin Biomech (Bristol, Avon). 2018;55:14-17. DOI: 10.1016/j.clinbiomech.2018.04.002

Solmaz D, Eder L, Aydin SZ. Update on the epidemiology, risk factors, and disease outcomes of psoriatic arthritis. Best Pract Res Clin Rheumatol. 2018;32(2):295-311. DOI: 10.1016/j.berh.2018.09.006

Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am. 2015;41(4):545-68. DOI: 10.1016/j.rdc.2015.07.001

Queiro R, Lorenzo A, Tejón P, Coto P, Pardo E. Obesity in psoriatic arthritis: Comparative prevalence and associated factors. Medicine (Baltimore). 2019;98(28):1. DOI: 10.1097/MD.0000000000016400

Dias IM, Cordeiro PC, Devito KL, Tavares M, Leite IC, Tesch Rde S. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis. Int J Oral Maxillofac Surg. 2016;45(3):313-7. DOI: 10.1016/j.ijom.2015.09.016

Priemel MH, Erler JME, Zustin J, Luebke AM, Stiel N, Spiro AS. Histological, epidemiological and anatomical analysis of 193 bone tumours of the scapula. J Bone Oncol. 2019;18:100258. DOI: 10.1016/j.jbo.2019.100258

Khan Z, Gerrish AM, Grimer RJ. An epidemiological survey of tumour or tumour like conditions in the scapula and periscapular region. SICOT J. 2016;2:34. DOI: 10.1051/sicotj/2016023

Loveless MS, Fry AL. Pharmacologic therapies in musculoskeletal conditions. Med Clin North Am. 2016;100(4):869-90. DOI: 10.1016/j.mcna.2016.03.015

Grodofsky S. Chronic pain in neurosurgery. Anesthesiol Clin. 2016;34(3):479-95. DOI: 10.1016/j.anclin.2016.04.003

British national formulary: BNF 76. 76 ed. London: Pharmaceutical Press; 2018. 1640 p.

Park HJ, Moon DE. Pharmacologic management of chronic pain. Korean J Pain. 2010;23(2):99-108. DOI: 10.3344/kjp.2010.23.2.99

Patanwala AE, Aljuhani O, Kopp BJ, Erstad BL. Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures. Am J Surg. 2017;214(4):738-42. DOI: 10.1016/j.amjsurg.2017.01.003

Friedman BW, Cisewski D, Irizarry E, Davitt M, Solorzano C, Nassery A, et al. A Randomized, double-blind, placebo-controlled trial of naproxen with or without orphenadrine or methocarbamol for acute low back pain. Ann Emerg Med. 2018;71(3):348-56. DOI: 10.1016/j.annemergmed.2017.09.031

Valtonen EJ. A double-blind trial of methocarbamol versus placebo in painful muscle spasm. Curr Med Res Opin. 1975;3(6):382-5. DOI: 10.1185/03007997509114791

Hidalgo DA, Pusic AL. The role of methocarbamol and intercostal nerve blocks for pain management in breast augmentation. Aesthet Surg J. 2005;25(6):571-5. DOI: 10.1016/j.asj.2005.09.003

Oliveras-Moreno JM, Hernandez-Pacheco E, Oliveras-Quintana T, Infante-Cossio P, Gutierrez-Perez JL. Efficacy and safety of sodium hyaluronate in the treatment of Wilkes stage II disease. J Oral Maxillofac Surg. 2008;66(11):2243-6. DOI: 10.1016/j.joms.2008.01.067

Emrich OM, Milachowski KA, Strohmeier M. [Methocarbamol in acute low back pain. A randomized double-blind controlled study]. MMW Fortschr Med. 2015;157 Suppl 5:9-16. DOI: 10.1007/s15006-015-3307-x

Dent RW, Ervin DK. Relief of acute musculoskeletal symptoms with intravenous methocarbamol (robaxin injectable): a placebo-controlled study. Curr Ther Res Clin Exp. 1976;20(5):661-5.

Lall JC, Gupta HL. Therapeutic trial of methocarbamol (Robinax) in tetanus neonatorum. Indian Pediatr. 1975;12(6):503-4.

Ignatowicz R, Gdakowicz B, Kowalczyk K, Zukowska-Walczyk E. Methocarbamol in the rehabilitation of spastic paresis in infantile cerebral palsy. Wiad Lek. 1974;27(17):1546-50.

Robin JP. Comparative study of the value of diazepam and methocarbamol in the treatment of backache. Vie Med Can Fr. 1973;2(5):442-3.

Bjerre I, Blennow G. Methocarbamol in the treatment of cerebral palsy in children. Neuropadiatrie. 1971;3(2):140-6. DOI: 10.1055/s-0028-1091806

Grisolia A, Thomson J. A clinical study of 46 males with low-back disorders treated with methocarbamol: a preliminary report from Veterans Administration Hospital, Grand Island, Nebraska. Clin Orthop Relat Res. 1959;13:299-306.

Lewis WB. Use of methocarbamol in orthopedics. Calif Med. 1959;90(1):26-8.

Park HW. Clinical results with methocarbamol, a new interneuronal blocking agent. J Am Med Assoc. 1958;167(2):168-72. DOI: 10.1001/jama.1958.02990190022005

Chou R, Peterson K, Helfand M. Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review. J Pain Symptom Manage. 2004;28(2):140-75. DOI: 10.1016/j.jpainsymman.2004.05.002

See S, Ginzburg R. Choosing a skeletal muscle relaxant. Am Fam Physician. 2008;78(3):365-70.

Looke TD, Kluth CT. Effect of preoperative intravenous methocarbamol and intravenous acetaminophen on opioid use after primary total hip and knee replacement. Orthopedics. 2013;36:25-32. DOI: 10.3928/01477447-20130122-54

Levine IM, Jossmann PB, Rudd J, De Angelis V. The quantitative evaluation intravenous methocarbamol of in the relief of spasticity. Neurology. 1968;18:69-74. DOI: 10.1212/wnl.18.1_part_1.69

Schlegelmilch R, Eydeler AU, Barkworth M, Radeke A. Bioequivalence study with two different oral formulations of methocarbamol in healthy subjects. A mono-centre, comparative, randomized, open-label, single-dose, 2-way crossover study. Arzneimittelforschung. 2009;59(5):238-42. DOI: 10.1055/s-0031-1296391

Preston KL, Wolf B, Guarino JJ, Griffiths RR. Subjective and behavioral effects of diphenhydramine, lorazepam and methocarbamol: evaluation of abuse liability. J Pharmacol Exp Ther. 1992;262(2):707-20.

Preston KL, Guarino JJ, Kirk WT, Griffiths RR. Evaluation of the abuse potential of methocarbamol. J Pharmacol Exp Ther. 1989;248(3):1146-57.

Scott RB, Tisdale SAJr, Cummings WB. Hemolytic potential of methocarbamol. Clin Pharmacol Ther. 1977;21(2):208-11. DOI: 10.1002/cpt1977212208

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Published

2019-11-22

How to Cite

1.
Jung H, Chae H. The Safety and Efficacy of Methocarbamol as a Muscle Relaxant with Analgesic Action: Analysis of Current Data. Innov Biosyst Bioeng [Internet]. 2019Nov.22 [cited 2024Dec.13];3(4):201-1. Available from: https://ibb.kpi.ua/article/view/183336

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