carisoprodol

(isomeprobamate)
(kar eye soe proe' dol)
Soma

Pregnancy Category C

Drug class
Centrally acting skeletal muscle relaxant

Therapeutic actions
Precise mechanism not known; chemically related to meprobamate, an anxiolytic; has
sedative properties; also found in animal studies to inhibit interneuronal activity in
descending reticular formation and spinal cord; does not directly relax tense skeletal
muscles.

Indications
• Relief of discomfort associated with acute, painful musculoskeletal conditions as
an adjunct to rest, physical therapy, and other measures

Contraindications and cautions

• Contraindicated with allergic or idiosyncratic reactions to carisoprodol,
meprobamate (reported cross-reactions with meprobamate); acute intermittent
porphyria, suspected porphyria, lactation.
• Use cautiously with renal or hepatic impairment, pregnancy.

Available forms
Tablets—350 mg

Dosages
ADULTS
350 mg PO tid–qid; take last dose hs.
PEDIATRIC PATIENTS
Not recommended for children < 12 yr.
GERIATRIC PATIENTS OR PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT
Dosage reduction may be necessary; monitor closely.

Pharmacokinetics
Route Onset Peak Duration
Oral 30 min 1–2 hr 4–6 hr
Metabolism: Hepatic; T1/2: 8 hr
Distribution: May cross placenta; enters breast milk
Excretion: Urine

Adverse effects
• CNS: Dizziness, drowsiness, vertigo, ataxia, tremor, agitation, irritability
 • CV: Tachycardia, orthostatic hypotension, facial flushing
• GI: Nausea, vomiting, hiccups, epigastric distress
• Hypersensitivity: Allergic or idiosyncratic reactions (seen with first to fourth
dose in patients new to drug)—rash, erythema multiforme, pruritus, eosinophilia,
fixed drug eruption; asthmatic episodes, fever, weakness, dizziness, angioneurotic
edema, smarting eyes, hypotension, anaphylactoid shock

Nursing considerations
Assessment
• History: Allergic or idiosyncratic reactions to carisoprodol, meprobamate; acute
intermittent porphyria, suspected porphyria; lactation
• Physical: T; skin color, lesions; orientation, affect; P, BP, orthostatic BP; bowel
sounds, liver evaluation; liver and kidney function tests, CBC

Interventions
• Reduce dose with liver dysfunction.
• Provide safety measures if CNS effects occur.

Teaching points
• Take this drug exactly as prescribed; do not take a higher dosage; take with food
if GI upset occurs.
• Avoid alcohol, sleep-inducing, or over-the-counter drugs; these could cause
dangerous effects; if you feel you need one of these preparations, consult your
health care provider.
• These side effects may occur: Drowsiness, dizziness, vertigo (avoid driving or
activities that require alertness); dizziness when you get up or climb stairs (avoid
sudden changes in position, use caution climbing stairs); nausea (take drug with
food; eat small, frequent meals); insomnia, headache, depression (transient
effects).
• Report rash, severe nausea, dizziness, insomnia, fever, difficulty breathing.

Adverse effects in Italic are most common; those in Bold are life-threatening.