Methocarbamol

Indications
 Oral
Painful muscle spasm associated with musculoskeletal conditions
Adult: Initially: 1.5 g 4 times daily, reduced according to response after 2-3 days. Maintenance: 2.25-4 g daily in divided doses. Max dose 8 g daily.
Elderly: Dose may need to be reduced by half.
Intravenous
Painful muscle spasm associated with musculoskeletal conditions
Adult: 1 g administered by slow inj or infusion at a rate not faster than 300 mg/min. In cases where patients are not able to continue with oral therapy, additional doses of 1 g every 8 hr may be used for up to 3 consecutive days. Max 3 g daily.
Elderly: Dose may need to be reduced by half.
Intramuscular
Painful muscle spasm associated with musculoskeletal conditions
Adult: Up to 500 mg into each gluteal region at intervals of 8 hr. In cases where patients are not able to continue with oral therapy, additional doses of 1 g every 8 hr may be used for up to consecutive 3 days. Max 3 g daily.
Elderly: Dose may need to be reduced by half.
Intravenous
Tetanus
Adult: Initial total dose: 3 g with 1-2 g via direct inj at a rate of 300 mg/minute and the remainder 1-2 g may be administered via infusion. Repeat infusion of 1-2 g every 6 hr until a nasogastric tube can be inserted. Tablets may be crushed and suspended in water or saline solutions and administered through the nasogastric tube. Total oral dosage of up to 24 g daily may be needed.
Child: 15 mg/kg or 500 mg/m2 given by IV inj (suggested rate 180 mg/m2/min). Dose may be repeated every 6 hr if necessary by IV inj or infusion. Max dose 1.8 g/m2 daily for 3 consecutive days.
Contraindications
 Coma or pre-coma states, brain damage, myasthenia gravis Do not admin parenteral solutions in patients with renal impairment, epilepsy or history of epilepsy.
Warnings / Precautions
 Renal or hepatic impairment; acidosis. Pregnancy and lactation. May impair ability to drive or operate machinery. Children ≤12 yr.
Adverse Reactions
 Nausea, anorexia, lassitude, drowsiness, dizziness, restlesness, anxiety, confusion, fever, headache, blurred vision, convulsions; hypersensitivity reactions e.g. rashes, pruritus, urticaria, angiodema. Parenteral: Flushing and a metallic taste; incoordination, diplopia, nystagmus, vertigo; sloughing and thrombophloebitis at the site of inj.
Potentially Fatal: Parenteral: Syncope, hypotension, bradycardia, anaphylaxis.
Overdose Reactions
 Manage with symptomatic and supportive treatment.
Drug Interactions
 Action potentiated by alcohol and other CNS depressants. May inhibit effect of pyridostigmine, use with caution with anticholinesterase agents.
See Below for More methocarbamol Drug Interactions
Lab Interactions
 May cause colour interference in screening tests for 5-hydroxyindoleacetic acid using nitrosonaphthol reagent and in screening tests for urinary vanillylmandelic acid using the Gitlow method.
Mechanism of Actions
 Methocarbamol is a centrally acting skeletal muscle relaxant whose precise mode of action is not known. It is said to cause general depression of the central nervous system.
Absorption: Rapidly and almost completely absorbed from the GI tract. Peak plasma concentration in 1-2 hr (oral).
Distribution: Plasma protein boumd 46-50%. Crosses placenta.
Metabolism: Metabolised by dealkylation and hydroxylation.
Excretion: Via urine as metabolites and unchanged drug. 1-2 hr (elimination half-life).
Administration
 May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
Storage Conditions
 Intramuscular: Store at 20-25°C Intravenous: Store at 20-25°C Oral: Store at 20-25°C
ATC Classification
 M03BA03 - methocarbamol ; Belongs to the class of carbamic esters. Used as centrally-acting muscle relaxants.
Storage
 Intramuscular: Store at 20-25°C Intravenous: Store at 20-25°C Oral: Store at 20-25°C
Available As
  • Methocarbamol 100 mg
  • Methocarbamol 1000 mg
  • Methocarbamol 250 mg
  • Methocarbamol 350 mg
  • Methocarbamol 400 mg
  • Methocarbamol 500 mg
  • Methocarbamol 750 mg

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