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Muscle Relaxants: What You Should Know What are muscle relaxants? Muscle relaxants are prescription drugs used to treat muscles that are stiff and rigid (muscle spasticity) or painful (muscle spasms). Each drug has different ingredients, and each works in its own way. Muscle spasticity is a condition in which the muscles are stiff and rigid and make jerky movements. This is the result of damage to parts of the brain or spinal cord that control movement. The damage can be caused by conditions such as cerebral palsy, MS, injury to the spinal cord, or a stroke. Spasticity can be very painful, keep you from going about your daily life normally, and last a long time. Muscles spasms cause pain when you move. The pain comes from stress on the muscles and bones. It can be caused by tension headaches, neck or back pain, or fibromyalgia. Muscle spasms usually do not last very long, but they can be very painful, and they can recur. Which muscle relaxant is best for me? You and your doctor will have to consider your condition and the benefits and risks of each drug. You may have to try two or more drugs before you find one that works for you. Studies do not show for sure that one drug is better than another. And each person reacts differently to different drugs. Muscle relaxants cause side effects. All muscle relaxants cause sedation—or a sleepy feeling —in most people. This can be helpful if pain keeps you awake. But it can be dangerous for pilots, drivers, and people who operate machines. Other side effects vary by drug and can include addiction, dizziness or lightheadedness, dry mouth, liver damage, and weakness. Over-the-counter and nondrug treatments may work as well. For muscle spasms, muscle relaxants are not the first therapy choice. Acetaminophen (Tylenol) and NSAIDs, such as ibuprofen (Advil and generic) and naproxen (Aleve and generic), relieve pain and inflammation. They may also help relieve pain that comes with stiff, rigid muscles (spasticity). There are also nondrug therapies, such as heat, chiropractic care, yoga, relaxation, and acupuncture, that can help. Talk to your doctor about trying these before using a muscle relaxant. Our advice: We compared cost, safety, and how well muscle relaxants work to treat muscle spasticity and muscle spasms. We chose these as our Consumer Reports Best Buy Drugs: For muscle spasticity—generic baclofen. If baclofen causes intolerable side effects, we recommend generic tizanidine. We do not recommend taking dantrolene because of the risk of serious liver damage. For muscle spasms—generic cyclobenzaprine. If cyclobenzaprine does not work or causes intolerable side effects, we recommend trying generic methocarbamol or chlorzoxazone. We do not recommend taking carisoprodol (Soma) because of the risk of abuse or addiction. Each muscle relaxant has different ingredients and each works in its own way. Ask your doctor about the risks, benefits, and costs of each. Muscle Relaxants: Drug Comparison Chart* Consumer Reports Best Buy Drugs are in blue. We recommend these drugs because they work as well and are as safe as the other drugs, and they cost less. Our analysis is based on a scientific review by the Oregon Health and Science University-based Drug Effectiveness Review Project. This is a summary of a longer, more detailed report you can find at www.CRBestBuyDrugs.org. Best Generic Name & Strength Brand Name A Pills per Buy Day B Approved Use Average Cost per Month C Baclofen 10 mg Generic Three Spasticity $27 Baclofen 20 mg Generic Three Spasticity $60 Carisoprodol 350 mg tablet Generic Three Spasms $11 Chlorzoxazone 500 mg tablet Generic Three – Four Spasms $8 – $11 Chlorzoxazone 500 mg tablet Parafon Forte DSC Three – Four Spasms $63 – $84 Cyclobenzaprine 5 mg tablet Generic Three Spasms $15 Cyclobenzaprine 10 mg tablet Generic Three Spasms $8 Cyclobenzaprine 5 mg tablet Flexeril Three Spasms $42 Cyclobenzaprine 10 mg tablet Flexeril Three Spasms $42 Dantrolene 50 mg capsule Dantrium Three – Four Spasticity $165 – $220 Dantrolene 100 mg capsule Dantrium Three – Four Spasticity $231 – $308 Methocarbamol 500 mg tablet Generic Four Spasms $11 Methocarbamol 500 mg tablet Robaxin Four Spasms $56 Tizanidine 2 mg tablet Generic Three Spasticity $81 Tizanidine 2 mg tablet Zanaflex Three Spasticity $195 * Due to space limitations, this chart does not list all muscle relaxants. For a more complete list, see the full report at www.CRBestBuyDrugs.org. A “Generic” indicates that this drug is sold under its generic name. B Depending on your health conditions, symptoms, and response to the medicine, your doctor may adjust your dose to be either higher or lower than what is stated in this price chart. C Prices are based on nationwide average retail prices for August 2009. Consumer Reports Best Buy Drugs obtained prices from data provided by Source Healthcare Analytics, LLC., which is not involved in our analysis or recommendations. This series is produced by Consumer Reports and Consumer Reports Best Buy Drugs, a public information project supported by grants from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin. This brief should not be viewed as a substitute for a consultation with a medical or health professional. It is provided to enhance communication with your doctor, not replace it.