Cyclobenzaprine is an oral prescription medication, indicated for treatment of pain associated with muscle spasm due to acute musculoskeletal conditions. Examples of common painful conditions for which cyclobenzaprine could be used include fibromyalgia, low back pain, and neck pain.

Cyclobenzaprine belongs to a heterogeneous class of medications known as muscle relaxants., More specifically, it is classified as an anti-spasmodic. It is structurally similar to the tricyclic antidepressants (e.g. amitriptyline), and has similar associated side effects including drowsiness, dizziness and dry mouth; according to the product monograph, these adverse effects occur in 39%, 27%, and 11% of patients, respectively.

Owing to its anticholinergic activity and long half-life, cyclobenzaprine is not recommended for use in the elderly. The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults recommend that muscle relaxants including cyclobenzaprine be avoided in the elderly; this is classified as a strong recommendation with a moderate level of evidence.

According to the product monograph, “cyclobenzaprine should be used only for short periods (up to two or three weeks), because adequate evidence of effectiveness for more prolonged use is not available”.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• Appendix 1 Selection of Included Studies
• Appendix 2 Summary of Study Characteristics
• Appendix 3 Summary of Critical Appraisal of Included Reports
• Appendix 4 Summary of Results of Included Systematic Reviews and RCTs
• Appendix 5 Summary of Recommendations from Included Guidelines

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.