Carisoprodol has been subject to abuse, misuse, and criminal diversion for nontherapeutic use [ see Warnings and Precautions 5. Abuse Abuse of Carisoprodol poses a risk of overdosage which may lead to death, CNS and respiratory depression, hypotension, seizures and other disorders [ see Warnings and Precautions 5.
Patients at high risk of Carisoprodol abuse may include those with prolonged use of Carisoprodol, with a history of drug abuse, or those who use Carisoprodol in combination with other abused drugs. Prescription drug abuse is the intentional non-therapeutic use of a drug, even once, for its rewarding psychological effects. Drug addiction, which develops after repeated drug abuse, is characterized by a strong desire to take a drug despite harmful consequences, difficulty in controlling its use, giving a higher priority to drug use than to obligations, increased tolerance, and sometimes physical withdrawal.
Drug abuse and drug addiction are separate and distinct from physical dependence and tolerance for example, abuse or addiction may not be accompanied by tolerance or physical dependence [ see Drug Abuse and Dependence 9. Dependence Tolerance is when a patient's reaction to a specific dosage and concentration is progressively reduced in the absence of disease progression, requiring an increase in the dosage to maintain the same.
Physical dependence is characterized by withdrawal symptoms after abrupt discontinuation or a significant dose reduction of a drug. Both tolerance and physical dependence have been reported with the prolonged use of Carisoprodol. Reported withdrawal symptoms with Carisoprodol include insomnia, vomiting, abdominal cramps, headache, tremors, muscle twitching, anxiety, ataxia, hallucinations, and psychosis.
Instruct patients taking large doses of Carisoprodol or those taking the drug for a prolonged time to not abruptly stop Carisoprodol [ see Warnings and Precautions 5. Serotonin syndrome has been reported with Carisoprodol intoxication. Many of the Carisoprodol overdoses have occurred in the setting of multiple drug overdoses including drugs of abuse, illegal drugs, and alcohol. The effects of an overdose of Carisoprodol and other CNS depressants e.
Fatal accidental and non-accidental overdoses of Carisoprodol have been reported alone or in combination with CNS depressants. Basic life support measures should be instituted as dictated by the clinical presentation of the Carisoprodol overdose. Vomiting should not be induced because of the risk of CNS and respiratory depression, and subsequent aspiration. Store at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle.
Carisoprodol is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription. Dosage Information in more detail What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at An overdose of carisoprodol can be fatal, especially if you take this medicine with alcohol or with other drugs that can slow your breathing.
Overdose symptoms may include vision problems, confusion, hallucinations, muscle stiffness, weak or shallow breathing, fainting, or coma. What should I avoid while taking carisoprodol? Carisoprodol may impair your thinking or reactions.
Avoid driving or operating machinery until you know how this medicine will affect you. Meprobamate and other muscle-relaxing drugs often were subjects of misuse in the s and 60s. Withdrawal of the drug after extensive use may require hospitalization in medically compromised patients. In severe cases the withdrawal can mimic the symptoms of alcohol withdrawal including the potentially lethal status epilepticus. Psychological dependence has also been linked to carisoprodol use although this is much less severe than with meprobamate itself presumably due to the slower onset of effects.
Psychological dependence is more common in those who abuse carisoprodol and those who have a history of drug abuse particularly sedatives or alcohol. It may reach clinical significance before physiological tolerance and dependence have occurred and as with benzodiazepines has been demonstrated to persist to varying degrees of severity for months or years after discontinuation. Psychotherapy and cognitive behavior therapy have demonstrated moderate success in reducing the rebound anxiety which results upon carisoprodol discontinuation but only when combined with regular and active attendance to a substance abuse support group.
Carisoprodol withdrawal can be life-threatening especially in high dose users and those who attempt to quit " cold turkey ". Medical supervision is recommended, with gradual reduction of dose of carisoprodol or a substituted medication, typical of other depressant drugs. Overdose symptoms are similar to those of other gabaminergics including excessive sedation and unresponsiveness to stimuli, severe ataxia , amnesia , confusion , agitation , intoxication and inappropriate potentially violent behavior.
Severe overdoses may present with respiratory depression and subsequent pulmonary aspiration , coma , and death. Carisoprodol is not detected on all toxicology tests which may delay diagnosis of overdose. Overdose symptoms in combination with opiates are similar but are distinguished by the presentation of normal or pinpoint pupils , which are generally unresponsive to light.
Carisoprodol as with its metabolite meprobamate is particularly dangerous in combination with alcohol. Flumazenil the benzodiazepine antidote is not effective in the management of carisoprodol overdose as carisoprodol acts at the barbiturate binding site.
Treatment mirrors that of barbiturate overdoses and is generally supportive, including the administration of mechanical respiration and pressors as implicated and in rare cases, bemegride.
Total amnesia of the experience is not uncommon following recovery. Pharmacokinetics Carisoprodol has a rapid, minute onset of action, with the aforementioned effects lasting about two to six hours.
It is metabolized in the liver via the cytochrome P oxidase isozyme CYP2C19 , excreted by the kidneys and has about an eight-hour half-life.
Misuse of habit-forming medicine can cause addiction, overdose, or death. Take carisoprodol exactly as it was prescribed for you. There are no data on the use of Carisoprodol during human pregnancy. In recreational drug users, deaths have resulted from carelessly combining overdoses of hydrocodone and carisoprodol. It may reach clinical significance before physiological tolerance and dependence have occurred and as with benzodiazepines has been demonstrated to persist to varying degrees of severity for months or years after discontinuation. Carisoprodol is present as a racemic mixture. Rats exposed to meprobamate in-utero showed behavioral alterations that persisted into adulthood. Keep track of the amount of medicine used from each new bottle. How should I take carisoprodol? Treatment mirrors that of barbiturate overdoses and is generally supportive, including the administration of mechanical respiration and pressors as implicated and in rare cases, bemegride. Meprobamate and other muscle-relaxing drugs often were subjects of misuse in the s and s, carisoprodol 350mg controlled substance.
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