Patient Education -- Medication Information

ANTI-INFLAMMATORIES
Celebrex, Vioxx

Description: Celecoxib (sell-a-COKS-ib) is used to relieve some symptoms caused by arthritis, such as inflammation, swelling, stiffness, and joint pain. However, this medicine does not cure arthritis and will help you only as long as you continue to take it. This medicine is available only with your doctor's prescription, in oral capsule form.

Before Using This Medicine: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For celecoxib, the following should be considered:

Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to celecoxib, other nonsteroidal anti-inflammatory drugs, aspirin or other salicylates, or sulfonamide-type medicines. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy--Celecoxib has not been studied in pregnant women. However, there is a chance that this medicine may cause unwanted effects on the heart or blood flow of the fetus or newborn baby if it is taken regularly during the last few months of pregnancy. Studies in animals have shown that celecoxib has caused birth defects of the ribs and
sternebrae. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding--It is not known whether celecoxib passes into breast milk. However, celecoxib may cause unwanted effects in nursing babies. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking celecoxib, it is especially important that your health care professional know if you are taking Aspirin, Fluconazole (e.g., Diflucan), or Lithium (e.g., Lithane).

Other medical problems--The presence of other medical problems may affect the use of celecoxib. Make sure you tell your doctor if you have any other medical problems, especially alcohol abuse, bleeding problems, stomach ulcer or other stomach or intestinal problems, tobacco use, anemia, asthma, dehydration, fluid retention (swelling of feet or lower legs), heart disease, high blood pressure, kidney disease, or liver disease. Celecoxib may make these conditions worse.

Proper Use of This Medicine: For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your health care professional. Taking too much of this medicine may increase the chance of unwanted effects.

Dosage: The dose of celecoxib will be different for different patients. Follow your doctor's orders or the directions on the label. If your dose is different, do not change it unless your doctor tells you to do so. The number of capsules that you take depends on the strength of the medicine, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking celecoxib. If your health care professional has ordered you to take this medicine according to a regular schedule, and you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the next dose and go back to your regular dosing schedule. Do not double doses.

Storage: To store this medicine, keep out of the reach of children. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine: If you will be taking this medicine for a long time, your doctor should check your progress at regular visits. Stomach problems may be more likely to occur if you drink alcoholic beverages while being treated with this medicine. Therefore, do not regularly drink alcoholic beverages while taking this medicine , unless otherwise directed by your doctor. Taking two or more of the nonsteroidal anti-inflammatory drugs together on a regular basis may increase the chance of unwanted effects. Also, taking acetaminophen, aspirin or other salicylates, or ketorolac (e.g., Toradol) regularly while you are taking a nonsteroidal anti-inflammatory drug may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your health care professional directs you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take acetaminophen or aspirin or other salicylates together with this medicine for more than a few days, and do not take any ketorolac (e.g., Toradol) while you are taking this medicine, unless your doctor has directed you to do so and is following your progress.

Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without any warning. However, possible warning signs often occur, including swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; and/or skin rash. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs. Check with your doctor immediately if fever, drowsiness, itching of the skin, tiredness, nausea, or stomach pain occurs; these effects may be the first signs of liver toxicity .

Celecoxib may cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin, other nonsteroidal anti-inflammatory drugs, or sulfonamide-type drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swellings of the eyelids or around the eyes. If these effects occur, get emergency help at once. Ask someone to drive you to the nearest hospital emergency room. If this is not possible, do not try to drive yourself. Call an ambulance, lie down, cover yourself to keep warm, and prop your feet higher than your head. Stay in that position until help arrives.

Side Effects of This Medicine: Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if you experience cough; fever; skin rash; sneezing; sore throat; swelling of face, fingers, feet, and/or lower legs, bloody or black tarry stools; burning feeling in chest or stomach; chills; congestion in chest; diarrhea; fatigue; loss of appetite; muscle aches and pains; nausea; shortness of breath; stomach pain (severe); tenderness in stomach area; unusual weight gain; vomiting of blood or material that looks like coffee grounds; or weakness.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome: back pain; dizziness; gas; headache; heartburn; inability to sleep; nausea; pain or burning in throat; stomach pain; stuffy or runny nose, anxiety; blurred vision; buzzing or ringing noise in ears; change in sense of taste; constipation; decreased appetite; depression; difficulty swallowing; dry mouth; fast heartbeat; increased sweating; joint or muscle pain or stiffness; loss of energy or weakness; nervousness; numbness or tingling in fingers and/or toes; pain or burning in throat; pounding heartbeat; sleepiness; sudden sweating and feelings of warmth; unusual tiredness; or vomiting. If you notice any other effects, check with your doctor.
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SKELETAL MUSCLE RELAXANTS
Robaxin, Skelaxin, Soma

Skeletal muscle relaxants are used to relax certain muscles in your body and relieve the stiffness, pain, and discomfort caused by strains, sprains, or other injury to your muscles. However, these medicines do not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem. Methocarbamol also has been used to relieve some of the muscle problems caused by tetanus.

Skeletal muscle relaxants act in the central nervous system (CNS) to produce their muscle relaxant effects. Their actions in the CNS may also produce some of their side effects.

These medicines are available in the oral tablet form. Sometimes, the medication is injected.

Before Using This Medicine: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For the skeletal muscle relaxants, the following should be considered:

Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to any of the skeletal muscle relaxants or to carbromal, mebutamate, meprobamate (e.g., Equanil), or tybamate. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy--Although skeletal muscle relaxants have not been shown to cause birth defects or other problems, studies on birth defects have not been done in pregnant women. Studies in animals with metaxalone have not shown that it causes birth defects.

Breast-feeding--Carisoprodol passes into the breast milk and may cause drowsiness or stomach upset in nursing babies. It is not known whether chlorphenesin, chlorzoxazone, metaxalone, or methocarbamol passes into the breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a skeletal muscle relaxant, it is especially important that your health care professional know if you are taking any of the following:

Other medical problems--The presence of other medical problems may affect the use of a skeletal muscle relaxant. Make sure you tell your doctor if you have any other medical problems, especially allergies, blood disease caused by an allergy or reaction to any other medicine, drug abuse or dependence, epilepsy, kidney disease, or liver disease.

Proper Use of This Medicine: Chlorzoxazone, metaxalone, or methocarbamol tablets may be crushed and mixed with a little food or liquid if needed to make the tablets easier to swallow.

Dosing--The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

Missed dose--If you miss a dose of this medicine and remember within an hour or so of the missed dose, take it right away. But, if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage--Keep out of the reach of children. Store away from heat and direct light. Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine: If you will be taking this medicine for a long time (for example, more than a few weeks), your doctor should check your progress at regular visits.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; other muscle relaxants; or anesthetics, including some dental anesthetics. Do not drink alcoholic beverages, and check with your doctor before taking any of the medicines listed above, while you are using this medicine .

Skeletal muscle relaxants may cause blurred vision or clumsiness or unsteadiness in some people. They may also cause some people to feel drowsy, dizzy, lightheaded, faint, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert, well-coordinated, and able to see well.

For diabetic patients: Metaxalone (e.g., Skelaxin) may cause false test results with one type of test for sugar in your urine. If your urine sugar test shows an unusually large amount of sugar, or if you have any questions about this, check with your health care professional. This is especially important if your diabetes is not well controlled.

Side Effects of This Medicine: Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor as soon as possible if you experience fainting; fast heartbeat; fever; hive-like swellings (large) on face, eyelids, mouth, lips, and/or tongue; mental depression; shortness of breath, troubled breathing, tightness in chest, and/or wheezing; skin rash, hives, itching, or redness; slow heartbeat (methocarbamol injection only); stinging or burning of eyes; stuffy nose and red or bloodshot eyes. Very rarely, you may experience blood in urine; bloody or black, tarry stools; convulsions (seizures) (methocarbamol injection only); cough or hoarseness; fast or irregular breathing; lower back or side pain; muscle cramps or pain (not present before treatment or more painful than before treatment); painful or difficult urination; pain, tenderness, heat, redness, or swelling over a blood vessel (vein) in arm or leg (methocarbamol injection only); pinpoint red spots on skin; puffiness or swelling of the eyelids or around the eyes; sores, ulcers, or white spots on lips or in mouth; sore throat and fever with or without chills; swollen and/or painful glands; unusual bruising or bleeding; unusual tiredness or weakness; vomiting of blood or material that looks like coffee grounds; yellow eyes or skin, blurred or double vision or any change in vision; dizziness or lightheadedness; or drowsiness.

Less common or rare side effects include abdominal or stomach cramps or pain; clumsiness or unsteadiness; confusion; constipation; diarrhea; excitement, nervousness, restlessness, or irritability; flushing or redness of face; headache; heartburn; hiccups; muscle weakness; nausea or vomiting; pain or peeling of skin at place of injection (methocarbamol only); trembling; trouble in sleeping; or uncontrolled movements of eyes (methocarbamol injection only).

In addition to the other side effects listed above, chlorzoxazone may cause your urine to turn orange or reddish purple. Methocarbamol may cause your urine to turn black, brown, or green. This effect is harmless and will go away when you stop taking the medicine. However, if you have any questions about this, check with your doctor.
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NARCOTIC ANALGESICS AND ACETAMINOPHEN (Systemic)
Darvocet, Lortab 7.5, Percocet

Combination medicines containing narcotic analgesics(nar-KOT-ik an-al-JEE-zicks) and (a-seat-a-MIN-oh-fen) are used to relieve pain. A narcotic analgesic and acetaminophen used together may provide better pain relief than either medicine used alone. In some cases, relief of pain may come at lower doses of each medicine.

Narcotic analgesics act in the central nervous system (CNS) to relieve pain. Many of their side effects are also caused by actions in the CNS. When narcotics are used for a long time, your body may get used to them so that larger amounts are needed to relieve pain. This is called tolerance to the medicine. Also, when narcotics are used for a long time or in large doses, they may become habit-forming (causing mental or physical dependence). Physical dependence may lead to withdrawal symptoms when you stop taking the medicine.

Acetaminophen does not become habit-forming when taken for a long time or in large doses, but it may cause other unwanted effects, including liver damage, if too much is taken. These medicines are available in oral tablet or capsule form.

Before Using This Medicine: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For narcotic analgesic and acetaminophen combinations, the following should be considered:

Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to acetaminophen or to a narcotic analgesic. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.
Pregnancy--For acetaminophen: Although studies on birth defects with acetaminophen have not been done in pregnant women, it has not been reported to cause birth defects or other problems. For narcotic analgesics: Although studies on birth defects with narcotic analgesics have not been done in pregnant women, they have not been reported to cause birth defects. However, hydrocodone caused birth defects in animal studies when very large doses were used. Codeine did not cause birth defects in animals, but it caused slower development of bones and other toxic or harmful effects in the fetus. Pentazocine and propoxyphene did not cause birth defects in animals. There is no information about whether dihydrocodeine or oxycodone causes birth defects in animals. Too much use of a narcotic during pregnancy may cause the fetus to become dependent on the medicine. This may lead to withdrawal side effects in the newborn baby. Also, some of these medicines may cause breathing problems in the newborn baby if taken just before or during delivery. For caffeine: Studies in humans have not shown that caffeine (contained in some of these combination medicines) causes birth defects. However, studies in animals have shown that caffeine causes birth defects when given in very large doses (amounts equal to those present in 12 to 24 cups of coffee a day).

Breast-feeding--Acetaminophen, codeine, and propoxyphene pass into the breast milk. It is not known whether other narcotic analgesics pass into the breast milk. However, these medicines have not been reported to cause problems in nursing babies.

Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking a narcotic analgesic and acetaminophen combination, it is especially important that your health care professional know if you are taking any of the following: Carbamazepine, Central nervous system (CNS) depressants, Tricyclic antidepressants, or Zidovudine.

Other medical problems--The presence of other medical problems may affect the use of narcotic analgesic and acetaminophen combinations. Make sure you tell your doctor if you have any other medical problems, especially alcohol and/or other drug abuse, brain disease or head injury, colitis, convulsions (seizures), emotional problems or mental illness, emphysema, asthma, or other chronic lung disease, hepatitis or other liver disease, kidney disease, underactive thyroid, enlarged prostate or problems with urination, gallbladder disease or gallstones, or heart disease.

Proper Use of This Medicine: Take this medicine only as directed by your medical doctor or dentist. Do not take more of it, do not take it more often, and do not take it for a longer time than your medical doctor ordered. If too much of a narcotic analgesic is taken, it may become habit-forming (causing mental or physical dependence) or lead to medical problems because of an overdose. Taking too much acetaminophen may cause liver damage. If you think that this medicine is not working properly after you have been taking it for a few weeks, do not increase the dose. Instead, check with your medical doctor.

Dosing--The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

Missed dose--If your medical doctor or dentist has ordered you to take this medicine according to a regular schedule and you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage--Keep out of the reach of children. Overdose is very dangerous in young children. Store away from heat and direct light. Do not store tablets or capsules in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Keep the liquid forms of this medicine from freezing. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine: If you will be taking this medicine for a long time or in high doses, your doctor should check your progress at regular visits. The narcotic analgesic in this medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; other prescription pain medicine or narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Also, there may be a greater risk of liver damage if you drink three or more alcoholic beverages while you are taking acetaminophen. Do not drink alcoholic beverages, and check with your medical doctor before taking any of the medicines listed above while you are using this medicine.

Too much use of the acetaminophen in this combination medicine together with certain other medicines may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your doctor directs you to take these medicines together on a regular basis, follow his or her directions carefully.

This medicine may cause some people to become drowsy, dizzy, or lightheaded, or to feel a false sense of well-being. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and clearheaded. Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Nausea or vomiting may occur, especially after the first couple of doses. This effect may go away if you lie down for a while. However, if nausea or vomiting continues, check with your medical doctor. Lying down for a while may also help relieve some other side effects, such as dizziness or lightheadedness, that may occur. Before having any kind of surgery or emergency treatment, tell the medical doctor in charge that you are taking this medicine.
Narcotic analgesics may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections. If you have been taking this medicine regularly for several weeks or more, do not suddenly stop taking it without first checking with your doctor. Your doctor may want you to reduce gradually the amount you are taking before stopping completely, to lessen the chance of withdrawal side effects. This will depend on which of these medicines you have been taking, and the amount you have been taking every day.

If you think you or someone else may have taken an overdose of this medicine, get emergency help at once. Taking an overdose of this medicine or taking alcohol or CNS depressants with this medicine may lead to unconsciousness or death. Signs of overdose of narcotics include convulsions (seizures), confusion, severe nervousness or restlessness, severe dizziness, severe drowsiness, shortness of breath or troubled breathing, and severe weakness. Signs of severe acetaminophen overdose may not occur until several days after the overdose is taken.

Side Effects of This Medicine: Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Get emergency help immediately if any of the following symptoms of overdose occur: cold, clammy skin; confusion (severe); convulsions (seizures); diarrhea; dizziness (severe); drowsiness (severe); increased sweating; low blood pressure; nausea or vomiting (continuing); nervousness or restlessness (severe); pinpoint pupils of eyes; shortness of breath or unusually slow or troubled breathing; slow heartbeat; stomach cramps or pain; or weakness (severe). Also, check with your doctor as soon as possible if you experience black, tarry stools; bloody or cloudy urine; confusion; dark urine; difficult or painful urination; fast, slow, or pounding heartbeat; frequent urge to urinate; hallucinations (seeing, hearing, or feeling things that are not there); increased sweating; irregular breathing or wheezing; mental depression; pain in lower back and/or side (severe and/or sharp); pale stools; pinpoint red spots on skin; redness or flushing of face; ringing or buzzing in ears; skin rash, hives, or itching; sore throat and fever; sudden decrease in amount of urine; swelling of face; trembling or uncontrolled muscle movements; unusual bleeding or bruising; or yellow eyes or skin.

After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on which of these medicines you were taking, the amount of medicine you were using, and how long you used it. During this time check with your doctor if you notice any of the following side effects: body aches; diarrhea; fast heartbeat; fever, runny nose, or sneezing; gooseflesh; increased sweating; increased yawning; loss of appetite; nausea or vomiting; nervousness, restlessness, or irritability; shivering or trembling; stomach cramps; trouble in sleeping; or weakness.
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CYCLOBENZAPRINE (Systemic)
Flexeril
Category: Skeletal muscle relaxant

Cyclobenzaprine (sye-kloe-BEN-za-preen) is used to help relax certain muscles in your body. It helps relieve the pain, stiffness, and discomfort caused by strains, sprains, or injuries to your muscles. However, this medicine does not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem. Cyclobenzaprine acts on the central nervous system (CNS) to produce its muscle relaxant effects. Its actions on the CNS may also cause some of this medicine's side effects. Cyclobenzaprine is available only with your doctor's prescription, in the form of oral tablets.

Before Using This Medicine: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For cyclobenzaprine, the following should be considered:

Allergies--Tell your doctor if you have ever had any unusual or allergic reaction to cyclobenzaprine. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy--Studies on birth defects with cyclobenzaprine have not been done in humans. However, cyclobenzaprine has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding--It is not known whether cyclobenzaprine passes into breast milk. Although most medicines pass into the breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Other medicines--Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking cyclobenzaprine, it is especially important that your health care professional know if you are taking alcohol, Central nervous system (CNS) depressants, Tricyclic antidepressants, protriptyline, trimipramine, Monoamine oxidase (MAO) inhibitors, or tranylcypromine.

Other medical problems--The presence of other medical problems may affect the use of cyclobenzaprine. Make sure you tell your doctor if you have any other medical problems, especially glaucoma, problems with urination, heart or blood vessel disease, or
overactive thyroid.

Proper Use of This Medicine: Take this medicine only as directed by your doctor. Do not take more of it and do not take it more often than your doctor ordered. To do so may increase the chance of serious side effects.

Dosing--The dose of cyclobenzaprine will be different for different people. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of cyclobenzaprine. If your dose is different, do not change it unless your doctor tells you to do so.

Missed dose--If you miss a dose of this medicine and remember within an hour or so of the missed dose, take it right away. Then go back to your regular dosing schedule. But if you do not remember until later, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage--Keep out of the reach of children. Store away from heat and direct light. Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine: This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; other muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine .

This medicine may cause some people to have blurred vision or to become drowsy, dizzy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and able to see well.

Cyclobenzaprine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Side Effects of This Medicine: Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. The following side effects may mean that you are having a serious allergic reaction to the medicine. Get emergency help right away if any of them occur. Rare side effects include changes in the skin color of the face; fast or irregular breathing; large swellings that look like hives on the face, eyelids, mouth, lips, and/or tongue; puffiness or swelling of the eyelids or the area around the eyes; shortness of breath, troubled breathing, tightness in chest, and/or wheezing; skin rash, hives, or itching. Check with your doctor immediately if you experience fainting, convulsions (seizures); drowsiness (severe); dry, hot, flushed skin; fast or irregular heartbeat; hallucinations (seeing, hearing, or feeling things that are not there); increase or decrease in body temperature; troubled breathing; unexplained muscle stiffness; unusual nervousness or restlessness (severe); vomiting (occurring together with other symptoms of overdose); clumsiness or unsteadiness; confusion; mental depression or other mood or mental changes; problems in urinating; ringing or buzzing in the ears; skin rash, hives, or itching occurring without other symptoms of an allergic reaction listed above; unusual thoughts or dreams; yellow eyes or skin. More common side effects include blurred vision; dizziness or lightheadedness; drowsiness; or dryness of mouth. Less common side effects include bloated feeling or gas, indigestion, nausea or vomiting, or stomach cramps or pain; constipation; diarrhea; excitement or nervousness; frequent urination; general feeling of discomfort or illness; headache; muscle twitching; numbness, tingling, pain, or weakness in hands or feet; pounding heartbeat; problems in speaking; trembling; trouble in sleeping; unpleasant taste or other taste changes; unusual muscle weakness; or unusual tiredness.

Additional Information: Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, cyclobenzaprine is used in certain patients with fibromyalgia syndrome (also called fibrositis or fibrositis syndrome). There is no additional information relating to proper use, precautions, or side effects for this use of cyclobenzaprine.
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