What is Cyclobenzaprine Used For?

Cyclobenzaprine is a prescription muscle relaxer commonly used to treat muscle spasms. You may know this drug by its most common brand names: Flexeril, Amrix, Fexmid, and FusePaq Tabradol.

This cost-effective muscle relaxer is usually prescribed if musculoskeletal pain does not improve after trying physical therapy and over-the-counter medications. It also has several off-label uses, chief among them including as a treatment for insomnia.

Cyclobenzaprine requires a prescription, regardless of dosage or intended use. It is not a controlled substance at the federal level and was approved by the FDA in 2007.

How is cyclobenzaprine used?

Cyclobenzaprine is approved by the FDA as a treatment for musculoskeletal pain. It also has numerous off-label uses, such as treating insomnia or tension headaches.

Musculoskeletal pain can be a debilitating condition. In addition to the chronic pain, irregular sleep and fatigue are common complications for those afflicted. Cyclobenzaprine helps to treat this pain and make sleep easier for many patients, improving their quality of life.

In a study measuring cyclobenzaprine’s effect on acute muscle spasms, patients not only experienced relief from their muscle spasms, but also reported reduced local pain and tenderness.

Cyclobenzaprine is used in conjunction with rest and physical therapy to treat pain and stiffness caused by muscle injuries, strains, and sprains.

Common off-label uses for cyclobenzaprine

While cyclobenzaprine is a muscle relaxer, it’s commonly prescribed off-label for other conditions.

Off-label prescribing is when a doctor prescribes medication as treatment for a condition other than what the FDA has approved it for. Medications are approved by the FDA to treat specific conditions, but doctors are permitted to prescribe medications “off-label” when they deem it medically appropriate for their patients.

This is such a common practice that as many as one in five of all medications are prescribed to treat off-label conditions.

Cyclobenzaprine is commonly prescribed off-label for the following conditions:

Sleep disorders

In low doses, cyclobenzaprine can help you get to sleep faster and stay asleep longer. In one particular study, patients took a low dose of cyclobenzaprine over an eight week period. Patients reported a decrease in musculoskeletal pain, improvement in tenderness, decrease in Hospital Anxiety and Depression (HAD) score, and reduced fatigue.

By treating some of the physical barriers that can interfere with sleep, cyclobenzaprine can be an effective sleep aid for those with insomnia. At Kick, cyclobenzaprine is one of the medications we prescribe as part of our sleep programs.

Fibromyalgia

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain, affecting six percent of American adults. Researchers believe fibromyalgia amplifies painful sensations by affecting the way the brain and spinal cord process painful and non-painful signals. Cyclobenzaprine is one of the handful of medications recommended as a fibromyalgia treatment.

Tension headaches

Tension headaches are the most common form of headache. They involve pain or discomfort in the head, scalp, or neck and associated muscle tension in these areas. This muscle tightness can be a response to stress, depression, anxiety, or physical injury.

Roughly three percent of people experience daily, chronic headaches, including tension and migraine headaches. Treatment for this condition usually includes tricyclic antidepressants. As a tricyclic antidepressant derivative, cyclobenzaprine can be an effective option when others fail. It’s worth noting, however, that it's not typically the first choice as a prophylactic to chronic tension headaches.

Tricyclic antidepressants, and more specifically amitriptyline, are widely tolerated and have a long history in the treatment of chronic tension headaches.

Tinnitus

Tinnitus is categorized by experiencing an internal sound sensation that is not from an external source. Often, this presents as a ‘ringing’ in the patient’s ears or temporarily losing a portion of hearing from one ear due to white noise.

Currently, there aren’t any over the counter medications to alleviate tinnitus. Prescription options for treatment typically include drugs in the antianxiety and tricyclic antidepressant class. However, there have been some promising studies showing cyclobenzaprine as a potential option to help treat tinnitus.

Myofascial pain

Myofascial pain, specifically due to temporomandibular disorders (TMDs), is a pain syndrome where pressure on sensitive muscular points causes pain and dysfunction in the jaw joint and muscles.

Although some studies have suggested that cyclobenzaprine can help alleviate jaw pain for those with TMDs, these studies were both small and inconclusive. There’s currently insufficient evidence to support the use of cyclobenzaprine over other, more researched treatments for TMDs, such as tricyclic antidepressants and antianxiety medications.

Posttraumatic stress disorder (PTSD)

Cyclobenzaprine may potentially help those with PTSD, but research is extremely limited and ongoing. In 2021, researchers demonstrated “dose effects” from cyclobenzaprine and symptom improvement for those suffering from military-related PTSD.  However, the patient population in this study was 93% male, and is considered a ‘proof of concept’ at its present stage.

The National Center for PTSD says “almost everyone” afflicted with PTSD struggles with a sleep disturbance, whether it’s from nightmares or insomnia. By promoting drowsiness and relieving musculoskeletal tension, cyclobenzaprine can lessen insomnia symptoms. Combined with Cognitive Behavioral Therapy for Insomnia (CBT-I), cyclobenzaprine can be an effective tool for improving sleep for good.

How cyclobenzaprine works

Cyclobenzaprine’s mechanism of action isn’t fully understood. Currently, it’s believed that cyclobenzaprine works within the brainstem, reducing motor activity and affecting some of the neurons involved with muscle tone and contraction. By limiting the excitability of these neurons, contracted muscles release and the associated discomfort is relieved.

Similar to a dimmer switch that controls the brightness of a lamp by adjusting the flow of electricity, cyclobenzaprine adjusts the flow of nerve impulses and lowers muscle activity.

Additionally, cyclobenzaprine has some structural similarity to tricyclic antidepressants, such as amitriptyline or nortriptyline. However, it  is not known to have significant antidepressant effects.  Unlike muscle relaxers, tricyclic antidepressants primarily work  by reducing the reuptake (absorption) of certain neurochemicals, such as serotonin and norepinephrine.

While cyclobenzaprine’s sedative effect is also likely due to its modulating effects on neurotransmitters, it has a different therapeutic use from tricyclic antidepressants.

Why cyclobenzaprine is used for better sleep

Muscle relaxers are considered a viable treatment option for sleep disorders because they have a high incidence of drowsiness. This is why cyclobenzaprine, particularly in very low doses, is prescribed for better sleep. It’s even proven effective for helping patients with fibromyalgia sleep better.

For those struggling with poor sleep or sleep disorders like insomnia, cyclobenzaprine’s mild sedative effect can bridge the gap between a long night staring at your phone or a good night’s rest. It’s also a generally safer alternative to Z-drugs such as Ambien.

While cyclobenzaprine can help improve your sleep and form better sleep patterns, it may not be right for everyone. Above all, it should not be relied upon solely and should be used in conjunction with Cognitive Behavioral Therapy for Insomnia (CBT-I) to improve the quality of your sleep over the long term.

As always, consult with your doctor to find the best treatment plan for your individual care.

Cyclobenzaprine side effects

Like all medications, cyclobenzaprine can have unintended effects in addition to its therapeutic benefits. These are known as side effects.

Not all patients will experience side effects and they can vary from patient to patient. Those most commonly associated with cyclobenzaprine include:

• Drowsiness and/or tiredness
• Headache and/or dizziness
• Dry mouth
• Upset stomach, nausea, and/or constipation

Please note that this is not a complete list. To see a detailed list of side effects, it's best to check the leaflet inside your packaging and discuss any concerns with your doctor.

How cyclobenzaprine is usually taken

Cyclobenzaprine prescriptions for musculoskeletal pain are meant to be short-lived, usually lasting only two to three weeks. When used to treat musculoskeletal pain, it’s generally recommended to take it three times a day.

When used for off-label purposes, such as for an insomnia treatment like you might be prescribed at Kick, it’s taken for longer but at much smaller dosages, once per day.

Below are the recommended guidelines for taking cyclobenzaprine. However, as with all medications, follow the directions on your prescription label and instruction sheets before dosing.

Always consult with your doctor if you have any questions about how much medication you should take.

General recommendations:

• Take the tablet or extended-release capsule with or without food, three times a day.
• Take the medication at the same time each day.
• Call your doctor if your symptoms do not improve after three weeks or if they get worse.
• Store at room temperature away from moisture, heat, and light.

How long cyclobenzaprine takes to start working

When taken for musculoskeletal pain, cyclobenzaprine has a typical onset duration of one hour after ingestion.

When taken as a sleep aid, cyclobenzaprine is generally most effective when taken two hours before you want to be asleep.

How long does cyclobenzaprine last?

Cyclobenzaprine reaches peak plasma concentration, or the highest concentration of the drug possible in the bloodstream, within three to eight hours. Effects of the medication are typically experienced within this window for roughly four-to-six hours.

Cyclobenzaprine has a half life of 18 hours, which is the time it takes for half of the medication to be eliminated from your body. Drugs with longer half lives typically have longer effects. Due to its short half life, it also has a short effect window (4-6 hours), which is why it’s often prescribed in multiple doses throughout the day.

How to know if cyclobenzaprine is right for you

While cyclobenzaprine was originally approved to relieve muscle spasms associated with painful musculoskeletal conditions, doctors also prescribe it off-label to treat other conditions.

Chief among those conditions is insomnia, as you’ll see prescribed by Kick’s doctors. However, cyclobenzaprine isn’t for everyone. So, how do you know if it’s right for you?

While there’s no substitute for professional medical advice, you can start by researching the list of common side effects, known drug interactions and who should not take this medication. This will give you a reasonable indication as to whether or not it’s a good fit.

As with any medication, the only true way to know if cyclobenzaprine is right for you is to speak to a doctor or medical professional about your medical history, medications, and your ideal outcome. Be sure to consult your doctor directly for more questions on cyclobenzaprine.

Cyclobenzaprine FAQ