Musculoskeletal conditions in the elderly are treated with one of various treatment options. This includes CNS depressants such as Methocarbamol to help the discomfort linked to the condition. The medication is typically a part of treatment regimen that includes adequate rest and physical therapy. Following subsections offer a detailed view of the drug, its uses, recommended dosages and possible methocarbamol side effects in elderly. This is intended to help patients and caregivers identify symptoms and take suitable remedial and preventive measures to prevent undesirable outcomes from turning adverse.

Overview of the CNS depressant

The drug was developed around seven decades ago and is in use since FDA approval in 1957. It belongs to the category of drugs known as guaiacol glyceryl ether, and is used in the treatment of muscle spasticity and for treating the pain linked to musculoskeletal conditions. Available either as tablets or as injections, it is also available as an OTC product with a lower dose. Most such formulations either contain other drug formulations or may be taken in combination with acetaminophen or ibuprofen.

How does methocarbamol work?

The mechanism of action of the CNS depressant is mainly attributed to the central nervous system. The depressant action is achieved by preventing or blocking certain reflexes, and by bringing about a reduction in the transmission in pathways. This helps to alleviate the pain and the discomfort linked to the condition. It is also known to work by extending the refractory period of muscle cells; in other words, the repeat action that occurs after a muscle has returned to its state of rest following some form of excitation is extended. This helps offer considerable relief from the pain and discomfort of the condition.

Ideal methocarbamol dosage  

Here is a short compilation of the ideal dosage of the CNS depressant. It is to be borne in mind that the actual dosage may differ and will depend on a variety of factors. For instance, the age of the patient, the gender of the patient, the condition being treated, the intensity of the condition and other medications in use. Patients and caregivers are to bear in mind that missed doses may be skipped, and no attempt must be made to make up for the missed dose by taking a double dose, or by taking a dose closer to the next dose.

Tablets are available in strengths of 500 and 75 mg. Ideally the dosage starts at 6000 mg daily, with the dose split up into four different doses of 1500 mg. Maintenance dosages are around 4000 mg daily, which is again divided into 4 doses.

Commonly reported methocarbamol side effects in elderly

All medications come with the possibility of undesirable effects and the CNS depressant is no exception. Different types of effects may be experienced by users of drugs and medications. The actual effects depend on various factors, such as the intake dosage, the schedule or frequency of intake, the period of medication, the condition being treated, the severity of the condition, gender, overall health of the patient, age of the patient, other diseases and other medications in use. Unwanted outcomes are typically classified in to two different categories – mild effects and serious effects.

The mild effects are known to occur more frequently and may not actually require any kind of treatment. The serious effects are relatively rare in occurrence and may need suitable medical intervention. It is necessary to check for symptoms in the elderly as the elderly are unlikely to correctly understand or inform others of changes. By carefully monitoring elders, it is possible to discern certain effects and take suitable remedial action, if needed. Here is a compilation of some of the mild and moderate effects. This is not an exhaustive compilation, but only covers certain types of effects to help patients an caregivers understand the broad category of effects or symptoms. I tis also important to add that effects may not necessarily be experienced by all individuals on the drug. Some are known to be free from all side effects whatsoever, and it is therefore wrong to assume that the drug will affect every patient.

Frequently reported outcomes

Patients on methocarbamol are more likely to experience certain mild effects such as throbbing headaches, and probable dizzy feelings. A distinct lightheaded feeling is also possible, apart from drowsiness that may be attributed to the sedative properties of the drug. These effects are more likely to last for not more than a few days or a few weeks, and will resolve naturally without the need for any medication. However, persistent effects or intense effects that have an impact on routines are to be treated.

Effects that are a cause for concern

There is the possibility of effects that may be a cause for concern. This is mainly because of the likelihood of the conditions or symptoms progressing and turning serious in nature. It is essential to take suitable and timely treatment when certain tell-tale symptoms are observed. For instance, patients with a history of allergies may experience allergic reactions, and this could turn serious in certain cases. Symptoms such as outbreak of rashes, itching sensations and hives are to be considered as indicative of possible allergic reactions. Other symptoms include difficulty breathing, or a distinct tight feeling in the chest, apart from swelling that may occur in the face, or the eyes and the mouth. Other possible serious conditions that may be experienced as an effect include angioneurotic edema. This refers to swelling that is not painful, but clearly discernible, with swelling under the skin.

Methocarbamol warnings: In addition to the above, symptoms that need to be considered as serious include pain the abdomen, and a clear reduction in heart beat rate. Patients who feel flushed with no possible explanation are also advised to seek medical attention.  There is the possibility of a reduction in blood pressure levels and this is to be monitored periodically in elderly patients as this could result in adverse outcomes.

Other effects that may be experienced by patients include the possibility of jaundice, with typical symptoms such as yellowing of the skin and the whites of the eyes. There is also the possibility of a reduction of white blood cell count due to the drug. The patient is likely to experience some impact on ability to memories things, while some are known to end up confused.  There is also a possibility of impact on vision, such as blurred vision, and double vision, apart from abnormal or unusual eye movements that are not controllable. Vision effects could also include reddish eye, while some experience itching sensations. There is also the possibility of watery eyes, and this may have an impact on routines or in social settings.

The individual may not be able to perform all tasks with the same amount of coordination that was possible before the medication. The individual may also have to contend with sleeplessness, apart from the possibility of seizures. Another outcome of the medication is vertigo that may have an impact on the patient’s confidence levels in social settings or at residences in high rises.

Muscle relaxant injection side effects

Patients who receive injections of methocarbamol are likely to experience injection site reactions. This includes swollen veins at the site of injection, apart from localized pain.  The skin may also peel at the site, apart from a reddish appearance that may last for a short time. These effects are not indicative of any serious reactions and are natural reactions that are typically limited to the site of injection. Most reactions may not require treatment and are usually left to resolve naturally. In certain circumstances, when the conditions persist or if the swelling does not reduce, it may require some medical attention.

Precautions to be followed when taking methocarbamol

It is essential to follow certain precautions while taking the CNS depressant due to the mechanism of action and the properties of the drug. For instance, individuals who consume alcohol are strictly advised to avoid indulging, as this will lead to increased sedation. By virtue of being a CNS depressant, the drug is likely to have certain effects on routine actions and abilities. For instance, this could affect coordination and the ability to focus. Individuals are likely to have impaired or significantly lowered reflexes when on the drug.

It is therefore important to stay off responsibilities that include operation of heavy machinery, or work in hazardous environments. Tasks that require quick reflexes are to be avoided, and driving needs to be restricted till the individual is fully aware of the effects or is in control of his/her voluntary actions.

Drug interactions of methocarbamol

Similar to methocarbamol side effects in elderly there is also the possibility of drug interactions when the medication is taken along with other drugs. Interactions occur when there is a conflict of mechanisms of action between the two medications, that may be taken either for the same condition or for different conditions. Interactions may trigger one of three different outcomes. The first type is a possible increase in the potency of either or both the medications. The second is a reduction in the efficacy of either or both the medications. The third is an aggravation of the normal side effects of either or both the medications.

Remedial measures to handle drug interactions include possible discontinuation or temporary suspension of use of one of the two medications. This is determined by assessing the importance of each and depending on the role of each drug, one could be temporarily or permanently discontinued. In the event that both the drugs are equally important in terms of roles, treating specialists generally resort to modification of dosage and alteration of intake schedule. This is carried out in effort to mitigate and reduce the possible outcomes of interactions. Here is a compilation of commonly occurring interactions between medications. This is not complete, but is only a broad reference of some categories that interact with methocarbamol. It is important to note that interactions may also occur with food products, and other herbal supplements, nutraceuticals etc.

Methocarbamol contraindications: Medications prescribed for reducing weakness in the muscles, such as pyridostigmine bromide may interact with methocarbamol. Other drugs that could trigger interactions include medications prescribed for anxiety, painkillers, drugs that belong the category of antipsychotics, and some antidepressants.

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