carisoprodol (isomeprobamate) Nursing Considerations & Management

 Drug Name

Generic Name : carisoprodol (isomeprobamate)

Brand Name: Soma

Classification: Centrally acting skeletal muscle relaxant

Pregnancy Category NR

Dosage & Route
  • Adjunct in the short-term symptomatic treatment of painful muscle spasm associated with musculoskeletal conditions
  • Adult: 350 mg 3-4 times daily for up to 2-3 wk.
  • Elderly: Half of the usual dose.
Therapeutic actions
  • Carisoprodol blocks interneuronal synaptic activity in the descending reticular formation and spinal cord resulting in skeletal muscle relaxation.
    • Duration: 4-6 hrs.
    • Absorption: Absorbed from the GIT (oral); peak plasma concentrations after 30 min.
    • Distribution: Enters breast milk (significant amounts).
    • Metabolism: Hepatic; yields meprobamate.
    • Excretion: Via urine (as metabolites).
  • Relief of discomfort associated with acute, painful musculoskeletal conditions as an adjunct to rest, physical therapy, and other measures
Adverse effects
  • Dizziness, drowsiness, nausea, epigastric distress, tachycardia, orthostatic hypotension, Hypersensitivity reactions, rash.
  • Potentially Fatal: Idiosyncratic reaction (rare).
  • Acute intermittent porphyria, hypersensitivity. Lactation.
Nursing considerations
  • History: Allergic or idiosyncratic reactions to carisoprodol, meprobamate; acute intermittent porphyria, suspected porphyria; lactation
  • Physical: T; skin color, lesions; orientation, affect; P, BP, orthostatic BP; bowel sounds, liver evaluation; LFTs, renal function tests, CBC
  • WARNING: Monitor patient for potentially serious idiosyncratic reactions—most likely with first few doses.
  • Reduce dose with hepatic impairment.
  • Provide safety measures if CNS effects occur.
  • Drug may be habit forming. Monitor patient.
Teaching points
  • Take this drug exactly as prescribed; do not take a higher dosage; take with food if GI upset occurs.
  • Avoid alcohol, sleep-inducing, or over-the-counter drugs; these could cause dangerous effects; if you feel you need one of these preparations, consult your health care provider.
  • You may experience these side effects: Drowsiness, dizziness, vertigo (avoid driving or activities that require alertness); dizziness when you get up or climb stairs (avoid sudden changes in position, use caution climbing stairs); nausea (take drug with food; eat frequent small meals); insomnia, headache, depression (transient effects).
  • Report rash, severe nausea, dizziness, insomnia, fever, difficulty breathing.