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Indications and usage:

Carisoprodol (Soma) is a muscle relaxant indicated for the relief of discomfort associated with acute, painful musculoskeletal conditions in adults, to relieve skeletal muscle spasms, musculoskeletal pain, stiffness, strain, sprain, muscle injuries, acute back pain, discomfort associated with short-term, painful musculoskeletal conditions, and for other medical purposes. It is also widely off-label used as recreational drug. Carisoprodol may be prescribed alone for monotherapy or in combinations with other medicines, such as psycholeptics, vitamins, pain relief medications.


Dosage and administration:

Recommended dose is 250 mg to 350 mg three times a day and at bedtime.


Dosage forms and strengths:

Soma (Carisoprodol) 250 mg, 350 mg, 500 mg tablets.

Carisoprodol (Pain-O-Soma, Prosoma, Somadril) 350 mg, 500 mg tablets.


Contraindications:

Acute intermittent porphyria

Hypersensitivity reactions to a carbamate such as meprobamate


Warnings and precautions:

Due to sedative properties, may impair ability to perform hazardous tasks such as driving or operating machinery

Additive sedative effects when used with other CNS depressants including alcohol

Cases of abuse, dependence and withdrawal

Seizures


Overdosage:

Clinical presentation

Overdosage of Carisoprodol (Soma) tablets commonly produces CNS depression. Death, coma, respiratory depression, hypotension, seizures, delirium, hallucinations, dystonic reactions, nystagmus, blurred vision, mydriasis, euphoria, muscular incoordination, rigidity, and/or headache have been reported with Soma overdosage. 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 this medication and other CNS depressants (e.g., alcohol, benzodiazepines, opioids, tricyclic antidepressants) can be additive even when one of the drugs has been taken in the recommended dosage. Fatal accidental and non-accidental overdoses of SOMA have been reported alone or in combination with CNS depressants.

Treatment of overdosage

Basic life support measures should be instituted as dictated by the clinical presentation of the Soma overdose. Vomiting should not be induced because of the risk of CNS and respiratory depression, and subsequent aspiration. Circulatory support should be administered with volume infusion and vasopressor agents if needed. Seizures should be treated with intravenous benzodiazepines and the reoccurrence of seizures may be treated with phenobarbital. In cases of severe CNS depression, airway protective reflexes may be compromised and tracheal intubation should be considered for airway protection and respiratory support.

For decontamination in cases of severe toxicity, activated charcoal should be considered in a hospital setting in patients with large overdoses who present early and are not demonstrating CNS depression and can protect their airway.

For more information on the management of an overdose of Soma (Carisoprodol) pills, contact a poison control center in your living area.


Adverse reactions, side effects:

Most common adverse reactions of carisoprodol (incidence > 2%) are drowsiness, dizziness, and headache.

To report suspected side effects of Soma (Carisoprodol) tablets contact Meda pharmaceutical company or your local FDA.


Drug interactions:

CNS depressants (e.g., alcohol, benzodiazepines, opioids, tricyclic antidepressants) - additive sedative effects.


Patient counseling information:

Patients should be advised to contact their physician if they experience any adverse reactions to Soma, Somadril, Pain-O-Soma, Prosoma (Carisoprodol) tablets.

Sedation

Advise patients that Soma may cause drowsiness and/or dizziness, and has been associated with motor vehicle accidents. Patients should be advised to avoid taking this medication before engaging in potentially hazardous activities such as driving a motor vehicle or operating machinery.

Avoidance of alcohol and other CNS depressants

Advise patients to avoid alcoholic beverages while taking carisoprodol and to check with their doctor before taking other CNS depressants such as benzodiazepines, opioids, tricyclic antidepressants, sedating antihistamines, or other sedatives.

Soma should only be used for short-term treatment

Advise patients that treatment with this medicine should be limited to acute use (up to two or three weeks) for the relief of acute, musculoskeletal discomfort. In the post-marketing experience with Soma, cases of dependence, withdrawal, and abuse have been reported with prolonged use. If the musculoskeletal symptoms still persist, patients should contact their healthcare provider for further evaluation.

Lactation

Advise nursing mothers using Carisoprodol (Soma) pills to monitor neonates for signs of sedation.