Muscle Relaxants for MS Spasticity: 6 Tips for Safe Use | MyMSTeam

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Muscle Relaxants for MS Spasticity: 6 Tips for Safe Use

Medically reviewed by Jazmin N. McSwain, PharmD, BCPS
Posted on May 22, 2023

Did you know muscle relaxants can be risky if not used properly? As many as 84 percent of people in the U.S. with multiple sclerosis (MS) experience muscle spasticity — muscles stiffness or tightness. Muscle relaxants are the mainstay medication for managing this painful symptom.

Used in combination with disease-modifying treatments, physical therapy, and assistive devices, muscle relaxants can be a helpful tool for easing spasticity. However, they can also interact with other medications or alcohol in dangerous ways. They can even worsen other MS symptoms, such as fatigue or balance problems.

Some of the most common medications used to manage MS spasticity include:

  • Baclofen (Lioresal)
  • Tizanidine (Zanaflex)
  • Diazepam (Valium)
  • Dantrolene (Dantrium)

Read on for six tips to help you take muscle relaxants safely, while avoiding dangerous side effects and drug interactions.

1. Stick to the Prescribed Dosage

Muscle relaxants are prescribed by your doctor with specific instructions about when and how much to take. It’s critical that you follow the directions exactly as prescribed to limit side effects and any risk for overdose and addiction.

Keep Track of Your Use

Almost all muscle relaxants cause drowsiness, so it can be easy to forget whether you’ve already taken your scheduled dose. Accidentally doubling up on your dose can put you at risk for side effects and injury. Writing down when you last took your medication, setting an alarm, or using a pill organizer can help you remember your medication and reduce the risk of an accidental overdose.

If You Still Have Pain, Talk to Your Doctor

If you have pain from severe spasticity that isn’t going away with your current treatment, it’s understandable to want to double the dose of your muscle relaxant or take it before its scheduled time. This is never advised unless a doctor gives you permission.

If you’re concerned your medication isn’t working, ask your doctor for help. Trying another medication or seeing a pain specialist or a physiatrist could be beneficial.

Overdosing on muscle relaxants can lead to hallucinations, seizures, heart attack, coma, and even death. If you think you’re experiencing an overdose, or if you’ve taken more pills than what’s been prescribed to you, call 911 or seek emergency care immediately.

Steer Clear of Addiction

Some muscle relaxants can be addictive. Taking more than the prescribed amounts puts you at greater risk of overdosing and of becoming physically dependent on the medication. Additionally, using them for a long period of time can increase your tolerance — meaning you need a higher dose to have the same effect. If you have a history of substance abuse, let your doctor know before beginning to take a muscle relaxant prescription.

2. Don’t Drive on Muscle Relaxants

Muscle relaxants can cause drowsiness — even if you’re taking them as directed by your doctor — so engaging in certain activities while taking them may be risky to you orothers. This includes driving a vehicle or using any type of heavy machinery. Some muscle relaxants can start working as quickly as 30 minutes, and their effects can last up to 24 hours. Avoid driving while taking a muscle relaxant.

If you must drive for work or another reason, ask your doctor about adjusting to a lower dose or changing the time when you take your medication to avoid impairment. It’s important to not take this lightly, since DUI laws aren’t just limited to alcohol. Driving while impaired because of muscle relaxant is illegal — even if your doctor prescribed the drug.

3. Don’t Mix Muscle Relaxants With Alcohol or Drugs

Because muscle relaxants cause fatigue and other side effects, mixing them with alcohol or drugs can quickly become unsafe. Alcohol and drugs like opioids and marijuana (cannabis) are depressants, meaning they slow the central nervous system and have a sedating effect. Muscle relaxants are also depressants. When they are combined, the risk of some side effects is higher and the side effects themselves can be stronger. These include:

  • Blurry vision
  • Low blood pressure
  • Dizziness and fainting
  • Drowsiness
  • Memory problems
  • Liver damage
  • Higher risk of overdose

Mixing a muscle relaxant and alcohol or drugs can also be life-threatening, as it can stop your breathing. The bottom line: Never take a muscle relaxant with alcohol, marijuana, opioids, or other illegal drugs.

4. Know and Avoid Common Medication Interactions

Muscle relaxants can interact with other medications you may be taking. Given the depressant characteristics of muscle relaxants, mixing them with other medications can be dangerous. Various classes of prescription medicine interact with muscle relaxants, including some commonly taken to manage other MS symptoms:

Always let your doctor know the full list of your prescription medications, so they can make sure it’s safe to add a muscle relaxant to your treatment plan.

5. Watch for Side Effects

Muscle relaxants have a number of side effects that can exacerbate the balance issues that come along with MS. Side effects that could put you at risk of injury include:

  • Drowsiness
  • Dizziness
  • Muscle weakness

In serious cases, muscle relaxants can cause blurry vision or fainting. If you’re experiencing any of these side effects, it’s important to tell your doctor.

Sometimes these side effects can increase the risk for falls. This is especially concerning if you take other medications that could make such an injury worse or even life-threatening, such as a blood-thinning medication. Your doctor can make a dose adjustment or change your medication to minimize or avoid these side effects.

6. Consider Alternative Treatments for Spasticity

Muscle relaxants aren’t always the best way to treat muscle spasms. Depending on your symptoms, muscle relaxants might increase your trouble with fatigue or balance. “My doctor is reluctant to give me muscle relaxant medicine, as she’s concerned that with my balance problems, it may cause me to fall and trip,” one MyMSTeam member shared.

Sometimes an alternative antispasticity treatment option is better than medication, especially since your body can build up a tolerance to the effects of muscle relaxants over time. Exercise, physical therapy, occupational therapy, electrical stimulation therapy, botulinum toxin (Botox) injections, or mobility equipment can also help with stiff muscles and painful muscle contractions. Talk to your doctor about the best treatment plan for your symptoms.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 198,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you tried muscle relaxants or other therapies for spasticity? What has helped you? What precautions do you take to avoid problems? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on May 22, 2023
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    Jazmin N. McSwain, PharmD, BCPS completed pharmacy school at the University of South Florida College of Pharmacy and residency training at Bay Pines Veterans Affairs. Learn more about her here.
    Remi A. Kessler, M.D. is affiliated with the Medical University of South Carolina and Cleveland Clinic. Learn more about her here.

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