Methocarbamol

Skeletal muscle relaxant (centrally-acting)

Methocarbamol

Robaxin (oral, injectable)

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Summary

Classes

Skeletal muscle relaxant (centrally-acting)

Common uses

Short-term relief of muscle spasm from acute musculoskeletal conditions (FDA)▲0▼, Tetanus adjunct (FDA, IV; rarely needed in current practice with immunization coverage)▲0▼

Pharmacy

Starting dose

Oral: 1500 mg PO QID for 2-3 days (load), then 750-1500 mg QID maintenance. IV/IM: 1000 mg every 8 hours for acute spasm

Preparations

Tablets 500, 750 mg; injection 100 mg/mL

US FDA Max

8 g/day (oral, short-term load); 6 g/day (chronic)

Pharmacology

Routes

Oral, intramuscular, intravenous

Onset

~30 minutes (oral)

Duration

4-6 hours

Half-life

1-2 hours

Bioavailability

~100% (oral; near-complete absorption)

Pregnancy

Limited human data.^{[citation needed]}

Legal status

Rx-only in US. Not a controlled substance, distinguishing it from carisoprodol which is Schedule IV

Purported mechanism

Centrally-acting skeletal muscle relaxant with mechanism not fully elucidated; effects appear mediated through general central nervous system depression rather than direct muscle relaxation or specific receptor activity. The lack of receptor-specific action explains both the relatively mild side-effect profile and the variable efficacy across patients.▲0▼ May cause harmless brown, black, blue, or green urine discoloration (the classic counseling point). Not associated with the abuse-liability concerns of carisoprodol or the anticholinergic burden of cyclobenzaprine, making methocarbamol a reasonable choice in elderly patients.