cyclobenzaprine / Generic mfg. - LARVOL DELTA

A Pheo False Alarm - Deception with Cyclobenzaprine (ENDO 2025) - "He had unnecessary CT scan and he also could have undergone unnecessary additional testing such as magnetic resonance imaging or functional imaging techniques. In conclusion, proper history is a critical part in making or ruling our certain diagnoses and can save a patient from being on the wrong medications or undergoing unnecessary testing."

Cardiovascular • Endocrine Cancer • Endocrine Disorders • Hypertension • Metabolic Disorders • Oncology • Pain • Solid Tumor

RHABDOMYOLYSIS AFTER UNINTENTIONAL CYCLOBENZAPRINE OVERDOSE (CHEST 2025) - No abstract available

Critical care

BACLOFEN AND MORTALITY RISK IN OLDER PATIENTS WITH NON-CANCER PAIN: A REAL-WORLD, ACTIVE COMPARATOR STUDY (EULAR 2025) - "In this retrospective cohort study of 181,677 older adults with non-cancer pain, there was no statistical difference in all-cause mortality or out-of-hospital mortality between new users of baclofen and cyclobenzaprine."

Clinical • Real-world • Real-world evidence • Back Pain • CNS Disorders • Diabetes • Hypertension • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Oncology • Pain

Clinical study of remazolam benzenesulfonate for sedation in ICU patients with severe pneumonia on invasive mechanical ventilation (ChiCTR) - P4 | N=60 | Not yet recruiting | Sponsor: Anhui Chest Hospital; Anhui Chest Hospital

New P4 trial • Anesthesia • Infectious Disease • Pneumonia • Respiratory Diseases

Shoulder Pain: It Really Gets On My Nerves (ACSM 2025) - "Gabapentin, cyclobenzaprine, lorazepam, steroid injection, and prednisone burst were all tried without any lasting relief of symptoms.Physical Exam: No obvious deformity of either arm was noted. Patient started PT for preservation of strength and ROM3. Has been able to resume some activity while still participating in PT."

Breast Cancer • Genetic Disorders • Immunology • Musculoskeletal Diseases • Musculoskeletal Pain • Oncology • Pain • Rheumatology • Solid Tumor • Turners Syndrome

Foot Injury - Runner (ACSM 2025) - "Flexeril and Gabapentin for her fibromyalgia, ice, and topical NSAIDs all did not help. Left ankle X-ray in 3 views: Small calcification over the Achilles insertion but otherwise unremarkable. US: evidence of plantar fasciitis, insertional Achilles tendinopathy, peroneal tendonitis with possible longitudinal split tearFINAL WORKING DIAGNOSIS:Medial Plantar neuropathyTREATMENT AND OUTCOMES:Patient had a complex picture with multiple pathology and pain generators identified on exam initially. Diagnostic tibial nerve block with Lidocaine was performed with complete resolution of her pain for 1 week.Given her response, an USG Medial Plantar nerve hydro-dissection was performed using Lidocaine and D5W at the 2 week follow up, and the patient had experienced complete resolution of her pain."

Back Pain • Diabetes • Fibromyalgia • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Rheumatology

Back Injury- Basketball (ACSM 2025) - "2.Meloxicam 15 mg daily, cyclobenzaprine 10 mg nightly PRN for spasms. MRI lumbar spine with early degenerative disc disease and mild facet arthritis. MRI sacroiliac joints with sclerosis on both sides of the anterior inferior aspects of the sacroiliac joints, right greater than left, consistent with osteitis condensans ilii. Rheumatological workup including HLA-B27, ESR, CRP, RF were all negative."

Back Pain • Gynecology • Immunology • Lumbar Back Pain • Musculoskeletal Diseases • Musculoskeletal Pain • Rheumatology

The Role of Pre-anesthesia Testing in Identifying Risk for Delayed Gastric Emptying and Aspiration: A Case Report (ATS 2025) - "The patient was also taking medications that increased her risk of delayed gastric emptying, including cyclobenzaprine and oxybutynin (which can slow gastric motility) and omeprazole. Aspiration is a significant perioperative complication, particularly inpatients with DGE risk factors like diabetes, GERD, and medications. Pre-anesthesia testing (PAT) protocols should include DGE risk screening to identify high-risk patients and prevent aspiration. Non-invasive tools like bedside ultrasonography could help assess gastric contents and emptying, further reducing aspiration risk invulnerable populations."

Case report • Clinical • Anesthesia • CNS Disorders • Depression • Diabetes • Endocrine Disorders • Gastroenterology • Gastroesophageal Reflux Disease • Infectious Disease • Inflammation • Metabolic Disorders • Pneumonia • Psychiatry • Renal Calculi • Respiratory Diseases

Uncommon but Real: Pulmonary Embolism in a Young CrossFit® Athlete - A Case Report Highlighting the Risks of Supplements and Missed Diagnoses (ATS 2025) - "Initially, he was diagnosed with a muscle strain and was prescribed ibuprofen and cyclobenzaprine...He was started on Apixaban and discharged to follow-up with hematology out-patient...Second, athletes face additional VTE risk factors, including dehydration, significant trauma, and injuries. Finally, the diagnosis of VTEs in young athletes is often delayed or missed."

Case report • Clinical • Cardiovascular • Genetic Disorders • Hematological Disorders • Musculoskeletal Diseases • Obesity • Pain • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases

A Case of Cardiac Myxoma Leading to Cardiogenic Shock and Death (ATS 2025) - "Upon admission, the patient was taking aspirin, atorvastatin for hyperlipidemia, metformin for diabetes, meloxicam for joint pain, and cyclobenzaprine for muscle spasms. Conclusion This case underscores the potentially aggressive nature of untreated cardiac myxomas and the impact of delayed intervention on clinical outcomes. Consistent imaging may be one way to track myxoma growth, re-evaluate medications, and prevent complications."

Clinical • Cardiovascular • Congestive Heart Failure • Diabetes • Dyslipidemia • Heart Failure • Infectious Disease • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Myocardial Infarction • Oncology • Pain • Pulmonary Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

A RARE CASE OF ACUTE ON CHRONIC PAIN IN SETTING OF LUMBAR SPINAL STENOSIS AND MULTIPLE SCLEROSIS (ASRA-SPRING 2025) - "Here, we present a case of lumbar spinal stenosis and associated radiculopathy in a patient with MS causing diagnostic difficulty CASE PRESENTATION A 47-year-old female with history of multiple sclerosis (diagnosed in 2003) on Ozanimod, L5-S1 spinal stenosis on cyclobenzaprine, tizanidine, and gabapentin, prior radiculopathy and myofascial pain - having received multiple trigger point injections with lidocaine over bilateral cervicothoracic paraspinals and prior TFESI (Transforaminal Lumbar Epidural Steroid Injections) in 2015, presented to the emergency department in 2024 with shooting pain starting at her right hip progressing down the back of her leg with associated numbness on the right ankle and foot...She was started on a multimodal pain regimen including oxycodone 5 mg, acetaminophen 975 mg, ibuprofen 800 mg, lidocaine patch, gabapentin 600 mg, cyclobenzaprine 10 mg, duloxetine 30 mg and hydromorphone for breakthrough pain...This case highlights the importance of..."

Clinical • CNS Disorders • Inflammation • Multiple Sclerosis • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Pain

THE TWILIGHT ZONE: A CASE REPORT OF DELAYED EMERGENCE AFTER GENERAL ANESTHESIA FOR A ROUTINE CYSTOSCOPY (ASRA-SPRING 2025) - "Her home medications prior to the procedure included diphenhydramine 25 mg, Imbruvica 140 mg, Flexeril 5 mg, Prazosin 2 mg, alprazolam 1 mg, zolpidem 10 mg, ropinirole 1 mg, Seroquel 100 mg...Induction was performed with propofol, fentanyl, rocuronium and maintenance with sevoflurane...She was reversed appropriately with sugammadex with qualitative TOF showing 4 twitches without fade prior to extubation...Our suspicion is that this patient may have suffered delayed emergence secondary to residual effects of volatile anesthetics or potentially secondary to a psychiatric disorder related to a catatonic response. Figure 1 displays a broad range of differential diagnoses to keep in mind when encountering a patient with DE."

Case report • Clinical • Anesthesia • Cardiovascular • Chronic Lymphocytic Leukemia • Chronic Obstructive Pulmonary Disease • CNS Disorders • Depression • Dyslipidemia • Gastroesophageal Reflux Disease • Hematological Malignancies • Hypertension • Immunology • Leukemia • Mental Retardation • Metabolic Disorders • Oncology • Pain • Psychiatry • Respiratory Diseases • Rheumatology • Type 2 Diabetes Mellitus

PERIPHERAL NERVE CATHETERS AS ADJUNCT TO ENHANCE SATISFACTION IN THE CHRONIC PAIN PATIENT WITH EXTREME OPIOID TOLERANCE (ASRA-SPRING 2025) - "His home pain regimen included p.o. Methadone 15mg q8hr, p.o. Ketamine 75mg q8hr, and p.o. Hydromorphone as needed. He was started on a hydromorphone IV PCA and was uptitrated to a demand dose of 6mg q10min with a 9mg bolus as needed q1hr, of which he was utilizing 1,556 milligram morphine equivalents (MME) per day...The interscalene catheter was infused with 0.2% Ropivacaine at 10mL/hr with a 20mL bolus q4hr...He was discharged on hospital day 18 on p.o. Methadone 15mg q8hr, p.o. oxycodone 40mg q2hr, p.o. naproxen 500mg q12hr, p.o. Tylenol 1,000mg q8hr, and p.o. cyclobenzaprine 10mg q8hr...Despite his unchanged MMEs after catheter placement, the addition of a peripheral nerve catheter improved endpoints such as sleep, willingness to participate in physical therapy, subjective pain score, and willingness to discharge. Overall, this case highlights that while regional anesthesia is often used to reduce opioid consumption, it can have additional benefits especially in the..."

Clinical • Anesthesia • Dermatology • Musculoskeletal Diseases • Oncology • Pain

TREATMENT OF PAIN IN GUILLAIN-BARRE SYNDROME WITH LIDOCAINE INFUSION (ASRA-SPRING 2025) - "He was started on high dose gabapentin, cyclobenzaprine, acetaminophen, lidocaine patches, and oxycodone for pain. We show that a 24-hour lidocaine infusion is both safe and efficacious and can certainly be considered as an adjunct to the pain regimen in patients with GBS refractory to standard treatment. To our knowledge, this is the first use of lidocaine infusion for this indication."

Anesthesia • Complement-mediated Rare Disorders • Infectious Disease • Inflammation • Musculoskeletal Diseases • Musculoskeletal Pain • Neuralgia • Otorhinolaryngology • Pain • Sinusitis

PELVIC PAIN CAUSED BY BERTOLOTTI SYNDROME (ASRA-SPRING 2025) - "Prior Treatments: non-steroidal anti-inflammatory drugs, acetaminophen, methocarbamol, cyclobenzaprine, oxycodone, corticosteroids, topiramate, amitriptyline, duloxetine, venlafaxine, vaginal diazepam, and pelvic floor physical therapy...At the time of initial evaluation, patient was only using ibuprofen as it provided minimal benefit and was tolerated better than other medications...She was started on baclofen 10mg and phenazopyridine 100 mg three times daily as needed...In a patient with chronic pelvic/low abdominal pain unrelated to organic urogynecologic and gastrointestinal pathologies, consider referred pain from Bertolotti Syndrome pseudoarticulation. Early identification may help avoid prolonged pain, effects on mental health, and decrease further sequelae of degenerative spine disease in the surrounding levels [2] [3]."

Back Pain • Gastrointestinal Disorder • Gynecology • Lumbar Back Pain • Musculoskeletal Pain • Neuralgia • Pain • Pruritus

Comparison of an Opioid-Free Multimodal Pain Regimen to an Opioid-Containing Regimen in Elective, Outpatient, Bunion, and Forefoot Surgery. (PubMed, Foot Ankle Spec) - "This study looks to compare a multimodal, opioid-free pain control regimen to a historical opioid regimen in patients undergoing elective, outpatient forefoot procedures.MethodsData were collected prospectively in patients undergoing elective outpatient forefoot procedures, including bunion, bunionette, and lesser toe corrections, who were using a multimodal pain regimen, consisting of Acetaminophen, Meloxicam, Ketorolac, Cyclobenzaprine, and Pregabalin, from December 2020 to June 2022 and retrospectively for patient's undergoing similar procedures using an opioid-containing regimen, consisting of either oxycodone or hydrocodone, from October 2018 to February 2020 to at a single academic institution. Multivariable analysis demonstrated utilization of the multimodal pain regimen did not significantly influence VAS scores at 2 weeks postoperatively when controlling for confounding variables (P = .06).ConclusionOur multimodal, opioid-free pain control regimen..."

Journal • Orthopedics • Pain

Factors Associated with Benzodiazepine Misuse Among Those Who Misused Opioids Within the Past Year: A U.S. National Analysis. (PubMed, Subst Use Misuse) - "The strongest predictors of misuse of both substances included misuse of several other substances in the past year: soma products (adjusted odds ratio (aOR): 6.1, p < 0.001), cyclobenzaprine products (aOR: 3.31, p < 0.001) and cocaine (aOR: 2.4, p < 0.001)...This study identifies risk factors for benzodiazepine and opioid misuse. Future studies should further investigate these findings to help implement targeted interventions for risk reduction in this population."

Journal • Addiction (Opioid and Alcohol)

Multimodal Analgesia Effect on Post Surgical Patient (clinicaltrials.gov) - P4 | N=60 | Completed | Sponsor: University of California, Davis | Recruiting ➔ Completed | Trial completion date: Dec 2025 ➔ Jun 2024 | Trial primary completion date: Dec 2024 ➔ Jun 2024

Trial completion • Trial completion date • Trial primary completion date • Genetic Disorders • Obesity

Hip Hip Hooray! PENG-Free in the ER: A Case Report (IARS-SOCCA 2025) - "Despite a multimodal pain regimen including 15 mg oxycodone, 10 mg cyclobenzaprine, 30 mg ketorolac, and a lidocaine patch, the patient was unable to ambulate or sit unassisted on the side of the bed...Negative aspiration was observed, and 20cc of 0.2% ropivacaine was administered in the desired plane with careful attention to avoid local spread to the point of the femoral nerve... Regional anesthetics continue to grow in the ER as strategies to manage acute pain while reducing opioid use and preventing hospital admissions. The PENG block is a technique that targets the sensory elements of femoral, obturator, and accessory obturator nerves to anesthetize the anterior hip joint.1 By targeting only sensory nerves, motor function is spared which is crucial for mobility and recovery. This is especially important for geriatric patients, who often present with hip fractures as they are more susceptible to complications associated with immobility such as weakness, thrombosis,..."

Case report • Clinical • Addiction (Opioid and Alcohol) • Alzheimer's Disease • Anesthesia • Cardiovascular • CNS Disorders • Cognitive Disorders • Depression • Gastrointestinal Disorder • Geriatric Disorders • Hematological Disorders • Musculoskeletal Diseases • Orthopedics • Pain • Psychiatry • Thrombosis

Low Dose Naltrexone for Treatment of Severe Hemochromatosis Pain (IARS-SOCCA 2025) - "Pharmacologically, he has tried various combinations of multimodal pain regimen—including acetaminophen, oxycodone, gabapentin, pregabalin, cyclobenzaprine, baclofen, tizanidine, carisoprodol, dexamethasone, and amitriptyline—with minimal to no pain relief...His current pain regimen includes LDN at 6 mg twice daily, gabapentin 900 mg three times daily, and duloxetine 60 mg daily... We present a patient with severe pain from hemochromatosis and arachnoiditis that was refractory to numerous interventions and medical treatments. Remarkably, noticeable pain improvement was achieved only with initiation of low-dose naltrexone (LDN). This case is noteworthy as there is no documented use of LDN specifically for hemochromatosis-associated pain and in this case it has been the only effective therapy trialed."

Anesthesia • CNS Disorders • Crohn's disease • Fatigue • Gastroenterology • Genetic Disorders • Hematological Disorders • Hepatology • Immunology • Inflammation • Inflammatory Bowel Disease • Multiple Sclerosis • Orthopedics • Pain • Rheumatology • Urinary Incontinence

Chronic Vaping and Renal Tubular Acidosis: A Case of Worsening Electrolyte Imbalance and Metabolic Acidosis in Chronic Kidney Disease (NKF-SCM 2025) - "Her chronic medications included verapamil, potassium supplements, ethinyl estradiol/norgestimate, cyclobenzaprine, levothyroxine, and pantoprazole. The patient's chronic e-cigarette use, absent from prior records, was revealed only through targeted questioning. Chronic toluene exposure from vaping may exacerbate CKD via distal RTA, worsening metabolic acidosis, hypokalemia, and electrolyte imbalances, complicating management.Conclusion Clinicians should routinely assess e-cigarette use in CKD patients with unexplained metabolic derangements, as chronic toluene exposure from vaping may contribute to RTA and CKD progression, warranting further study."

Clinical • Cardiovascular • Chronic Kidney Disease • Endocrine Disorders • Hypertension • Metabolic Disorders • Nephrology • Rare Diseases • Renal Disease

Co3O4/fluoro-copolymer nanocomposite modified boron-doped diamond electrode non-enzymatic sensor for the determination of skeletal muscle relaxant drug cyclobenzaprine in biological fluids. (PubMed, Talanta) - "The sensor exhibited high specificity, unaffected by common interferents such as ions, carbohydrates, and heavy metals. This work introduces, for the first time, a Co₃O₄/Nafion-modified BDDE sensor for CBZ determination, offering rapid, selective, and interference-free analysis with potential applications in therapeutic drug monitoring and pharmaceutical quality control."

Journal

Exploring the Novel Role and Mechanistic Insights of Skeletal Muscle Relaxant Cyclobenzaprine Hydrochloride in Esophageal Squamous Cell Carcinoma Treatment. (PubMed, Eur J Pharm Sci) - "Flexeril exhibits anti-cancer effects in ESCC by inhibiting the JAK1-STAT3-WDHD1 axis and inducing DDR. These findings suggest that Flexeril may serve as a potential novel therapeutic agent for the treatment of ESCC."

Journal • Esophageal Cancer • Esophageal Squamous Cell Carcinoma • Musculoskeletal Pain • Oncology • Pain • Squamous Cell Carcinoma • JAK1 • JAK2

WHY SO BLUE? METHYLENE BLUE AS A TREATMENT IN POLYPHARMACY OVERDOSE (SCCM 2025) - "The medications taken include a total of 4.9mg clonidine, 43.2g gabapentin, 170mg cyclobenzaprine, 40g methocarbamol, 140mg duloxetine, 4g magnesium oxide, 30mg olanzapine, 3.6mg tamsulosin, and 300mg bupropion, as well as an unknown amount of trazodone. Intentional polysubstance overdose with cardioactive medications may result in profound vasodilation despite standard treatment modalities. Our experience describes the successful use of methylene blue as an adjunctive option to achieve hemodynamic stability given its alternative mechanism of action."

Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Hypotension • Pain • Psychiatry • Vascular Neurology

INTRATHECAL MORPHINE DELIVERED BY BACLOFEN PUMP FOR STATUS DYSTONICUS IN LESCH-NYHAN SYNDROME (SCCM 2025) - "Throughout the 42 hospitalization days (HD), he received intermittent benzodiazepines (HD 2-33), ketorolac (HD 1-23; 22 total doses), both intermittent (HD 3-24) and continuous infusions (HD 24-32) of ketamine, dantrolene (HD 3-41), prucalopride (HD 7-41), hydromorphone (HD 7-40), methadone (HD 15-20), cyclobenzaprine (HD 7-37), hyoscyamine (HD 13-39), amitriptyline (HD 19-41), and dexmedetomidine infusion (HD 20-35)...Gabapentin, previously avoided for history of allergic reaction, was started on HD 28...When the spine is inaccessible, utilization of preexisting intrathecal baclofen pump should be considered for delivery of opiates. More research is needed regarding long term safety, efficacy, and timing to optimize therapy and avoid polypharmacy."

Anesthesia • CNS Disorders • Dystonia • Immunology • Inflammatory Arthritis • Movement Disorders • Nephrology • Renal Calculi • Rheumatology