cyclobenzaprine / Generic mfg. - LARVOL DELTA

Paper-Based Reaction Devices as Accelerated Platforms in Forced Degradation Studies. (PubMed, J Pharm Sci) - "Strips of cellulose paper were employed as reactive microenvironments to investigate the degradation of two model drugs, cyclobenzaprine (CBP) and deflazacort (DFL), under oxidative, acidic, basic, and metal-ion stress conditions. The PRD approach is proposed as an investigational and preformulation-level tool for early-phase stability assessment, complementing rather than replacing conventional stress testing methods. Its simple, robust, and high-throughput format offers a valuable alternative for rapid stability evaluation during the early stages of drug development and formulation design."

Journal

Short-term efficacy and safety of sublingual cyclobenzaprine for fibromyalgia: A systematic review and meta-analysis. (PubMed, Clin Rheumatol) - "This meta-analysis of TNX-102 SL for fibromyalgia found that once-nightly sublingual cyclobenzaprine produced consistent improvements in pain response and global impression compared to placebo, with a good tolerability profile. TNX-102 SL represents an essential new non-opioid option for fibromyalgia. Key Points • In a meta-analysis of four randomized, double-blind trials (n = 1,684), TNX-102 SL increased ≥ 30% and ≥ 50% pain responder rates versus placebo (RR 1.44 and 1.43; low heterogeneity). • TNX-102 SL improved Patient Global Impression of Change (RR 1.52), while FIQ-R scores -were not significantly different from placebo. • Treatment-emergent adverse events were more frequent and primarily transient oral effects (hypoesthesia, paresthesia, dysgeusia), with similar discontinuation rates and no reportd deaths."

Clinical • Journal • Retrospective data • Fatigue • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

The role of SLC22A4 in Acute Myeloid Leukaemia. (PubMed, Mediterr J Hematol Infect Dis) - "Drug-sensitivity analysis showed positive correlations with cyclobenzaprine, hydrochloride, SGX-523, and simvastatin, and negative correlations with fluorouracil, abexinostat, EMD-534085, hypothemycin, tamoxifen, and sunitinib. SLC22A4 may be useful as a potent molecular-targeted agent in AML."

Journal • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology

Zoster sine herpete: An atypical presentation of herpes zoster without rash (ASRA-FALL 2025) - "Of note, they were recently diagnosed with pneumonitis concomitant with severe persistent asthma by a pulmonologist and were on week four of a prednisone taper and trimethoprim-sulfamethoxazole regimen...They were also prescribed lidocaine 5% ointment and advised to continue their chronic pain regimen consisting of tapentadol extended-release 50 mg two times daily to provide neuropathic and nociceptive pain control in addition to acetaminophen, celecoxib, 1% diclofenac gel, and cyclobenzaprine...Discussion ZSH is an important diagnosis to consider for immunocompromised patients presenting with acute, localized, dermatomal pain without skin changes or a clear, identifiable source. Similar to HZ, ZSH treatment includes antivirals like valacyclovir or acyclovir alongside analgesics.2,4,5 Prevention also plays an important role with the herpes zoster vaccine given as a two-dose series.1,4 While rare, prompt diagnosis and timely treatment of ZSH are crucial to avoid..."

Asthma • Fibromyalgia • Herpes Zoster • Immunology • Infectious Disease • Inflammation • Musculoskeletal Pain • Neuralgia • Pneumonia • Respiratory Diseases • Rheumatology • Varicella Zoster

Restorative Neurostimulation of lumbar multifidus muscles in a patient with severe degenerative lumbar scoliosis. (ASRA-FALL 2025) - "Current medication regimen includes gabapentin, etodolac, acetaminophen, cyclobenzaprine and tramadol Known severe degenerative scoliosis MRI confirmed grade 2 (>50%) multifidus atrophy For management of symptoms, Reactiv8 regenerative neurostimulation device implanted Outcome: 12 day post operative visit: No complications. Therapy sessions initiated 10 week follow up: Subjective improvement in pain and functionality, requiring less etodolac and acetaminophen, Left-sided lead activated, Reports ongoing right leg pain 15 month follow up: Patient undergoes right total hip arthroplasty for management of right leg pain 19 month follow up: Ongoing relief of back pain, Patient able to discontinue use of tramadol Discussion Restorative neurostimulation shows promise as pain management strategy for patients with scoliosis and MD. Further research is needed to determine overall safety, feasibility and efficacy"

Clinical • Back Pain • Lumbar Back Pain • Muscular Atrophy • Musculoskeletal Pain • Orthopedics

Influenza A-Induced Acute Liver Injury: A Rare Adverse Effect (ACG 2025) - "The patient's home medications include atorvastatin, carbamazepine, cyclobenzaprine, famotidine, fluoxetine, gabapentin, hydroxyzine, metformin, multivitamin, propranolol, senna, Seroquel, vitamin B1, Vivitrol. Additionally, labs from a month ago showed liver enzymes to be at baseline. These findings along with the IVA infection point towards IAV-induced ALF.Given the potential for ALI, especially in severely ill patients, routine liver enzyme testing is recommended in the management of IAV infection."

Adverse events • Autoimmune Hepatitis • Chronic Kidney Disease • Hepatology • Immunology • Infectious Disease • Inflammation • Influenza • Liver Failure • Metabolic Disorders • Respiratory Diseases

THE SHOULDER PAIN THAT WASN'T: AN UNEXPECTED DIAGNOSIS OF ATYPICAL METASTATIC NSCLC WITH VARIABLE CDX2 EXPRESSION (CHEST 2025) - "He was diagnosed with muscle spasms and prescribed meloxicam and cyclobenzaprine, along with a referral to physical therapy.One month later, due to persistent symptoms, he presented to the emergency department (ED)...He was treated symptomatically with lidocaine patches and toradol and discharged on the same medications with short course of diazepam...The patient was treated with palliative radiation therapy (RT) followed by carboplatin and pemetrexed, resulting in significant tumor regression on repeat CT imaging after four months... This case underscores the importance of early imaging in smokers presenting with unexplained musculoskeletal pain, particularly when refractory to standard treatment. It also highlights the diagnostic complexity of CDX2 positive NSCLC, advocating for comprehensive workup and molecular profiling to ensure appropriate management. Increased awareness of such atypical presentations may aid in earlier detection and improved outcomes in lung..."

Metastases • Gastrointestinal Cancer • Hypertension • Lung Cancer • Mood Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Non Small Cell Lung Cancer • Pain • Solid Tumor • CDX2

Pharmacologic treatment of fibromyalgia: an update. (PubMed, Front Pharmacol) - "Pharmacological therapy remains unsatisfactory: only pregabalin, duloxetine, and milnacipran have gained U.S. FDA approval, providing clinically meaningful relief in a minority of patients, and their frequent adverse events limit adherence. Numerous other agents, including cyclobenzaprine, gabapentinoids, NMDA antagonists, cannabinoids, and sodium oxybate, have been evaluated, but most remain investigational or limited by safety concerns. Current guidelines emphasize that pharmacological interventions alone are insufficient and should be integrated with non-pharmacological strategies, especially patient education, exercise, and psychological support. This review summarizes the evidence on available and emerging pharmacological options for FM, highlights their limitations, and underscores the need for individualized, multimodal treatment strategies to improve patient outcomes and quality of life."

Journal • Review • CNS Disorders • Cognitive Disorders • Fatigue • Fibromyalgia • Mood Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology • Sleep Disorder

RHABDOMYOLYSIS AFTER UNINTENTIONAL CYCLOBENZAPRINE OVERDOSE (CHEST 2025) - "Cyclobenzaprine is a common muscle relaxant with potential for overdose. AKI can often be present due decreased intake. However, for myoglobin-associated AKI, the patient requires adequate urine output in addition to hydration."

Acute Kidney Injury • Back Pain • Cardiovascular • CNS Disorders • Depression • Lumbar Back Pain • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Psychiatry • Renal Disease • Respiratory Diseases • Ventricular Tachycardia • Xerostomia • MB

Symptom Burden and Treatment Experience in Fibromyalgia: Results From a National Patient Survey (ACR Convergence 2025) - "Among current medications, off-label therapies were most common; most frequently SSRIs/SNRIs or gabapentin (30% each), cyclobenzaprine (20%), and trazodone or tramadol (13% each). This survey found patients with FM frequently experience persistent, burdensome and impactful symptoms, even after years of treatment. Symptom relief and treatment satisfaction were limited, and expectations for future improvement were low. Use of off-label and combination therapies was high, and rates of discontinuation due to side effects or lack of efficacy were common."

Clinical • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Fatigue • Fibromyalgia • Migraine • Mood Disorders • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology

Relax the Body: Dual-Agent Nighttime Therapy for Fibromyalgia: Symptom Reduction Using Tricyclic Antidepressants and Muscle Relaxants (ACR Convergence 2025) - "All participants were prescribed a low dose TCA (amitriptyline, doxepin, or trazodone) in the early evening, titrated as needed to induce deep sleep. Once patients reported improved sleep, a nightly muscle relaxant - either cyclobenzaprine or tizanidine - was introduced and gradually increased based on tolerability, up to 30 mg or 24 mg respectively... This study introduces a novel multimodal pharmacologic regimen combining tricyclic antidepressants and muscle relaxants to target both central and peripheral mechanisms contributing to FM symptomatology. Results suggest that such a combination can improve pain, sleep, and energy in a substantial portion of FM patients, with minimal side effects. Given the limitations of existing monotherapies and the heterogeneity of FM symptoms, this approach warrants further exploration in larger randomized controlled trials."

Anesthesia • CNS Disorders • Fatigue • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology • Sleep Disorder

Thirty Percent of Older Adults with Rheumatic Disease Receive High-Risk Medication (ACR Convergence 2025) - "Thirty percent of older adults with rheumatic diseases received at least one high-risk medication. The most common medications prescribed were cyclobenzaprine and zolpidem, suggesting that this population has significant pain and sleep dysfunction prompting use of HRMs. Further research is warranted to identify optimal strategies and medications to balance symptom relief with patient safety, ensuring that pain, mood, and insomnia in older adults with rheumatic disease are effectively managed without incurring undue harm in this vulnerable population."

Clinical • CNS Disorders • Fibromyalgia • Gout • Inflammatory Arthritis • Insomnia • Musculoskeletal Diseases • Musculoskeletal Pain • Orthopedics • Psychiatry • Rheumatology • Seronegative Spondyloarthropathies • Sleep Disorder

NON-INVASIVE NEUROMODULATION OF COMORBID MIGRAINE, TRAUMATIC BRAIN INJURY, AND PTSD (WCN 2025) - "Sumatriptan 1-2 times/week. These cases support the benefit of NNM in treating comorbid migraine, PTSD, and TBI."

Non-invasive • CNS Disorders • Insomnia • Migraine • Pain • Post-traumatic Stress Disorder • Psychiatry • Sleep Disorder • Vascular Neurology

Cyclobenzaprine-related adverse events: a comprehensive pharmacovigilance analysis using the FDA Adverse Event Reporting System. (PubMed, Front Med (Lausanne)) - "These findings underscore the need for enhanced monitoring and further research to mitigate risks, particularly in vulnerable populations. Clinicians should remain vigilant for both somatic and psychiatric AEs when prescribing cyclobenzaprine, especially in patients with a history of mental health issues or substance abuse."

Adverse events • Journal • Cardiovascular • CNS Disorders • Immunology • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry • Substance Abuse

Efficacy and safety of TNX-102 SL in patients with fibromyalgia: a systematic review and meta-analysis. (PubMed, Pain Manag) - "TNX-102 SL is a new sublingual tablet formulation of cyclobenzaprine (CBP) for rapid transmucosal absorption. Pooled data show TNX-102 SL significantly reduces pain, improves sleep quality, and enhances quality of life in FM patients. www.crd.york.ac.uk/prospero identifier is CRD42024588069."

Journal • Retrospective data • Review • Anesthesia • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Analytical green star area (AGSA) as a new assessment tool for the electrochemical determination of cyclobenzaprine hydrochloride in wastewater samples using recycled graphite-modified nitrogen-doped CQDs. (PubMed, RSC Adv) - "Using molecular docking, the α-CD ionophore was found to be the most favorable orientation of CBZ towards the highly selective ionophore in the membrane sensor. The open source and accessible nature of the Analytical Green Star Area (AGSA) facilitates cross-disciplinary comparisons."

Journal

Safety of Baclofen and Tizanidine in Older Adults: A Retrospective Cohort Study in a Large Integrated Health Care System. (PubMed, J Am Geriatr Soc) - "Older adult patients dispensed baclofen or tizanidine were found to have an increased risk of injury when compared with cyclobenzaprine, currently included on the Beers Criteria. These findings support the inclusion of baclofen and tizanidine on the Beers Criteria along with other SMRs as potentially inappropriate medications in use in older adults with musculoskeletal complaints. Due to a retrospective design, the risk for residual confounding may remain."

Journal • Retrospective data • CNS Disorders • Musculoskeletal Diseases • Orthopedics • Vascular Neurology

Preclinical Safety, Tolerability and Pharmacokinetics of a Novel Cyclobenzaprine Hydrochloride Nasal Spray. (PubMed, Regul Toxicol Pharmacol) - "Microscopic evaluations of the nasal cavity and other anatomical structures showed mild non-adverse changes, with no significant histopathological findings in the olfactory epithelium, olfactory bulb, or brain. These findings indicate that Cyclobenzaprine Hydrochloride Nasal Spray is well-tolerated with a NOAEL of 1.05 mg/animal/day in rats and ≥10.5 mg/animal/day in dogs, suggesting potential for safe intranasal administration in clinical use."

Journal • PK/PD data • Preclinical • Hematological Disorders • Ophthalmology

Multimodal Analgesia Effect on Post Surgical Patient (clinicaltrials.gov) - P4 | N=60 | Active, not recruiting | Sponsor: University of California, Davis | Completed ➔ Active, not recruiting

Enrollment closed • Genetic Disorders • Obesity

Global Consensus on Interstitial Cystitis/Bladder Pain Syndrome: An Update on Therapeutic Treatments. (PubMed, Neurourol Urodyn) - "In this review, we present currently available treatment options for IC/BPS. These include conservative therapies, oral medications, intravesical therapies, and neuromodulation. Novel and investigational therapies are presented as well as promise for future directions."

Journal • Review • Gynecology • Interstitial Cystitis • Musculoskeletal Pain • Pain

Effect of cyclobenzaprine on the velocity time integral of the left ventricular outflow tract in elderly patients undergoing painless colonoscopy (ChiCTR) - P=N/A | N=120 | Not yet recruiting | Sponsor: The First People’s Hospital of Lianyungang; The First People’s Hospital of Lianyungang

New trial • Pain

Ketamine Use in a Laboring Mother With Type 4 Ehlers-Danlos Syndrome, a Family History of Malignant Hyperthermia, and Opioid-Induced Seizures. (PubMed, Cureus) - "Due to her complex medical history, traditional methods for labor analgesia, including neuraxial techniques and remifentanil patient-controlled analgesia, were associated with significantly increased risks. A tailored pain management regimen was implemented, consisting of intravenous acetaminophen, cyclobenzaprine, and a ketamine infusion. The patient delivered a healthy neonate without complications. This case highlights the successful use of ketamine for labor analgesia in a high-risk obstetric patient with EDS."

Journal • Anesthesia • CNS Disorders • Epilepsy • Genetic Disorders • Obstetrics • Pain • Rheumatology • COL3A1

Urinary metabolic ratio of pain management and substance abuse treatment drugs: Drug-drug interactions. (PubMed, J Opioid Manag) - "The 18 drugs include dextromethorphan, oxycodone, hydrocodone, tramadol, morphine, buprenorphine, fentanyl, clonazepam, alprazolam, quetiapine, carisoprodol, tapentadol, ketamine, methadone, impramine, and amitriptyline. The 14 interfering drugs include fluoxetine, paroxetine, bupropion, citalopram, sertraline, venlafaxine, duloxetine, risperidone, trazodone, aripiprazole, cyclobenzaprine, amphetamine, and tetrahydrocannabinol...Using the MR reference intervals of the 18 drug pairs established in an earlier study, and the current DDI system, we can alert providers of unusual metabolism caused by DDIs. This will help providers do better prescribing or review more closely all medications and supplements patients are taking, thus avoiding underdosing or potential medication adverse reactions."

Journal • Pain • Substance Abuse • CYP2C19 • CYP3A4

Cyclobenzaprine HCl ameliorates OVA-induced asthma through modulating the TLR4/MyD88/NF-κB and PI3K/AKT/mTOR signaling pathways. (PubMed, Int Immunopharmacol) - "Additionally, CBP alleviated asthma airway inflammation by regulating TLR4/MyD88/NF-κB and PI3K/AKT/mTOR signaling pathways. Our data suggest that CBP is expected to become a potential new drug for relieving or treating asthma."

Journal • Asthma • Immunology • Inflammation • Musculoskeletal Pain • Pain • Pulmonary Disease • Respiratory Diseases • MYD88 • TLR4

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