Metaxalone is a prescription drug that is used for acute muscular injuries like sprains, strains, and injuries. This medication falls into a class of medications called skeletal muscle relaxants, and is generally safe for short-term use when taken as prescribed. Common side effects of metaxalone include drowsiness, dizziness, nausea, and agitation. Less commonly, severe side effects like allergic reactions, confusion, and psychosis can occur. [1][2]
- Metaxalone is a prescription medication that is used to treat muscular injuries and pain
- Metaxalone belongs to a class of medications called skeletal muscle relaxants, which work by slowing the activity of the central nervous system to induce relaxation and relieve muscular pain
- Metaxalone is generally safe when taken as prescribed, but side effects like sedation, dizziness, nausea, and anxiety are sometimes reported
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Understanding metaxalone
Metaxalone is a prescription muscle relaxant that is used to treat injuries, musculoskeletal problems, and pain. This medication was first FDA-approved under the brand name Skelaxin, which is no longer on the market. Generic forms of the medication are still available and widely prescribed to help people experiencing musculoskeletal pain and tension. [1][2]Â
Metaxalone is a medication that is generally used for acute muscle pain and stiffness, including for injuries like sprains or strains. [2] Because of this, it is generally recommended for short-term use, rather than being used for the management of more chronic and long-term problems and pain management.
How metaxalone works in the body
Metaxalone works to relieve pain and muscle stiffness, spasms, and tension. Its exact mechanism of action is not established, but the primary effects are believed to be related to its effects on the central nervous system (CNS). [2]Â
Like other muscle relaxants, metaxalone depresses the activity of the nervous system, slowing down the response to promote relaxation. This can also help to relieve pain caused by muscle spasms, tension, and injuries. [2][3]
What metaxalone is used for
Metaxalone is primarily used to treat acute musculoskeletal pain related to injuries. Sprains and strains are common examples of what this medication may be prescribed for. Metaxalone can help people with muscular injuries experience relief from the pain and stiffness causing discomfort, limited range of movement, and tension. Metaxalone is generally not used for more chronic musculoskeletal pain. [1][2]
Recommended dosage and administration
Metaxalone is available in either 400 mg or 800 mg tablets and is taken orally. The recommended dose for children and adults over the age of 12 years old is 800 mg. This medication is often recommended to be taken three to four times per day, as the effects only last for 4-6 hours. [1]Â
Taking more of this medication than prescribed can increase the risk for adverse effects, including the risk of extreme sedation, overdose, and in some instances, respiratory depression or coma. These risks are increased for individuals who are taking this medication in combination with other substances or prescribed medications, particularly those that are CNS depressants. [4][5]
Common side effects of metaxalone
The most common side effects of metaxalone include dizziness, drowsiness, and nausea. Some people also report experiencing headaches, agitation, and anxiety after taking this medication. The side effects of metaxalone are similar to those of other CNS depressants, as well as other muscle relaxers. [1][2][3]Â
Some people report that after taking the medication, they feel slightly impaired. Both cognitive and motor impairment are possible after taking this medication, which may affect a person’s ability to drive, operate machinery, or think clearly during tasks that require a lot of concentration. [2]
Serious risks, contraindications, and drug interactions
Serious side effects are uncommon, but do occur in some individuals. Some of the possible serious side effects of metaxalone include:
- Tachycardia
- Agitation
- Confusion
- Hallucination and delusions.
Serious adverse effects may be more likely to occur in individuals with certain pre-existing conditions. For example, people with anemia are not recommended to take this medication, as it can result in a worsening of their condition. People with impaired liver or kidney function are also not recommended to take metaxalone because of the role these organs play in helping to metabolize the medication. [1]
Individuals who are allergic to this medication may develop a rash, hives, or swelling of the face, lips, or tongue. While uncommon, these reactions are serious and require immediate medical attention. [1][2]
Finally, people who are pregnant, breastfeeding, and children under the age of 13 are not recommended to take this medication. [1]Â
Serotonin syndrome and metaxalone overdose
One study reported that a person developed serotonin syndrome, a rare but potentially life-threatening condition, after taking metaxalone. Notably, this individual was taking other medications in conjunction with metaxalone, which likely affected their outcome, but as of 2024, the FDA has included this risk on the labeling, so while rare, the risk exists and should be taken into consideration when making decisions with regard to medications. Taking metaxalone in conjunction with antidepressants or other medications that work on serotonin receptors may increase the risk for this rare adverse effect. [6]
Metaxalone vs. Other muscle relaxants
Metaxalone is comparable to other muscle relaxants, which all work by depressing and slowing the activity of the central nervous system (CNS). These effects are believed to be responsible for the analgesic and muscle-relaxing effects of metaxalone. Overall, metaxalone has a similar risk and safety profile to other muscle relaxers. [3]
Is metaxalone addictive?
Metaxalone is not a controlled substance and is generally considered safe and non-addictive. Normally, this medication is indicated for short-term use and prescribed after acute injuries that cause muscular sprains, strains, and pain. [1][4]
Still, metaxalone may be abused by some people for its sedating effects, which are related to its action as a CNS depressant. Some people combine this medication with alcohol, opioids, or other CNS depressants to enhance the effects. This is dangerous and could increase the chances of negative adverse effects, including accidental overdose. [4]
Low risk of dependence and withdrawal
Metaxalone is not believed to cause withdrawal symptoms, especially when used short-term and as prescribed for acute injuries. There have not been significant reports of metaxalone abuse, addiction, or withdrawal, except as part of a polydrug use pattern. Some people abuse muscle relaxants like metaxalone in combination with other drugs to enhance or offset the effects. [4]
There have been a few reports of accidental metaxalone overdose, but all involved other drugs or medications. Taking metaxalone in addition to other medications or substances can be risky, especially when taken with other CNS depressants like alcohol, opioids, or benzodiazepines. Polydrug use can lead to dangerous health effects, including increasing the risk for respiratory depression, which ultimately leads the body and brain to be starved of oxygen. [4][5]
Signs of medication misuse
Misuse of a medication happens when a person takes more of a medication than prescribed, takes it more often than prescribed, or uses it for recreational rather than therapeutic purposes. Misuse of medication can also present as polysubstance use patterns, with people taking other drugs or medications to enhance the effects of a drug.
When a person misuses medication, there may be certain warning signs, including: [7]
- Taking more of a medication than prescribed, or taking it more often than prescribed
- Running out of prescriptions early.
- ‘Doctor shopping’ for additional refills or prescriptions.
- Taking someone else’s prescription medication.
- Taking prescription medication for recreational vs therapeutic reasons.
- Taking a prescription medication in ways not recommended (i.e., crushing or snorting the medication vs taking an oral tablet).
- Taking a prescription medication in addition to other medications or substances to achieve a high or enhance the euphoric or relaxing effects.
- Changes in mood and energy, including seeming more lethargic or unmotivated.
- Changes in behavior and habits, including sleeping more, skipping work, being more secretive, etc.
- Appearing intoxicated or impaired, poor coordination, and poor cognition.
Safe use guidelines
It is important to take any medications only as prescribed. Taking the medication in higher doses or more frequently than prescribed can increase the risk for serious adverse effects. Also, taking this medication in combination with other CNS depressants like alcohol, opioids, or benzodiazepines can increase the risk for accidental overdose, which can lead to respiratory depression. In a few instances, combining this medication with other drugs has resulted in fatal overdose. [4][5][7]Â
Here are some guidelines on how to use metaxalone safely: [7]
- Only take metaxalone as prescribed, and do not exceed the recommended dose or administration schedule.
- Until you are used to the effects of the medication, avoid driving, operating machinery, or engaging in other tasks that require precision motor skills or concentrated attention.
- Talk honestly with your prescriber about other substances you are using, including other prescribed medications, alcohol, and illicit substances.
- Do not use this medication in combination with alcohol or other CNS depressants, unless you have discussed this with your prescriber or doctor.
- Monitor for any adverse side effects and set up a follow-up appointment if you have concerns about mild or moderate side effects.
- Report to the nearest emergency room if you develop serious side effects like hives, trouble swallowing, or extreme changes in attentiveness or cognition.
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