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Cyclobenzaprine for Fibromyalgia

Currently, cyclobenzaprine (Flexeril) is not FDA-approved for fibromyalgia, but it is frequently used off-label for people with this condition. It has been studied as a potential fibromyalgia treatment since the 1980s.

Cyclobenzaprine lessens muscle pain, tenderness, and fatigue in people with fibromyalgia. It can also lessen the number of tender points 2. Cyclobenzaprine, taken at bedtime, noticeably improves sleep quality and brings more nights of restorative sleep 1.

Cyclobenzaprine dosage for fibromyalgia is between 5-10 mg, taken up to three times a day 3.

Cyclobenzaprine plus Fluoxetine

Cyclobenzaprine combined with fluoxetine improves pain intensity, the number of painful tender points, and morning stiffness better than cyclobenzaprine alone4.

Cyclobenzaprine vs Amitriptyline

Although not approved by the FDA for fibromyalgia syndrome, cyclobenzaprine and amitriptyline have been used to treat fibromyalgia for years. Both have undergone extensive clinical testing for safety and effectiveness.

Cyclobenzaprine is related to the tricyclic antidepressants. Its chemical structure is quite similar to that of amitriptyline and differs by only one double bond.

A long-term study5, which followed 208 patients treated with amitriptyline, cyclobenzaprine, or placebo for 6 months reported significant improvement for both drugs, although initial improvement was lost at 6 months.

After 1 month, 21%, 12%, and 0% of the amitriptyline, cyclobenzaprine, and placebo patients, respectively, had significant improvement. These percentages increased to 36%, 33%, and 19%, respectively, at the 6-month. The nature and frequency of side effects reported by patients treated with amitriptyline and those reported by patients treated with cyclobenzaprine were similar5.

See also

References

  • 1. Moldofsky H, Harris HW, Archambault WT, Kwong T, Lederman S. Bedtime cyclobenzaprine on symptoms and sleep physiology in patients with fibromyalgia syndrome: a double-blind randomized placebo-controlled study. J Rheumatol. 2011 Dec;38(12):2653-63.
  • 2. Bennett RM, Gatter RA, Campbell SM, et al. Cyclobenzaprine vs placebo in the management of fibrositis. ACR Journal 1988 Dec;31(12):1535-42.
  • 3. Santandrea S, Montrone F, Sarzi-Puttini P, Boccassini L, Caruso I. A double-blind crossover study of two cyclobenzaprine regimens in primary fibromyalgia syndrome. J Int Med Res. 1993 Mar-Apr;21(2):74-80. PubMed
  • 4. Cantini F, Bellandi F, Niccoli L, Di Munno O. Fluoxetin combined with cyclobenzaprine in the treatment of fibromyalgia. Minerva Med. 1994 Mar;85(3):97-100.
  • 5.

Author: OriginalDrugs Team
Last reviewed: February, 2015

Quick facts

flexeril

  • Cyclobenzaprine is used to treat the pain, stiffness, and sleep problems that occur with fibromyalgia.