Is Cyclobenzaprine a Controlled Substance?

Almost everyone experiences muscle spasms or sprains at some point in their lives, whether from an acute injury or a chronic health condition. According to the World Health Organization, roughly 1.7 billion people suffer from a musculoskeletal disorder that causes chronic pain.[1]

Without proper pain management, many turn to street drugs or alcohol to cope. They might also use powerful painkillers like OxyContin and fentanyl to relieve their pain. Sadly, these medications carry a high risk of abuse and, when misused, can lead to a substance use disorder.

Fortunately, non-addictive medications are available to treat acute pain caused by chronic musculoskeletal conditions. One example is cyclobenzaprine.

What Is Cyclobenzaprine?

Cyclobenzaprine is a muscle relaxer that belongs to the skeletal muscle relaxant class of drugs.[2] It is available as a generic medication and is also sold under the brand names Flexeril, Amrix, and Fexmid.[3]

According to StatPearls, this medication is typically used for a short period of two to three weeks.[4] Its limited usage duration is due to the lack of studies supporting long-term effectiveness, as well as the fact that pain from musculoskeletal conditions is generally short-lived. It also works best when combined with physical therapy.

Mechanism of Action

The prescription medication cyclobenzaprine works by blocking pain signals from reaching the brain, rather than acting directly on the skeletal muscle.[5] This prevents the pain signal from traveling from the neurotransmitters to pain receptors in the brain.

Off-Label Uses 

Cyclobenzaprine is only FDA-approved for musculoskeletal pain.[6] However, it is also prescribed for several off-label conditions, including:[7]

• Fibromyalgia
• Myofascial pain
• Post-traumatic stress disorder (PTSD)
• Sleep disorders

Administration

Cyclobenzaprine is available in immediate-release tablets and extended-release capsules.[4]

Dosing schedules for these formulations are as follows:[4]

• Immediate release: Immediate-release tablets are available in strengths of 5 mg, 7.5 mg, and 10 mg. A standard dosing schedule is 5 mg taken up to three times daily. This dose may be titrated if needed.
• Extended-release: Can be taken twice daily as a 15 mg capsule or once daily as a 30 mg capsule.

The maximum daily dosage for both immediate and extended-release cyclobenzaprine is 30 mg.[4]

Elimination Half-Life

It takes roughly 18 hours for half of the immediate-release formulation to be cleared from the body, and 32 hours for the extended-release formulation.[4]

Does Cyclobenzaprine Appear on the Controlled Substances Schedule?

Even though cyclobenzaprine is a muscle relaxer, the U.S. Drug Enforcement Administration (DEA) has not listed it as a controlled substance. This is because it does not have physically addictive or abusive properties.[8]

However, according to Drugs.com, like any other medication, patients taking cyclobenzaprine may become psychologically dependent on it if misused or experience withdrawal symptoms when stopping use.[9]

Can Cyclobenzaprine Misuse Lead to Addiction?

Even though cyclobenzaprine is not associated with addiction, like opioids or benzodiazepines, abruptly discontinuing use can trigger withdrawal symptoms that include nausea, headache, and general malaise.[9] To avoid withdrawal, it is best to taper off the medication under your physician’s supervision.

Note: Misusing cyclobenzaprine is more likely to result in dependence and withdrawal. Taking abusive doses can also increase the risk of an overdose.

What Is Considered Misuse?

Using cyclobenzaprine in any way other than prescribed is considered misuse.[10]

This includes:

• Taking higher doses than prescribed
• Taking doses too close together
• Mixing cyclobenzaprine with other muscle relaxers
• Doubling doses
• Crushing it and sniffing it

Who Is Most Likely to Become Dependent on Cyclobenzaprine?

Individuals who are likely to become dependent on medications like cyclobenzaprine are those who have used it over a long period at high doses.[11] Individuals who use the drug in a way other than directed are also at a higher risk of becoming psychologically dependent.

If you feel you have a dependency on cyclobenzaprine, it is important to work with your healthcare provider to taper off safely. Sudden cessation can result in withdrawal.

What Are the Signs of Cyclobenzaprine Dependence?

Someone dependent on cyclobenzaprine may continue using the medication despite no longer needing it.

They may also display the following behaviors:[12]

• Doctor shopping to obtain refills
• Taking more pills than prescribed
• Running out of their prescription before the scheduled time
• Borrowing cyclobenzaprine pills from other people
• Mixing cyclobenzaprine with other painkillers to increase its effectiveness
• Experiencing a cyclobenzaprine overdose

Cyclobenzaprine overdose can cause serious side effects that vary from individual to individual.[4]

Overdose symptoms include:[4]

• Fast heart rate
• Confusion
• Tremor
• Seizure
• Slurred speech
• Dizziness

If you or someone you know has experienced adverse side effects of cyclobenzaprine use, seek medical attention immediately.

Can Taking Cyclobenzaprine Lead to a Substance Use Disorder?

Chronic pain significantly contributes to the risk of addiction or substance use disorder.[13] Sadly, people enduring chronic pain often require lifelong medication, which raises their chances of dependence on painkillers and developing tolerance.[14] This can cause them to increase their doses beyond the prescribed amount in an attempt to find relief.

Although cyclobenzaprine does not have the addictive properties that some other muscle relaxers possess, taking more than the recommended dose or using it beyond the prescribed duration can lead to seeking more addictive substances to manage the pain. This is a slippery slope that almost always ends in addiction.

Finding Help for Prescription Drug Addiction 

If you or someone you know is struggling with an addiction to prescription painkillers, quitting cold turkey can be very challenging. Withdrawal symptoms, a return of pain, and physical dependence on the drug can make it seem impossible to break free from addiction. However, there is hope for recovery.

At Engage Wellness, we provide outpatient and therapeutic services for individuals who struggle with substance use disorder and addiction. Our fully accredited facility offers these services as a day treatment program, intensive outpatient, and outpatient levels of care.

We offer medication-assisted treatment to individuals in need of prescription drugs to lessen cravings and manage withdrawal symptoms, all under the supervision of licensed medical professionals. This approach is the safest and most effective way to begin your journey to sobriety.

To learn more about how our facility can help you overcome addiction, contact us today.

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