withdrawal
Carisoprodol (Soma) Adverse Reactions
Adverse effects most common during carisoprodol therapy are drowsiness (up to 40%) and dizziness, which may require dosage reduction. Other CNS effects can emerge such as vertigo, ataxia, lethargy, tremor, insomnia, agitation, irritability, headache, depression, and syncope. Respiratory depression may occur with excessive dosage and/or with concurrent use of other CNS depressants (e.g., barbiturates, benzodiazepines, opiate agonists). Other systemic reactions include weakness (asthenia), fatigue, temporary vision loss (visual impairment), confusion or impaired cognition, mydriasis, and disorientation. Other reported side effects of carisoprodol include nausea/vomiting, hiccups, increased bowel activity, sinus tachycardia, orthostatic hypotension, and flushing.
Idiosyncratic, allergic or anaphylactoid reactions, may occur within the period of the first to fourth dose in patients having had no previous exposure to carisoprodol. These reactions are similar to those patients can experience from meprobamate. If an allergic response to meprobamate has occurred, a similar reaction can occur with carisoprodol because it is partially metabolized to meprobamate. Although rare, the symptoms may be severe and can occur within minutes or hours. These include transient quadriplegia, temporary loss of vision or memory, diplopia, extreme weakness, mydriasis, dysarthria (slurred speech), agitation, euphoria, disorientation and confusion. Rash (unspecified), erythema, pruritus, urticaria, and fixed-drug eruptions can occur. Severe allergic reactions can lead to anaphylactic shock. In some patients, these reactions disappear after a few hours. If allergic or idiosyncratic reactions continue, the drug should be withdrawn and appropriate supportive and symptomatic therapy should be initiated, which may include antihistamines or epinephrine. Corticosteroids may be necessary in severe reactions manifested by fever, weakness, dizziness, angioneurotic edema, hypotension and anaphylactic shock.
Excessive doses of carisoprodol can produce stupor, coma, shock, respiratory depression, and rarely, death. Additive effects from alcohol, other CNS depressants or psychotropic agents can have additive effects and potentiate carisoprodol, even when one agent has been taken in the usual recommended dose. Abrupt discontinuance of carisoprodol at doses of 100mg/kg/day, which is about five times the recommended adult dose, produced mild withdrawal symptoms such as abdominal muscle cramps, insomnia, chills, headache and nausea. Delirium and convulsions were not reported as occurring secondary to withdrawal.
[ Last revised: 7/21/2003 1:39:00 PM ]
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