metaxalone

(me tax' ah lone)

Skelaxin

Pregnancy Category C

Drug class
Skeletal muscle relaxant (centrally acting)

Therapeutic actions
Precise mechanism of action not known, but may be due to general CNS depression; does
not directly relax tense skeletal muscles or directly affect the motor endplate or motor
nerves.

Indications
• Adjunct to rest, physical therapy, and other measures for the relief of discomfort
associated with acute, painful musculoskeletal disorders

Contraindications and cautions

• Contraindicated with hypersensitivity to metaxalone; tendency for hemolytic or
other anemias; severe renal or hepatic disfunction, lactation.
• Use cautiously with mild liver dysfunction, pregnancy.

Available forms
Tablets—400 mg

Dosages
ADULTS AND PEDIATRIC PATIENTS > 12 YR
800 mg PO tid–qid.
PEDIATRIC PATIENTS < 12 YR
Not recommended.

Pharmacokinetics
Route Onset Peak Duration
Oral 60 min 2 hr 4–6 hr

Metabolism: Hepatic; T1/2: 2–3 hr

Distribution: Crosses placenta; may enter breast milk
Excretion: Urine

Adverse effects
• CNS: Light-headedness, dizziness, drowsiness, headache, fever, blurred vision
• Dermatologic: Urticaria, pruritus, rash
• GI: Nausea, vomiting, GI upset, liver dysfunction
• Other: Hemolytic anemia, leukopenia

Interactions
Drug-drug
• Increased risk of sedation with other CNS depressants and alcohol
Drug-lab test
• False-positive Benedict's test; use of a more specific glucose test is advised

Nursing considerations
Assessment
• History: Hypersensitivity to metaxalone; tendency for hemolytic or other
anemias; severe renal or hepatic dysfunction; lactation, pregnancy
• Physical: Body temperature; skin—color, lesions; orientation, affect, vision
exam, reflexes; bowel sounds, normal output; CBC, renal and hepatic function
tests

Interventions
• Establish safety precautions if dizziness, drowsiness, blurred vision occur (use
side rails, accompany patient when ambulating).
• Arrange for analgesics if headache occurs (and possibly as adjunct for relief of
discomfort of muscle spasm).
• Provide positioning, massage, warm soaks as appropriate for relief of pain of
muscle spasm.
• Provide support and encouragement to deal with discomfort of underlying
condition and drug effects.

Teaching points
• Take this drug exactly as prescribed. Do not take a higher dosage than that
prescribed.
• Continue the use of rest, physical therapy, and other measures to relieve the
discomfort.
• Avoid the use of alcohol, sleep-inducing or over-the-counter drugs while you are
taking this drug. These could cause dangerous effects. If you feel that you need
one of these preparations, consult your health care provider.
• These side effects may occur: Drowsiness, dizziness (avoid driving a car or
engaging in activities that require alertness if these occur); nausea (take drug with
food and eat frequent small meals).
• Report rash, itching, yellow discoloration of the skin or eyes.

Adverse effects in Italic are most common; those in Bold are life-threatening.