Patient/caregiver was educated on how to take Norflex as follows:

  1. Take the medication at the same time, every day, to avoid forgetting the medication. Taking the medication at regularly spaced intervals helps to maintain appropriate blood levels of norflex needed to derive the desired beneficial effects and also prevent toxicity with the medication.
  2. Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
  3. Do not change the dose on this medication without consulting your physician.
  4. Oral norflex can induce some nausea and vomiting, especially when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid these unpleasant gastrointestinal symptoms. Norflex can also induce extreme dry mouth and constipation. Sucking on a sugar free hard candy can help with symptomatic relief of dry mouth. Proper hydration measures and compliance with daily fluid intake recommendations can help with relief from constipation. If you experience any further bothersome constipation, report it to your physician for a recommendation on laxative/stool softener use. Observing compliance with fiber intake recommendations in the diet can also help with preventing episodes of constipation with the medication.
  5. Norflex use can result in episodes of confusion, dizziness, and light-headedness. Starting the medication at a low dose and gradually increasing the dose, to help optimum control of your symptoms, can contribute to reducing the risk for drowsiness and dizziness due to the medication. Do not change the prescribed dose on this medication without consulting your physician. The dizziness should progressively decrease and ease out in due course of time. If the dizziness continues/worsens and becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until you are used to the side effects caused by norflex intake. Observing compliance with use of recommended assistive devices, such as, cane and walker can further safety during confused states. Avoiding quick changes in position can also contribute towards fall and accident prevention.
  6. Do not take norflex with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the dizziness and confusion caused by norflex. A number of OTC cough medications, antihistamines, antiseizure, antidepressant, and antianxiety medications, can potentiate the confusion caused by norflex and so, must be avoided taking along with norflex. Avoid taking any other medications with potential to cause drowsiness along with norflex at the same time.
  7. Take the regular tablet as a whole with a glass of water. If you encounter difficulty swallowing the whole regular tablet, check with your doctor if you may cut the pill and swallow it in pieces with a glass of water. Usually tablets that can be cut bear a scoreline, displaying the line of cut. Check if your tablet has any. For individuals with severe swallowing difficulties, check with your doctor if you may also crush the tablet and sprinkle the powder on a spoonful of soft jelly or applesauce and swallow the jelly or sauce along with the medication. If you are crushing the tablet, make sure your tablet is not labeled as coated or controlled-release or extended-release, as coated/controlled-release/extended-release tablets are to be consumed as a whole and not to be crushed. Other preparations of medication could also be available to help an easy intake. Check with your physician on the same.
  8. Norflex could also be prescribed as a suspension that is administered as a shot into the vein or muscle. When administered as a shot, norflex is administered over a span of at least one minute, as an intravenous push through an IV catheter or into a muscle.
  9. Norflex could potentially interact with a lot of other medications and precipitate serious reactions. If you are being newly started on norflex, discuss with your physician regarding all your current medications and their safety with norflex. Also, notify your physician regarding any current norflex intake, if you are being started on any new medications and discuss their safety with norflex.
  10. Norflex could take some time to fairly adjust to your body, before any optimal relief with muscle spasms and easing of side-effects is experienced. So, do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
  11. Norflex only helps with relieving muscle spasms, probably by depressing the brain and inhibiting the conduction of nerve impulses from the brain and spinal cord to the skeletal muscles. Norflex only temporarily relieves the spasms but does not fix the actual condition causing the muscle spasms and so, is not a permanent cure. Continue taking norflex as ordered, even if you experience relief from muscle pain and spasms, until your physician orders for the discontinuation on the medication.
  12. Norflex has some potential for addiction and abuse, especially after prolonged use and/or in individuals with history of substance/drug abuse. Individuals on sudden withdrawal from norflex, especially after prolonged use or use in high doses, can present with mild unpleasant withdrawal symptoms, such as, listlessness, lack of energy, appetite changes, mood changes, rebound muscle stiffness, muscle spasms, runny nose, tearing of eyes, excessive nausea & salivation, stomach cramps, and sweating. Discontinuation on norflex use must be slow and gradual, using tapering doses, and only on your physician recommendation.
  13. Your physician could change the dose of norflex, based on the response you show, relief obtained, and side-effects presented with. So, maintain compliance with follow-up physician appointments and be accommodative to the plan of dose changes, until you show an optimum response.
  14. Notify your doctor of any unresolving muscle spasms, progressively worsening muscle pain and discomfort, compromised range of motion in the involved muscle groups, and any continuing or worsening unpleasant side-effects, so that, your dosage on the medication could be revised.
  15. Norflex is metabolized inside the body by the liver and is excreted out of the body mainly in urine by the kidneys. If liver function is deficient, metabolism of the drug could be compromised, which can result in higher concentrations of the drug in the body for longer periods of time. If kidney function is deficient, elimination of the drug could be compromised, which also can result in higher concentrations of the drug and metabolites in the body for longer periods of time. Either case can contribute to toxicity. While taking norflex, periodical labs could be ordered for evaluation of liver and kidney functions. So, maintain compliance with follow-up physician appointments and lab draws ordered. Be accommodative to the plan of dose changes accordingly to achieve an optimum response and prevent development of any undesired side-effects & toxicity.
  16. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose, which can result in toxicity. Notify your doctor and other health care personnel regarding your dose noncompliance.