Patient/caregiver was educated on the side-effects of using Flexeril as follows:
Serotonin syndrome
- Serotonin is one chemical in the brain, which in permissible amounts, is believed to reduce anxiety and promote happiness and well-being.
- Very excessive concentrations of serotonin in the brain can lead to serotonin syndrome. Individuals with serotonin syndrome can present with mania, excitement, hallucinations, agitation, insomnia, pounding heartbeat, very rapid irregular heart rate or arrhythmia, seizures, overactive reflexes, and diarrhea.
- Flexeril use can contribute to increase in the serotonin levels and lead to development of serotonin syndrome. Flexeril use, especially along with a few other antidepressants, such as, citalopram, fluoxetine, and sertraline, can increase the risk for serotonin syndrome many fold and so, must be avoided.
- Report symptoms of serotonin syndrome to your physician promptly for any appropriate measures to be considered.
Cardiovascular side-effects
- Flexeril, especially when taken in high doses, carries the risk of depressing the cardiovascular center in the brain, which regulates the heart rate and blood pressure. Consequently, intake of flexeril can result in low heart rate and blood pressure.
- This risk with flexeril can be even high when it is taken along with any other products and medications causing hypotension and bradycardia, such as, antihypertensives, antidepressants, antianxiety medications, and sedatives.
- Flexeril use can also result in fast and pounding heartbeat. Individuals with history of cardiac arrhythmias can be at increased risk for precipitation of arrhythmic episodes with flexeril use.
- Individuals taking flexeril must be increasingly watchful to report worsening symptoms of arrhythmias, such as, chest pain, low blood pressure, confusion, dizziness, increasing shortness of breath, and worsening fatigue.
- Hypotension and irregular heartbeat, secondary to flexeril intake, can contribute to the confusion and dizziness, thus significantly increasing the risk for fall and accidents.
- Individuals with history of hyperthyroidism can inherently be at risk for cardiac arrhythmias. Use of flexeril is such individuals can increase the risk for arrhythmias significantly. So, flexeril use is either avoided in such individuals for a safer alternative or used with extreme caution and close follow-up for any signs of developing or worsening arrhythmias.
Withdrawal
- Individuals on sudden withdrawal from flexeril, especially after prolonged use or use in high doses, can present with unpleasant withdrawal symptoms, such as, listlessness, lack of energy, exacerbation of depressive symptoms, anxiety, agitation, sleep disturbances, confusion, appetite changes, delusions, hallucinations, mania, bad muscle spasms, and seizures. Discontinuation on flexeril use must be slow and gradual, using tapering doses, and only on your physician recommendation.
