Patient/caregiver was educated on contraindications for using Metaxalone as follows:
- Metaxalone use, especially along with antidepressants, such as, citalopram, fluoxetine, sertraline, and many others can significantly increase the serotonin levels in the body. 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 heart rate, overactive reflexes, and diarrhea.
- Metaxalone use, especially in individuals with seizure history, can occasionally result in deterioration of seizure control and fresh episodes of seizures. Metaxalone must either be avoided for an alternative or used with extra caution in individuals with seizure history, to prevent exacerbation of seizure episodes.
- Metaxalone must be avoided in individuals with history of severe head injury and brain damage. Individuals with history of head injury and brain damage can be at a very high risk to present with severe depression of brain and associated respiratory centers with metaxalone, leading to complications such as, coma, breathing difficulty, and respiratory arrest, which can be fatal.
- Metaxalone use can sometimes result in poor red blood cell integrity, predisposing the cells to lysis, contributing to development of hemolytic anemia. Anemic individuals can present with pallor of skin, episodes of confusion, dizziness, exacerbated shortness of breath, and compromised endurance. Also, breakdown of red blood cells with metaxalone intake, can result in elevated levels of the yellow pigment, bilirubin, in the blood, leading to signs and symptoms of jaundice, such as, itching, dark urine, yellowing of skin and eyes, nausea and vomiting, poor metabolism, and fatigue. Metaxalone is contraindicated in individuals with history of hemolytic anemia or used with extreme caution, with close watch maintained for development of symptoms of jaundice and anemia.
