10 best muscle relaxants
Muscle spasm is a very unpleasant and sometimes dangerous phenomenon. How to alleviate the situation, choose the perfect drug, and why you should not take muscle relaxants without a doctor’s prescription, read in our article.

Muscle relaxants are a generic name for a number of drugs that, due to the action of one or another active substance, allow you to relax skeletal muscles up to complete immobility. Such drugs are used in the treatment of various diseases, as well as for diagnostic purposes, when it is necessary for a person to be conscious, and his muscles should not contract.

Muscle relaxants help reduce excess tension in the lower back, relieve increased muscle tone in patients who have had a stroke, after a traumatic brain or spinal injury, with multiple sclerosis1 and a number of other diseases.

There are muscle relaxants of central and peripheral action. The former inhibit the process of excitation in the central nervous system and suppress reflexes. The latter do not affect the neurons of the brain, but act directly on the points of contact of the muscles with the nerve endings.

Important advantages of using muscle relaxants2:

  • relieve muscle tension
  • reduce pain,
  • improve motor activity,
  • allow you to reduce the dose of painkillers and enhance their effect.

Muscle relaxants can be used in combination with analgesics and NSAIDs (non-steroidal anti-inflammatory drugs), as well as together with acupuncture and exercise therapy1.

Muscle relaxants have a number of contraindications and side effects. Often while taking the drug there is drowsiness, fatigue, dizziness, lethargy. This must be taken into account when choosing a medicine, so you can not do without a preliminary consultation with a doctor.

Rating of the top 10 inexpensive and effective muscle relaxants according to KP

In pharmacies, you can buy drugs with different names themselves, but they most often use 3 active ingredients: baclofen, tolperisone or tizanidine. The choice of one or another muscle relaxant depends on the purpose, the presence of contraindications and possible side effects. We will consider the most popular and safe muscle relaxants that doctors recommend.

1. Baklosan

The drug is available in tablets of 10 and 25 mg. Designed to reduce muscle tone in multiple sclerosis, diseases of the spinal cord (tumors, syringomyelia, trauma, etc.) and cerebrovascular diseases, cerebral palsy, meningitis, traumatic brain injury.

The active substance – baclofen – effectively relieves painful spasms. The drug is prescribed even for children older than 3 years.

However, there is a wide list of contraindications, which, in addition to hypersensitivity, include: epilepsy, convulsions, psychosis, Parkinson’s disease, gastric and duodenal ulcers, lactase deficiency, lactose intolerance, pregnancy and lactation.

fast effect, low price in the segment.
an impressive list of side effects.

2. Tolperisone

The drug was developed in the middle of the last century and during this time has demonstrated its effectiveness and safety.3. Tolperisone does not affect the peripheral parts of the nervous system, it has an analgesic and vasodilating effect.

Tolperisone is prescribed for the treatment of spinal and cerebral palsy, diseases with severe muscle tension and spasm, rheumatic diseases, epilepsy and a number of other diseases.

It is not recommended to use the drug in case of hypersensitivity to the components, myasthenia gravis, as well as during pregnancy, breastfeeding and children under 18 years of age.

Important: for one course (regardless of the prescribed treatment), you will need several packages of the drug. In one – only 30 tablets of 50 mg.

Side effects are rare, which is a big plus for muscle relaxants.
not suitable for children, uneconomical packaging.

3. Tizanidine

Another muscle relaxant that can be used in the treatment of painful muscle spasms, muscle hypertonicity in multiple sclerosis, diseases and injuries of the spinal cord.

There is no universal regimen of admission – it all depends on the disease itself and the health characteristics of each patient. Therefore, the dosage regimen and dosage will be prompted only by the attending physician.

In addition to hypersensitivity to components, lactase intolerance / deficiency, and pregnancy, severe liver dysfunction is on the list of contraindications. It is not recommended to use the drug for lactating women and children under 18 years of age.

Among the “side effects” are often muscle weakness, drowsiness, dizziness, dry mouth, fatigue.

low price in the segment, fast effect.
frequent side effects.

4. Tolisor

Domestic generic Tolperisone is available in the form of capsules of 50 and 150 mg. It is recommended for the treatment of diseases and pathologies associated with increased skeletal muscle tone.

The list of contraindications is the same as for other muscle relaxants. In addition, the drug should be used with caution in people with hypersensitivity to lidocaine and in patients with renal and hepatic insufficiency. Side effects (weakness, drowsiness) are quite rare.

Important: you need to take the drug strictly after meals. On an empty stomach, the medicine is absorbed worse by the body, and there will be no effect.

little risk of side effects.
uneconomical packaging, which ultimately affects the cost.

5. Mydocalm

As part of the drug, a substance already familiar to readers is tolperisone. It is used to relax skeletal muscles in various neurological, orthopedic and other diseases accompanied by muscle hypertonicity (for example, multiple sclerosis, myelopathy, encephalomyelitis), cerebral palsy.

You should not take this muscle relaxant if you have a history of myasthenia gravis, severe kidney and liver diseases, hypersensitivity to the drug substances, lactose intolerance/insufficiency, pregnant and lactating women.

But for children from the age of 3, the drug is allowed, but only in the form of tablets of 50 mg.

approved for use in children (from 3 years).
high price.

6. Kalmirex

The tablets contain the active substance Tolperisone. The drug is intended for the treatment of increased muscle tone after a stroke, with muscle spasm, accompanied by pain. This muscle relaxant can only be used by adults and on prescription.

 Contraindications: hypersensitivity to the components, myasthenia gravis, lactose intolerance / deficiency, breastfeeding.

Use with caution in people with renal and hepatic insufficiency – there is a high risk of developing adverse events. In general, side effects (drowsiness, fatigue, weakness, dizziness) are rare.

wide spectrum of action, rare side effects.
the course will need several packages (only 30 tablets in one).

7. Sirdalud

The tizanidine-based drug is a popular muscle relaxant. It is quite effective for painful muscle spasms associated with diseases of the spine (cervical, lumbar syndromes), with multiple sclerosis and chronic myelopathy, and can also be used after surgical interventions (for example, during the rehabilitation period after removal of a spinal hernia)4.

Sirdalud tablets can be divided in half and taken in parts, since the correct selection of the dose is very important, but this is not always convenient.

wide range of action, high efficiency.
inconvenient reception mode.

8. Lioresal intrathecal

The muscle relaxant, the active ingredient of which is baclofen, is available as a solution for injection directly into the spinal cord, and therefore is used only in a hospital setting.

The drug is recommended for people with chronic muscle spasm caused by damage to the brain or spinal cord. The medicine helps to reduce pain during spasms, reduces cramps and twitches. As a result, physical activity increases, sleep improves, and the work of the bladder normalizes.

There are also disadvantages: the drug can cause drowsiness, respiratory depression and the work of the cardiovascular system.

quick effect, improves the quality of life of bedridden patients, suitable for those who find it difficult to swallow tablets and capsules.
difficult to find commercially, frequent side effects.

9. Tolmio

An injectable drug (can be administered both intramuscularly and intravenously) helps to reduce increased muscle tone, dilates blood vessels, reduces pain and spasms, and lidocaine has a local anesthetic effect.

Tolmio is used for diseases accompanied by painful muscle spasms, as well as for muscle hypertonicity during a stroke.

Do not use Tolmio in the presence of the following contraindications: hypersensitivity to the components, severe myasthenia gravis, pregnancy and breastfeeding, children’s age (up to 18 years). Patients with renal and hepatic insufficiency – with caution and only on the recommendation of the attending physician. Side effects after taking the drug are rare or infrequent.

minor side effects, suitable for patients with difficulty in swallowing.
difficult to find on sale, high price in the segment.

10. Tizalud

A muscle relaxant based on tizanidine can help relax muscles and reduce pain from spasms associated with diseases of the spine, after surgery and neurological diseases such as multiple sclerosis, degenerative diseases of the spinal cord, cerebral palsy (but only from 18 years).

The use of Tizalud is also contraindicated in case of hypersensitivity to the components of the drug (including lactose), severe liver dysfunction, during breastfeeding. Do not simultaneously use this drug with the antidepressant fluvoxamine and the antibiotic ciprofloxacin (and analogues). Patients over 65 years of age and patients with hepatic and renal insufficiency should first consult a doctor.

Do not forget that you need to strictly regulate the dosage of tizanidine, so the tablets will have to be divided into small parts.

wide range of action, low price in the segment.
inconvenient reception format (you need to divide the tablets into parts for the correct dosage).

How to choose muscle relaxants

The choice of the drug should be treated with particular care, given its purpose. Despite the common “target” – spasm, the list of diseases may vary. It is also important to study the list of contraindications and restrictions.

Many muscle relaxants are “rich” in side effects that can occur with varying degrees of probability, and this must also be taken into account.

Undoubtedly, only a doctor can choose the optimal drug in each case. That is why muscle relaxants are prescription drugs so that a person does not harm himself by self-medicating.

If you think that you can not do without a muscle relaxant, contact your doctor with this question. Don’t forget to indicate your health conditions (allergies, sensitivity to lactose, lidocaine and other substances, etc.).

Reviews of doctors about muscle relaxants

Despite the rather long history of the use of muscle relaxants, the opinions of doctors about their appointment still differ.

Some experts recommend the use of muscle relaxants for back pain.

— When used correctly, muscle relaxants significantly improve the quality of life of patients, — notes neurologist of the highest category Olga Lisenkova.

Other doctors consider such treatment inappropriate5. A number of doctors are convinced that research data on the effectiveness of muscle relaxants is not enough, so they do not need to be prescribed.

Popular questions and answers

How muscle relaxants work and why they need to be used with great care, Olga Lisenkova, a neurologist of the highest category, answers.

When are muscle relaxants used?

– Muscle relaxants (“myo” – muscle, “relax” – relaxation) – a large group of drugs used when muscles need to be relaxed. They are used in anesthesiology (for anesthesia), for back pain (in the form of tablets and injections), for spasticity – this is a painful muscle spasm that occurs with diseases of the nervous system. Spasticity occurs after a stroke, traumatic brain injury, with multiple sclerosis and other diseases.

Why are muscle relaxants dangerous?

Like any medication, muscle relaxants have side effects. In case of an overdose, excessive muscle weakness, heart rhythm disturbances, dizziness, etc. may occur.

How many days can I take muscle relaxants?

— The course of treatment depends on the diagnosis and condition of the patient. Muscle relaxants can be taken from a few days (for back pain) to a constant daily intake for many years. For example, the drug baclofen can be administered using a so-called “baclofen pump” – a device that is implanted in the human body and releases the drug into the spinal canal.

Why muscle relaxants can not be used without a doctor’s prescription?

– These are serious drugs with a large number of side effects and contraindications. The effect often depends on the dose, which is selected individually. It is also very important to consider the risk of interactions with other drugs. Without a doctor, all this is unlikely to be sorted out.

How can muscle relaxants be replaced if the neck or lower back hurts?

– The two most common “provocateurs” of pain in the neck and lower back: stress and sedentary work. Therefore, the best replacement for muscle relaxants is a good psychological preparation and physiotherapy exercises. A positive result gives a manual or hardware massage.

Sources:

  1. O. Kotova, A. Artemenko, E. Akarachkova, A. Belyaev. The use of muscle relaxants for nonspecific pain in the lower back // Vrach. 2018. No. 9. pp. 13-16 https://cyberleninka.ru/article/n/primenenie-miorelaksantov-pri-nespetsificheskoy-boli-v-nizhney-chasti-spiny/viewer
  2. N. Maslova, K. Agafonov. Oral muscle relaxants for nonspecific back pain. Vrach. 2017. No. 9. pp. 38-40
  3. V.A. Golovacheva, A.A. Golovacheva, O.E. Zinoviev, V.L. Golubev. Tolperisone in the treatment of acute and chronic nonspecific back pain // Neurology, neuropsychiatry, psychosomatics. 2020. Volume 12. No. 4. pp. 137-142
  4. M.L. Maksimov. The place of muscle relaxants in the treatment of pain syndrome // Russian Medical Journal. 2014. No. 7. P. 514 https://www.rmj.ru/articles/klinicheskaya_farmakologiya/Mesto_miorelaksantov_v_lechenii_bolevogo_sindroma/
  5. A. Vasiliev. Modern oral muscle relaxants in the complex therapy of pain syndromes. Vrach. 2017. №3. pp. 25-29

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