Skeletal Muscle Relaxants

Preparations

1. Pancuronium:
   0.04–0.1 mg/kg i.v.
   PAVULON, PANURON, NEOCURON 2 mg/ml in 2 ml amp.
2. Doxacurium:
   0.03–0.08 mg/kg i.v.
3. Pipecuronium:
   0.05–0.08 mg/kg i.v.
   ARDUAN 4 mg/2 ml inj.
4. Vecuronium:
   0.08–0.1 mg/kg i.v.
   NORCURON, NEOVEC 4 mg amp. and 10 mg vial; dissolve in 1–2.5 ml solvent supplied.
5. Atracurium:
   0.3–0.6 mg/kg i.v.
   TACRIUM 10 mg/ml in 2 ml vial.
6. Cisatracurium:
   0.15–0.2 mg/kg i.v.
7. Rocuronium:
   0.6–0.9 mg/kg i.v.
   CUROMID, ROCUNIUM 50 mg/5 ml, 100 mg/10 ml vials.
8. Mivacurium:
   0.07–0.15 mg/kg i.v.
9. Succinylcholine (Suxamethonium):
   0.5–0.8 mg/kg i.v.
   MIDARINE, SCOLINE, MYORELEX, ENTUBATE 50 mg/ml in 2 ml amp.
10. Dantrolene:
    25–100 mg QID oral, 1 mg/kg i.v. repeated as required.
11. Carisoprodol:
    350 mg TDS–QID oral
    CARISOMA 350 mg tab; SOMAFLAM 175 mg + ibuprofen 400 mg tab.
12. Chlorzoxazone:
    500 mg BD–TDS
    ULTRAZOX 250 mg + diclofenac 50 mg + paracetamol 325 mg tab; MOBIZOX 500 mg + diclofenac 50 mg + paracetamol 500 mg tab; PARAFON 250 mg + paracetamol 300 mg tab; FLEXON- MR 250 mg + ibuprofen 400 mg + paracetamol 325 mg tab.
13. Chlormezanone:
    100–200 mg TDS–QID
    DOLOBAK 100 mg + paracetamol 450 mg tab.
14. Methocarbamol:
    400–800 mg TDS oral, 100–200 mg i.m./i.v.
    ROBINAX 0.5 g tab, 1 TDS: 100 mg/ml inj. for i.v. or i.m. use. ROBIFLAM 750 mg + ibuprofen 200 mg tab; NEUROMOL-MR 400 mg + paracetamol 500 mg tab. Skeletal Muscle Relaxants Drugs Acting on Peripheral (somatic) Nervous System 62
15. Baclofen:
    10 mg BD–25 mg TDS oral
    LIORESAL, LIOFEN 10, 25 mg tabs.
16. Thiocolchicoside:
    4 mg TDS-QID
    NUCOXIA-MR: thiocolchicoside 4 mg + etoricoxib 60 mg tabs.
17. Tizanidine:
    2 mg TDS; max 24 mg/day
    SIRDALUD 2, 4, 6 mg tab; TIZAN 2, 4 mg tab; BRUFEN-MR, TIZAFEN 2 mg + ibuprofen 400 mg tab; TIZANAC 2 mg + diclofenac 50 mg tab., PROXYVON-MR 2 mg + nimesulide 100 mg cap.

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Classification

Peripherally Acting Muscle Relaxants

I. Neuromuscular blocking agents

A. Nondepolarizing (Competitive) blockers

1. Long acting: d-Tubocurarine, Pancuronium, Doxacurium, Pipecuronium
2. Intermediate acting: Vecuronium, Atracurium, Cisatracurium, Rocuronium, Rapacuronium
3. Short acting: Mivacurium

B. Depolarizing blockers
Succinylcholine (SCh., Suxamethonium), Decamethonium (C-10)

II. Directly acting agents
Dantrolene sodium
Quinine

Centrally Acting Muscle Relaxants

1. Mephenesin congeners: Mephenesin, Carisoprodol, Chlorzoxazone, Chlormezanone, Methocarbamol
2. Benzodiazepines: Diazepam and others
3. GABA derivative: Baclofen
4. Central α2 agonist: Tizanidine