Can I Take Muscle Relaxer Medications While I’m Pregnant?
Key takeaways:
Muscle cramps — or muscle spasms — are a common complaint for many expecting mothers.
Pregnant women have several treatment options to consider for muscle cramps. But certain medications, like muscle relaxers, tend to have conflicting safety data.
A few questions surround muscle relaxers in pregnancy, so it's best to talk with your healthcare provider about which treatment option may be best for you.
Are you pregnant and experiencing muscle cramps? Well, you’re not alone. Muscle cramps are a common condition that affect as many as 50% of expectant mothers.
Muscle cramps can occur during pregnancy for a number of reasons. Dehydration, strained muscles and joints (from the excess weight you’ve been carrying), and low electrolyte levels (such as magnesium or potassium) are all common reasons. Elevated nerve pressure and changes in your body’s blood flow are also possible causes.
Fortunately, many options are available for treating muscle cramps during pregnancy, including muscle relaxer medications. But with so many options, how do you know which one may be right for you? Is one option considered to be the safest?
Search and compare options
If you’re thinking about turning to muscle relaxers to find some relief, here are some important things to know.
What is muscle relaxer medication?
Muscle relaxers are a group of medications that work to treat sudden, involuntary muscle contractions. Many of them use different strategies to treat muscle spasms. Common muscle relaxers include:
Cyclobenzaprine
Baclofen
Carisoprodol (Soma)
Methocarbamol
Metaxalone (Skelaxin)
Tizanidine (Zanaflex)
Diazepam (Valium)
We’ll go over each one in detail below.
Which muscle relaxers are safe to take during pregnancy?
Muscle relaxers have been available in the U.S. for a while now. Over time, we’ve learned more about how safe they are in pregnancy. Let’s review which muscle relaxers are likely OK to take if you’re pregnant.
Cyclobenzaprine
Cyclobenzaprine is a medication that works in your brain to help relax your muscles. For the best results, you should use this medication in combination with rest and physical therapy. The recommended dose of cyclobenzaprine for people ages 15 and older is one 5 mg to 10 mg tablet, 3 times per day for up to 2 to 3 weeks.
Read more like this
Explore these related articles, suggested for readers like you.
Cyclobenzaprine’s safety in pregnancy was first studied in animals. In these studies, there was no evidence of harm to the parent or baby. And while there’s little evidence to say it causes harm to human babies, some small case reports show potential complications if it’s used in the third trimester.
Cyclobenzaprine use in pregnancy is most likely safe — mainly in the first or second trimesters. But you should only use it under the supervision of a healthcare provider at the lowest dose for the shortest amount of time possible.
Do any medications not have enough evidence to know if they’re safe?
Pregnant women are considered a vulnerable population, so they’re often left out of research studies. While this may protect unborn children from potential harm, this leads to a lack of information about medication safety in pregnancy. Muscle relaxers are no exception to this.
Below is a list of muscle relaxers that don’t have enough information for us to say if they’re safe for most pregnant women. For each of these, your healthcare provider can tell you more information about your specific risks if you’re interested in potentially taking them.
Carisoprodol
Carisoprodol is a muscle relaxer that communicates with your nervous system to relax your muscles. It’s considered a Schedule IV controlled substance. The usual dose of carisoprodol is 250 mg to 350 mg, 3 times per day and at bedtime. It shouldn’t be used for more than 2 to 3 weeks at a time. It can be used by people ages 16 and older.
Carisoprodol has been studied in animals. Some of these studies showed it may worsen growth and survival in newborns. But there haven’t been many human studies to determine risk to your baby. A few small reports show there probably isn’t a big risk of birth defects, but more data is needed.
Because of this varying information, your healthcare provider can determine the need for carisoprodol on an individual basis.
Methocarbamol
Methocarbamol is a muscle relaxer that works by calming your nervous system. After you start taking it, you’ll usually take 750 mg or 1,000 mg by mouth 3 or 4 times per day. It can be used by people ages 16 and older.
Reproductive studies for methocarbamol haven’t been done in animals. But there have been reports of abnormalities in developing babies when exposed to methocarbamol during pregnancy.
Similar to carisoprodol, it’s important that you and your healthcare provider weigh methocarbamol’s risks versus benefits before taking it.
Metaxalone
Metaxalone is a muscle relaxer that’s thought to work by calming nerves that talk to your muscles. Metaxalone is usually taken as a 800 mg tablet, 3 to 4 times a day. It can be used by people ages 12 and older.
When studied in animals, metaxalone didn’t show harmful side effects in pregnancy. But this information is limited and incomplete. Data about metaxalone in human pregnancy is also very limited, with only a few postmarketing reports showing that it may be a safe option.
Because so little is known about the possible effects of metaxalone on unborn babies, it’s recommended to avoid metaxalone in most cases. You should only take it if the benefits outweigh the risks.
Tizanidine
Tizanidine is an alpha agonist muscle relaxer that slows down spinal nerves to relax your muscles. People usually start by taking one 2 mg capsule or tablet 3 times a day. You can go up to a maximum dose of 36 mg per day, if needed. It can be used by adults ages 18 and older.
Most animal studies don’t link tizanidine with birth defects during pregnancy. However, high doses of tizanidine resulted in early pregnancy in some animal studies. Tizanidine hasn’t been adequately studied in pregnant women.
Based on the lack of human reproductive data, it’s also recommended to avoid tizanidine unless the benefits outweigh the risks.
Other muscle relaxers
Muscle relaxers like orphenadrine, chlorzoxazone, and dantrolene (Dantrium) are also available. They’re less common, and little is known about their safety in pregnancy. Be sure to ask your healthcare professional for more information if you’re curious.
Which muscle relaxers should I avoid during pregnancy?
Birth defects occur in about 3% of babies born each year. Medications are one possible cause of birth defects. To minimize the chance of harm to your baby, it’s important to know which muscle relaxers you should typically avoid while pregnant.
Baclofen
Baclofen is a muscle relaxer that works on nerves in your spine to relax your muscles. You should try to avoid it in pregnancy when possible. You also shouldn’t take it if you’re younger than 12.
The primary concern with baclofen is the potential for withdrawal symptoms in newborns. This includes symptoms like seizures, hallucinations, and others.
If you’re taking baclofen, it’s important to let your healthcare provider know if you’re trying to get pregnant or are currently pregnant. They can work with you to slowly taper your dose in a safe way for you and your baby.
Diazepam
Diazepam is a benzodiazepine medication. It’s a Schedule IV controlled substance that can be used by children and adults, but you should try to avoid it in pregnancy when possible.
Defects in development have been observed in animal reproductive studies of diazepam. It’s recommended to avoid benzodiazepines like diazepam — especially later in pregnancy — due to the following incidences being observed in newborns:
Low birth weight
Premature birth
Cleft lip and palate
Breathing problems
For expectant mothers who require diazepam for certain conditions like seizures, speak with your healthcare provider about the safest dose for you and your baby.
Are there any other risks of taking these medications while pregnant?
Muscle relaxers may provide short-term relief, but their use doesn’t come without risks.
Muscle relaxers work on your brain and nervous system. They’re not thought to work directly on your muscles. So, some of these medications can be habit-forming and have the potential for misuse. This risk is highest with carisoprodol and diazepam.
These medications can also make you sleepy, due to how muscle relaxers work on your central nervous system (CNS). Caution should be taken when operating heavy machinery, such as driving a car.
In a similar way, pregnancy can worsen your risk of dizziness and balance issues. Muscle relaxers may increase these risks, which can result in accidental injuries.
What can I take instead of muscle relaxers for muscle pain during pregnancy?
What if you don’t feel comfortable taking a prescription medication for your muscle cramps? That’s OK. You still have multiple alternatives to consider. Medications are just one option in a toolbox of possible treatments.
Some natural alternatives to muscle relaxers include:
Adding heat to the affected muscle
Applying a cool compress to the affected muscle
Stretching
Gentle massages
Drinking plenty of water
Over-the counter (OTC) medications are another option, such as:
Acetaminophen (Tylenol)
Magnesium supplements. Limited research suggests magnesium may have a positive benefit on leg cramps in pregnancy.
Before you try any of these alternatives at home, make sure you get the green light from your healthcare provider.
The bottom line
Muscle cramps are a common, treatable condition in pregnancy. There are many factors that influence which treatment option may be best for you. But we still have a lot to learn about the safety of muscle relaxers in pregnancy. Your healthcare provider can discuss your symptoms with you and help you determine the best treatment for you. Be sure to discuss any questions or concerns you have before, during, and after treatment.
Why trust our experts?
References
A-S Medication Solutions. (2021). Methocarbamol [package insert].
Advanced Rx Pharmacy of Tennessee, LLC. (2021). Tizanidine [package insert].
Allen, R. E., et al. (2012). Nocturnal leg cramps.
American Addiction Centers. (2021). Benzodiazepines & pregnancy: Safety & effects on the baby.
American Pregnancy Association. (n.d.). Muscle cramps during pregnancy.
American Pregnancy Association. (n.d.). Treating muscle cramps during pregnancy.
Briggs, G. G., et al. (2008). High-dose carisoprodol during pregnancy and lactation. Annals of Pharmacotherapy.
Bryant Ranch Prepack. (2021). Carisoprodol [package insert].
Bryant Ranch Prepack. (2021). Diazepam [package insert].
Centers for Disease Control and Prevention. (2020). Data & statistics on birth defects.
da Silva Schmidt, P. M. S., et al. (2010). Hearing and vestibular complaints during pregnancy. Brazilian Journal of Otorhinolaryngology.
Duncan, S. D., et al. (2013). Use of baclofen for withdrawal in a preterm infant. Journal of Perinatology.
Moreira, A., et al. (2014). Maternal use of cyclobenzaprine (Flexeril) may induce ductal closure and persistent pulmonary hypertension in neonates. Journal of Maternal-Fetal and Neonatal Medicine.
PD-Rx Pharmaceuticals, Inc. (2021). Skelaxin [package insert].
PD-Rx Pharmaceuticals, Inc. (2022). Cyclobenzaprine [package insert].
van der Zande, I. S. E., et al. (2017). Vulnerability of pregnant women in clinical research. Journal of Medical Ethics.
