Orphenadrine citrate is a muscle relaxer that's used to relieve muscle pain and discomfort. It's often used together with other pain-relieving methods, such as resting and physical therapy. Orphenadrine is available as a tablet that's taken by mouth as well as an injection that's administered by a healthcare provider for certain situations. Side effects can include dry mouth, headache, and drowsiness. Orphenadrine is a generic medication; its brand-name version, Norflex, is no longer available.
Relief of muscle discomfort from short-term muscle conditions
Orphenadrine is a muscle relaxant. It's unclear how the medication works, but we know that it doesn't work directly on your muscles. Orphenadrine is thought to relieve muscle pain by working in the nervous system to block nerve signals between your spinal cord and muscles.
Source:Â DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
chills
hallucinations (seeing, hearing, or feeling things that are not there)
headache
shortness of breath, troubled breathing, tightness in chest, and/or wheezing
skin rash, hives, itching, or redness
sores, ulcers, or white spots on lips or in mouth
swollen and/or painful glands
unusual bruising or bleeding
unusual tiredness or weakness
Incidence not known
Abdominal or stomach pain
fainting
fast, pounding irregular heartbeat or pulse
joint or muscle pain
numbness or tingling of face, hands, or feet
redness and soreness of eyes
swelling of feet or lower legs
vomiting
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of Overdose
Blurred vision
confusion, delirium, or hallucinations
difficult urination
drowsiness
dry eyes, mouth, nose, or throat
flushing or redness of face
troubled breathing
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common or rare
Dizziness or lightheadedness
excitement, irritability, nervousness, or restlessness
headache
muscle weakness
unusually large pupils of eyes
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Not a first choice option for short- or long-term pain relief
Not recommended for older adults because of higher risk for side effects
Can't use if you have glaucoma, certain stomach or gut problems, urination or swallowing problems, or nerve problems that affect the muscles
Swallow the orphenadrine tablet whole with water; don't crush or cut the tablet. Crushing or cutting the tablet can cause the medication to be released into your body too quickly, which can be harmful.
Orphenadrine can make you sleepy or tired. It's important to know how you react to the medication before driving a car or doing anything that requires concentration. For example, you can take orphenadrine at night the first time you take it to see how you react to the medication.
It's recommended to avoid drinking alcohol while you're taking orphenadrine. Also avoid taking other medications that can make you tired with orphenadrine. Mixing orphenadrine with these medications or with alcohol can make side effects like sleepiness and tiredness worse and affect your ability to think clearly.
Orphenadrine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Taking other medications that also cause sleepiness or tiredness | Alcohol
You might briefly feel lightheaded, dizzy, or sleepy while you're taking orphenadrine. These side effects can affect your ability to focus, think, and react. Avoid drinking alcohol or taking other medications that make you tired with orphenadrine because they can make you feel even worse. Also don't do any activities that need your focus, such as driving a car or operating machinery, until you know how this medication affects you. Let your provider know if the lightheadedness, dizziness, or sleepiness from orphenadrine starts to negatively affect your daily life.
Risk factors: History of fast or irregular heartbeat | History of heart failure or other heart problems
Some people taking orphenadrine have had fast or irregular heartbeats. For this reason, tell your provider if you have any heart problems before you start orphenadrine. This medication should be used with caution in people with heart rhythm problems or severe heart failure. Let your provider know if you experience any abnormal heart beats or worsening symptoms of your heart problem while you're taking orphenadrine.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
100mg | 20 tablets | $18.16 | $0.91 |
The typical dose is 100 mg by mouth in the morning and in the evening.
Orphenadrine is also available as an injection that's given into your muscle or vein by a provider in a healthcare setting (e.g., clinic, hospital).
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Blockage in your stomach or gut
Blockage in your bladder
Enlarged prostate (benign prostatic hyperplasia or BPH)
Conditions that make it hard to swallow
Myasthenia gravis (a nerve problem that causes muscle weakness)
Relief of muscle discomfort from short-term muscle conditions
Muscle discomfort caused by acute (not long-term) conditions
Muscle discomfort caused by acute (not chronic) conditions when rest or physical therapy isn't enough for relief
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2023 American Geriatrics Society Beers Criteria® Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society.
Abd-Elsalam, S., et al. (2018). Pilot study of orphenadrine as a novel treatment for muscle cramps in patients with liver cirrhosis. United European Gastroenterology Journal.
Akorn. (2022). Orphenadrine citrate injection [package insert]. DailyMed.
Cheah, K. Y., et al. (2020). A randomized single-dose, two-period crossover bioequivalence study of two fixed-dose paracetamol/orphenadrine combination preparations in healthy volunteers under fasted condition. BioMed Central Pharmacology and Toxicology.
Department of Justice/Drug Enforcement Administration. (2020). Narcotics.
Sandoz, Inc. (2024). Orphenadrine citrate tablet, extended release [package insert]. DailyMed.
See, S., et al. (2008). Choosing a skeletal muscle relaxant. American Family Physician.
Witenko, C., et al. (2014). Considerations for the appropriate use of skeletal muscle relaxants for the management of acute low back pain. Pharmacy and Therapeutics.
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