Cyclobenzaprine:
Using Flexeril To Combat Insomnia

Cyclobenzaprine (brand name Flexeril) is a muscle relaxer used to minimize muscle spasms. Recent evidence also suggests it can act as an effective sleep aid.

You know that feeling of getting a great night of sleep? You wake up feeling alert and refreshed, no need to hit that snooze button.

Maybe you remember this feeling but it’s been so long since you’ve woken up well-rested that truly good sleep feels like some far-off dream.

Or maybe it’s been such a long time since you’ve gotten any real sleep that your body doesn’t seem to remember anything outside of pure exhaustion.

If you find yourself spending more of your nights awake than asleep - even after trying meditation, switching out your mattress, and giving melatonin gummies a go - it may be time to seek out medical advice about other options.

But doesn’t speaking to a doctor about sleep medication automatically mean an Ambien prescription?

Absolutely not.

If you speak with a seasoned sleep expert, you’ll find there are quite a few options available to you other than z-drugs, including off-label prescriptions.

Cyclobenzaprine is just one example that your doctor may suggest, especially if you’re experiencing what’s known as terminal insomnia (ie: you have no problem falling asleep but you’re rarely able to stay asleep for more than a few hours or regularly wake up way earlier than you should).

Let’s take a closer look at this prescription medication to help you get a better understanding of it as an insomnia treatment option.

01

What Is Cyclobenzaprine?

Cyclobenzaprine hydrochloride (often referred to under the brand names Flexeril, Amrix, or Fexmid) is an FDA-approved prescription skeletal muscle relaxant.

It’s used as short-term relief for muscle spasms, acute back pain, sprains, or other muscle injuries that tend to interrupt your daily activities, including your sleep. It’s also used to treat medical conditions like fibromyalgia.

However, it’s not an effective pain reliever for all types of pain. For instance, this medication doesn’t help spasms resulting from a central nervous system disease (for example, cerebral palsy).

Most often, this prescription is given along with physical therapy and instructions for rest. It may also be given in addition to over-the-counter pain relievers like acetaminophen.

It’s been reported to relieve pain and improve muscular range of motion, which can, in turn, help you perform daily activities. It’s also been shown to prevent sleep disruptions caused by pain.

For those not experiencing pain, the effect of sedation caused after taking this medication may provide relief from insomnia.

02

How Does Cyclobenzaprine Work?

When used as a muscle relaxant, cyclobenzaprine works by boosting norepinephrine levels in your brain. The elevated norepinephrine then binds to serotonin receptors, which reduces pain and muscle spasms.

Structurally, this medication is similar to tricyclic antidepressants (ie: both classes of drugs influence hormone levels in the brain).

But how can this medication help with sleep?

Well, it turns out a primary side effect of cyclobenzaprine is drowsiness. It’s also been shown to promote a calming effect.

03

How Long Does Cyclobenzaprine Last?

Cyclobenzaprine generally starts to work within one hour of being taken, and the effects last around 4-6 hours.

However, the process of eliminating the medication from the body is a pretty slow process, ranging anywhere from 7 to 37 hours.

Cyclobenzaprine’s half-life is 18 hours.

With this in mind, if you’re being prescribed this medication for sleep, your doctor will likely prescribe you the lowest dose possible to help prevent you from experiencing grogginess after waking up.

However, it’s important to point out that all of this depends on whether you’re taking the immediate-release or extended-release capsule. Your doctor will help you understand which version will be most effective for you based on your needs.

04

What’s The Cyclobenzaprine Dosage Used For Sleep?

When prescribed for sleep, cyclobenzaprine is given at a very low dose. Most likely your doctor will recommend 5mg to be taken once a day.

In some cases, the dosage may be increased up to 10mg. But this is rare as a dose this large has been shown to be oversedating and increase your chances of feeling groggy in the morning.

Though both immediate-release and extended-release versions are available, it’s most likely you’ll be prescribed the immediate-release version as it’s been shown more effective for insomnia.

Finally, it’s important to point out that cyclobenzaprine is meant to be prescribed for short-term relief, in most cases between 2-3 weeks. Some studies suggest that, past that time window, it may lose its effectiveness.

In some cases, your doctor will offer this medication to be used on an as-needed basis (ie: you’ve been losing sleep over the past couple of nights due to increased stress at work). In fact, research suggests you don’t need to take this medication consistently for it to be effective.

Be sure to clearly talk through dosage and instructions for taking your prescription with your doctor.

05

Does Cyclobenzaprine Have Side Effects?

Like any other prescription drug available, cyclobenzaprine does carry a risk for some adverse effects.

The most common side effects associated with this medication are tiredness and drowsiness. If you’re taking it for sleep, these side effects should be welcome news!

In some cases, grogginess the following morning can occur. If this happens to you, reach out to your doctor who may adjust your dosing or opt for an alternative treatment altogether.

Other side effects may include:

  • Dry mouth
  • Dizziness
  • Nausea
  • Constipation
  • Heartburn

Though not as common, other more serious side effects are possible. It’s important to seek immediate medical help if you experience any of the following:

  • Signs of an allergic reaction (skin rash, hives, swelling in your face or tongue)
  • Increased heart rate
  • Irregular heartbeat
  • Pain or pressure in your chest
  • Sudden numbness or weakness

Please keep in mind this list isn’t exhaustive so be sure to read through your doctor’s instructions and any other information included with your medication.

Finally, cyclobenzaprine can impair your reaction rate. It’s imperative you never drive, operate machinery, or participate in any activity that requires your focus after taking this medication.

Last but not least, avoid alcohol when taking your cyclobenzaprine prescription.

06

Who Shouldn’t Use Cyclobenzaprine?

Though cyclobenzaprine can be an effective treatment option, it isn’t appropriate for everyone.

This medication is not approved for use by anyone 15 years or younger. Older adults should also advise caution before starting this prescription.

Pregnant women, women who may be pregnant, or are currently breastfeeding should also speak with a doctor before starting this medication.

You should not take cyclobenzaprine if you have a history of:

  • A thyroid disorder, including hyperthyroidism
  • Heart block
  • Congestive heart failure
  • Heart rhythm disorder
  • Recent heart attack
  • Glaucoma

Drug interactions are possible and some medications shouldn’t be used in addition to cyclobenzaprine.

Do not take this medication if you have taken MAO inhibitors in the last 14 days. Failing to do so can increase your risk of serotonin syndrome.

Some benzodiazepines are also not appropriate to take alongside a cyclobenzaprine prescription.

Always let your doctor know if you’re taking any other medication for pain management, including opioids.

Additionally, make sure to let your healthcare professional know if you’re taking medications or herbal supplements for any of the following:

  • Depression
  • Mental illness
  • Parkinson’s disease
  • Migraine headaches
  • Serious infections
  • Prevention of nausea or vomiting

Other medications and supplements may decrease the effectiveness of cyclobenzaprine or increase your risk for side effects. Always be sure to provide a fully updated medical history and a complete list of all medications you’re currently taking so your doctor can make the best recommendation possible.