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Use and Dosing

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Acute musculoskeletal pain

Note: Use upto 2-3 wks

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Acute musculoskeletal pain

>16 yrs

Note: Use upto 2-3 wks

[Outline]

Indications

Contraindications

Black Box Warnings

Dosing Adjustment

Renal Dose Adjustment

Hepatic Dose Adjustment

Warnings/Precautions

See Supplemental Patient Information

Cautions: Use cautiously in

Supplemental Patient Information

Pregnancy/Breast Feeding

Pregnancy Category:D

Breastfeeding: Not necessarily a reason to discontinue breastfeeding if carisoprodol is required by the mother. Slight sedation has occurred in a breastfed newborn infant on exposing carisoprodol during pregnancy and lactation; effect is more pronounced in newborns when exposed for the first time during nursing. Prefer an alternative agent especially while nursing a newborn or preterm infant. Avoid aspirin during breastfeeding, especially with very young infants; although a rare single low dose of aspirin daily is unlikely to cause problems in the infant. The risks with chronic high dose aspirin use are less clear. Monitor infant salicylate serum levels particularly in neonates. Avoid breastfeeding for 1-2 hrs after a dose to minimize antiplatelet effects. Higher dosages of oral narcotics in mothers while breastfeeding can cause infant drowsiness. Newborn infants are particularly sensitive to the effects of even small dosages of narcotic analgesics, particularly in the first week of life. Newborn's dosage is limited by the small volumes of colostrum in the first 2-3 days postpartum. Once the mother's milk comes in, it is best to use a nonnarcotic analgesic and limit the maternal dosage and duration of treatment with codeine and combinations to 4 days. Mothers with ultrarapid CYP2D6 metabolism may excrete unexpectedly higher amounts of morphine into their milk after use of codeine and increase the risk of adverse effects in infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 30 December 2010). Carisoprodol may reduce effective infant feeding (due to sedation) and/or decreased milk production. Nursing mothers should avoid the use of aspirin as it may lead to bleeding in the infant. Manufacturer advises to use the lowest dose of a product containing codeine for the shortest period of time to achieve the desired clinical effect; closely monitor mother-infant pairs and notify pediatricians about the use of codeine during breastfeeding. Manufacturer advises to use the product in a pregnant woman only if clearly needed.

Adverse Reactions

Clinical Pharmacology

Aspirin

Carisoprodol

Codeine

Brands and Availability

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US Trade Name(s)

US Availability

aspirin/carisoprodol/codeine (generic)

Soma compound with codeine

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Canadian Trade Name(s)

Canadian Availability

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UK Trade Name(s)

UK Availability

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Australian Trade Name(s)

Australian Availability


[Outline]

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Classification

Analgesics

Skeletal Muscle Relaxant Combinations

Pill

Drug Name: ASA 325 MG / carisoprodol 200 MG / codeine phosphate 16 MG Oral Tablet

Ingredient(s): Aspirin mixture with Carisoprodol and Codeine

Imprint: A138

Color(s): White, Yellow

Shape: Round

Size (mm): 6.00

Score: 1

Inactive Ingredient(s): d&c yellow #10 aluminum lake / corn starch / hydroxypropyl cellulose / lactose monohydrate / microcrystalline cellulose / silicon dioxide / sodium starch glycolate / stearic acid / zinc stearate

Drug Label Author:
Actavis Totowa LLC

DEA Schedule:
CIII


Drug Name: Soma Compound with Codeine (ASA 325 MG / carisoprodol 200 MG / codeine phosphate 16 MG) Oral Tablet

Ingredient(s): Aspirin mixture with Carisoprodol and Codeine

Imprint: SOMA;CC;WALLACE;2403

Color(s): White, Yellow

Shape: Oval

Size (mm): 17.00

Score: 1

Inactive Ingredient(s): croscarmellose sodium / microcrystalline cellulose / d&c yellow #10 / hydroxypropyl methylcellulose / magnesium stearate / povidine / sodium metabisulfite / starch / stearic acid

Drug Label Author:
MedPointe Pharmaceuticals

DEA Schedule:
CIII