orphenadrine (Oral route)

Pronunciation

or-FEN-a-dreen

Commonly used brand name(s)

In the U.S.

  • Norflex

Available Dosage Forms:

  • Tablet
  • Tablet, Extended Release

Therapeutic Class: Skeletal Muscle Relaxant, Centrally Acting

Pharmacologic Class: Antimuscarinic

Uses For orphenadrine

Orphenadrine is used to help relax certain muscles in your body and relieve the stiffness, pain, and discomfort caused by strains, sprains, or other injury to your muscles. One form of orphenadrine is also used to relieve trembling caused by Parkinson's disease. However, orphenadrine does not take the place of rest, exercise or physical therapy, or other treatment that your doctor may recommend for your medical problem.

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Orphenadrine acts in the central nervous system (CNS) to produce its muscle relaxant effects. Orphenadrine also has other actions (anticholinergic) that produce its helpful effects in Parkinson's disease. Orphenadrine's CNS and anticholinergic actions may also be responsible for some of its side effects.

orphenadrine is available only with your doctor's prescription.

Before Using orphenadrine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For orphenadrine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to orphenadrine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of orphenadrine in the pediatric population. Safety and efficacy have not been established .

Geriatric

No information is available on the relationship of age to the effects of orphenadrine in geriatric patients. However, elderly patients are more likely to have age-related heart, liver, or kidney problems which may require caution in patients receiving orphenadrine .

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking orphenadrine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using orphenadrine 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.

  • Alfentanil
  • Anileridine
  • Buprenorphine
  • Codeine
  • Fentanyl
  • Hydrocodone
  • Hydromorphone
  • Levorphanol
  • Meperidine
  • Morphine
  • Morphine Sulfate Liposome
  • Oxycodone
  • Oxymorphone
  • Propoxyphene
  • Remifentanil
  • Sodium Oxybate
  • Sufentanil
  • Umeclidinium

Using orphenadrine 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.

  • Perphenazine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of orphenadrine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Enlarged esophagus or
  • Enlarged prostate or
  • Glaucoma or
  • Intestinal blockage or
  • Myasthenia gravis or
  • Stomach ulcer or
  • Urinary tract blockage—Orphenadrine should not be used in patients with these conditions .
  • Heart problems (e.g., fast or irregular heartbeats, heart failure)—Use with caution. Orphenadrine may worsen these conditions .

Proper Use of orphenadrine

Swallow the extended-release tablet whole. Do not crush, break, or chew it .

Dosing

The dose of orphenadrine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of orphenadrine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release tablets):
    • For relaxing stiff, sore muscles:
      • Adults and teenagers—100 milligrams (mg) two times a day, one tablet each in the morning and evening.
      • Children—Use and dose must be determined by your doctor .
  • For oral dosage form (tablets):
    • For relaxing stiff, sore muscles and for Parkinson's disease:
      • Adults—50 milligrams (mg) three times a day.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of orphenadrine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using orphenadrine

It is very important that your doctor check your progress at regular visits to make sure that orphenadrine is working properly. Blood tests may be needed to check for unwanted effects .

Orphenadrine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Check with your doctor right away if you have a rash; itching; swelling of the face, tongue, and throat; trouble with breathing; or chest pain after using orphenadrine .

orphenadrine may cause some people to become dizzy, lightheaded, faint, or less alert than they are normally. It may also cause muscle weakness in some people. Make sure you know how you react to orphenadrine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and able to see well.

orphenadrine may add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; barbiturates; medicine for seizures; other muscle relaxants; or anesthetics, including some dental anesthetics. Do not drink alcoholic beverages, and check with your doctor before taking any of the medicines listed above, while you are using orphenadrine.

Orphenadrine may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. .

orphenadrine Side Effects

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
  • Chest pain
  • chills
  • cough
  • fever
  • 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
  • diarrhea
  • fainting
  • fast, pounding irregular heartbeat or pulse
  • glaucoma
  • joint or muscle pain
  • nausea
  • 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
  • constipation
  • difficult urination
  • drowsiness
  • dry eyes, mouth, nose, or throat
  • eye pain
  • 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
Incidence not known
  • Anxiety
  • deep or fast breathing with dizziness
  • itching skin
  • mental confusion
  • numbness of feet, hands and around mouth
  • trembling or shaking of hands or feet shakiness in legs, arms, hands, or feet

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.

See also: Side effects (in more detail)

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