My daughter (20 years old) is feeling like she had a high dose of caffeine as well as experiencing significant hand tremors. She took a dose of the medication (5mg) last night before going to bed (10:30 pm, and she awoke at 10:30 am with these symptoms. She is also on methotrexate and oxaprozin for rheumatoid arthritis, but was just put on flexoril (generic form) for tortacolis (tightening of the neck muscle).
Hi first I am sorry your princess suferss from RA so young... it has touched my heart
You know this ..but anyway..I also need to know
Flexeril (cyclobenzaprine hydrochloride) is a muscle relaxant. It is meant to be used temporarily to treat muscle spasms due to injury or other muscle problems.
Tremors( does not specify which part of the body)
When one drinks or gets a high from caffeine this usually happens and are side effects of this med
She is obviously experincing some of the side effects of the new med.
Contact her Doctor and explain everything as you have done here do no exclude any detail from... a caring individual
NOTE: IMPORTANTANT INFORMATION LISTED BELOW YOU SHOULD READ.
MY WARMEST AND BEST WISHES TOYOUR PINCESS AND YOU.
methotrexate ↔ oxaprozin
Applies to: methotrexate, oxaprozin
MONITOR CLOSELY: Coadministration with nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the plasma concentrations and toxicities of methotrexate. The proposed mechanism is NSAID inhibition of the renal elimination of methotrexate and its metabolite, 7-hydroxymethotrexate, although data from pharmacokinetic studies are inconsistent and conflicting. Displacement of methotrexate binding to serum albumin by certain NSAIDs may also play a secondary role. Unexpectedly severe and sometimes fatal bone marrow suppression, aplastic anemia, gastrointestinal toxicity, and nephrotoxicity have been reported during concomitant administration of methotrexate with NSAIDs. The risk is greatest in patients receiving high dosages of methotrexate and those with renal impairment. In clinical studies, methotrexate at dosages of 7.5 to 15 mg/week has been used without apparent problems in patients with rheumatoid arthritis who also received constant dosage regimens of NSAIDs. However, there have been occasional reports of stomatitis, pneumonitis, bone marrow toxicity, and fatality in patients receiving low-dose weekly methotrexate with daily NSAIDs.
MANAGEMENT: NSAIDs should generally not be administered prior to or concomitantly with high dosages of methotrexate, such as those used to treat osteosarcoma. Caution should be exercised when NSAIDs are administered concomitantly with lower dosages of methotrexate. Close monitoring for signs and symptoms of bone marrow suppression, nephrotoxicity, and hepatotoxicity is recommended during treatment. Patients should be advised to contact their physician if they develop stomatitis, nausea, vomiting, diarrhea, rash, anorexia, jaundice, dark urine, dry cough, shortness of breath, and/or signs and symptoms of myelosuppression such as pallor, dizziness, fatigue, lethargy, fainting, easy bruising or bleeding, fever, chills, sore throat, body aches, and other influenza-like symptoms. Patients should also be counseled to avoid any other over-the-counter NSAID products.
No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.
Other drugs that your selected drugs interact with
* methotrexate interacts with more than 300 other drugs.
* oxaprozin interacts with more than 200 other drugs.
* Flexeril (cyclobenzaprine) interacts with more than 300 other drugs.
Interactions between your selected drugs and food
methotrexate ↔ food
Applies to: methotrexate
MONITOR: Limited data suggest that consumption of greater than 180 mg/day of caffeine may interfere with the efficacy of methotrexate (MTX) in patients with rheumatoid arthritis. The exact mechanism of interaction is unknown but may be related to the antagonistic effect of caffeine on adenosine receptors, as anti-inflammatory properties of MTX is thought to result from the accumulation of adenosine. In a study of 39 patients treated with MTX 7.5 mg/week (without folate supplementation) for 3 months, patients with high caffeine intake (more than 180 mg/day) experienced significantly less improvement in morning stiffness and joint pain from baseline than patients with low caffeine intake (more than 120 mg/day). There were no significant differences between the responses of patients with moderate caffeine intake (120 to 180 mg/day) and those of the other 2 groups. In an interview of 91 patients treated with MTX, 26% of patients who discontinued the drug were regular coffee drinkers compared to only 2% of those still receiving the drug. Because treatment failure was the reason for MTX discontinuation in 80% of patients who discontinued, the investigators suggested that caffeine may have interfered with MTX efficacy.
MANAGEMENT: Until further information is available, the potential for interaction should be considered in patients who consume substantial amounts of caffeine and caffeine-containing foods and are prescribed methotrexate for rheumatoid arthritis. It may be appropriate to limit caffeine intake if an interaction is suspected in cases of treatment failure.
- Caffeine Information for Consumers
- Caffeine Information for Healthcare Professionals (includes dosage details)
- Side Effects of Caffeine (detailed)
Search for questions
Still looking for answers? Try searching for what you seek or ask your own question.
Posted 30 Jul 2010 • 1 answer
Posted 4 Nov 2012 • 1 answer
Posted 19 Feb 2013 • 2 answers
Posted 3 Aug 2014 • 1 answer
Posted 20 Apr 2016 • 1 answer