Carisoprodol and Carisoprodol combinations

Drug - Carisoprodol 250mg/350mg tablets
            Carisoprodol, aspirin and codeine tablets
            Carisoprodol and aspirin tablets

March 2015

Therapeutic area - Muscle Relaxants

Carisoprodol should only be used for short periods (up to two to three weeks in duration)

PA approval criteria

Patient diagnosis of: multiple sclerosis, cerebral palsy, muscular dystrophy, or paralysis

• Patient has tried and failed tizanidine tablets and cyclobenzaprine and baclofen without efficacy/benefit. Approvals may be issued for up to one year.

All other diagnoses (e.g. myalgia; low back pain):

• Patient has tried and failed tizanidine tablets and cyclobenzaprine and baclofen without efficacy/benefit.
• Approval will be limited to short term use; one initial fill of 60 tablets, with one refill to allow for dose tapering before discontinuation, per year.

Background information

Carisoprodol is considered a drug of concern by the U.S. Department of Justice Drug Enforcement Agency Office of Diversion Control and has been identified by Minnesota Health Care Programs Universal Pharmacy Policy Workgroup as a substance of abuse. There are other effective pharmacological agents that can be used as alternative muscle relaxants such as baclofen, cyclobenzaprine, tizanidine and methocarbamol.

Carisoprodol's primary metabolite is meprobamate, a controlled substance which may precipitate withdrawal symptoms if the drug is abruptly discontinued. Tapering of carisoprodol is recommended over abrupt discontinuation.

Questions?

MHCP Provider Call Center 651-431-2700 or 800-366-5411