Carisoprodol dosing adjustments should be considered for patients with severe hepatic insufficiency, as carisoprodol is extensively metabolized by the liver. Carisoprodol is also renally eliminated and should be dosed cautiously in patients with severe renal impairment1-3 .
Chlorzoxazone should be administered cautiously, if at all, in patients with a history of hepatic disease as hepatotoxicity has been reported with chlorzoxazone use. Chlorzoxazone should not be prescribed to patients with active hepatic disease, including hepatitis1,2,4 .
Cyclobenzaprine is extensively metabolized by liver and is not recommended for use in patients with moderate to severe hepatic impairment. Cyclobenzaprine dosage adjustments are necessary in patients with mild hepatic impairment1,2,5-7 .
Administer baclofen cautiously in patients with renal impairment as the drug is primarily renally excreted1,2,11 .
Orphenadrine should be administered cautiously to patients with renal and hepatic disease, as the drug is extensively metabolized in the liver, with metabolites and unchanged drug eliminated by the kidneys1,2,10 .
Dosage adjustments for methocarbamol may be necessary for patients with hepatic impairment, as the drug is extensively metabolized in the liver1,2,9 .
Metaxalone is contraindicated for use in patients with significantly impaired renal and/or hepatic function1,2.Dantrolene should not be prescribed to patients with hepatic disease due to risk of hepatic injury associated with this drug1,2,16.
Tizanidine is extensively metabolized by the liver and eliminated by the kidneys; therefore, tizanidine should be prescribed cautiously to patients with hepatic and renal impairment1,2,15< ./p>