1.2. Pediatrics

With the exception of dantrolene, skeletal muscle relaxants are not FDA-approved for use in children1,2,16. Safety and efficacy of cyclobenzaprine extended-release capsules (Amrix®) have not been evaluated in pediatric patients, including adolescents1,2,7. Select skeletal muscle relaxants are FDA-approved for use in adolescents. Recommended pediatric dosages and age limitations for skeletal muscle relaxants are summarized in Table 2.

Although not FDA-approved, baclofen has been used for spasticity in pediatric patients 2 to 7 years of age in doses up to 40 mg/day and in children 8 to 11 years of age in maximum doses of 60 mg/day1.

Table 3. Maximum Recommended Dosages for Skeletal Muscle Relaxants (Pediatric Patients)
Drug Name Treatment Indication Maximum Recommended Dosage
baclofen spasticity Greater than or equal to 12 years of age: 80 mg/day, in divided doses
dantrolene spasticity Greater than or equal to 5 years of age: 400 mg/day, in divided doses
carisoprodol muscle spasm Greater than or equal to 16 years of age: 1400 mg/day, in divided doses
cyclobenzaprine tablets muscle spasm Greater than or equal to 15 years of age: 30 mg/day, in divided doses
metaxalone muscle spasm Greater than 12 years of age: 3200 mg/day, in divided doses
methocarbamol muscle spasm Greater than or equal to 16 years of age: 8 g/day, in divided doses