Flexeril vs. Skelaxin
See how Flexeril and Skelaxin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Flexeril and Skelaxin are both prescription muscle relaxants used short-term with rest and physical therapy for acute muscle spasm, but they work differently and are dosed differently.
Flexeril causes drowsiness in up to 39% of patients and dry mouth in up to 27%, while Skelaxin's label lists similar side effects without specific rates.
Flexeril is limited to 2 to 3 weeks of use and has heart-related contraindications, while Skelaxin has fewer cardiac restrictions but costs significantly more per month.
Flexeril vs. Skelaxin Drug Summary
Flexeril
Flexeril (cyclobenzaprine) is a tricyclic-related skeletal muscle relaxant used short-term, alongside rest and physical therapy, to relieve muscle spasm from acute musculoskeletal injuries. It's taken as an oral tablet three times a day, usually for no more than 2 to 3 weeks.
Skelaxin
Skelaxin (metaxalone) is a skeletal muscle relaxant used, like Flexeril, alongside rest and physical therapy for acute painful muscle spasm. It's taken as an oral tablet three to four times a day and is approved for adults and adolescents 13 and older.
Flexeril vs. Skelaxin Side Effects
Flexeril
Skelaxin
Flexeril vs. Skelaxin Dosage
Flexeril
Skelaxin
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg three times daily | At the start |
| Maximum dose | 10 mg three times daily | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 800 mg 3-4 times daily | At the start |
| Maximum dose | 800 mg 3-4 times daily | Same as starting |
| Dose changes | None | Fixed dose |
Flexeril
| STAGE | DOSE | WHEN |
| Starting dose | 5 mg three times daily | At the start |
| Maximum dose | 10 mg three times daily | If needed |
| Dose changes | 1 increase | As tolerated |
Skelaxin
| STAGE | DOSE | WHEN |
| Starting dose | 800 mg 3-4 times daily | At the start |
| Maximum dose | 800 mg 3-4 times daily | Same as starting |
| Dose changes | None | Fixed dose |
Flexeril vs. Skelaxin Indications
Flexeril
Flexeril is FDA-approved only as an adjunct to rest and physical therapy for muscle spasm caused by acute musculoskeletal conditions, not for spasticity from brain or spinal cord disease. It's also used off-label for fibromyalgia pain and sleep symptoms, though that isn't an FDA-approved use.
Relief of muscle spasm from acute musculoskeletal injury
Used with rest and physical therapy, not alone
Off-label: fibromyalgia pain and sleep symptoms
Not effective for spasticity from CNS conditions
Skelaxin
Skelaxin is FDA-approved as an adjunct to rest and physical therapy for acute, painful musculoskeletal conditions in adults and adolescents 13 and older. It has no widely recognized off-label uses and isn't approved for children 12 and under.
Relief of acute painful musculoskeletal conditions
Used with rest and physical therapy, not alone
Approved for adults and adolescents 13 and older
Not approved for children 12 and under
Flexeril vs. Skelaxin Pros and Cons
Flexeril
Cyclobenzaprine has been used since 1977 and is now only available as a generic, keeping its cost relatively low. It causes more drowsiness and dry mouth than many alternatives and carries specific heart-related contraindications that limit who can take it.
Pros
Available only as low-cost generic
Decades of clinical use and familiarity
Simple three-times-daily dosing
Roughly $20 to $55 per month, well below Skelaxin
Cons
Drowsiness in up to 39% of patients
Dry mouth in up to 27% of patients
Contraindicated with MAO inhibitors and several heart conditions
Not recommended for use beyond 2 to 3 weeks
Skelaxin
Metaxalone has no boxed warning and fewer cardiac contraindications than cyclobenzaprine, but its absorption depends heavily on whether it's taken with a high-fat meal. It's also significantly more expensive, with list prices several times higher than Flexeril's generic.
Pros
No boxed warning on its label
Fewer cardiac contraindications than Flexeril
Approved for adolescents 13 and older
Less anticholinergic effect, no reported dry mouth
Cons
Absorption changes significantly with food timing
Roughly $110 to $265 per month, well above Flexeril
Contraindicated in severe renal or hepatic impairment
Serotonin syndrome risk with other serotonergic drugs
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