Flexeril vs. Soma

See how Flexeril and Soma compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Both Flexeril and Soma are approved only for short-term relief of acute muscle spasm, not chronic pain conditions.

  • Flexeril is not a controlled substance, while Soma is a Schedule IV drug with real potential for misuse and dependence.

  • Flexeril's most common side effects are drowsiness and dry mouth, while Soma's are drowsiness and dizziness at lower rates.

Flexeril vs. Soma Drug Summary

Flexeril

Flexeril (cyclobenzaprine) is a tricyclic-related skeletal muscle relaxant used to relieve muscle spasm from acute musculoskeletal injuries. It works as an adjunct to rest and physical therapy and is taken as an oral tablet, usually three times a day for no more than two to three weeks.

Soma

Soma (carisoprodol) is a skeletal muscle relaxant used to relieve discomfort from acute, painful musculoskeletal conditions. It is taken as an oral tablet three times a day plus a bedtime dose, and is limited to short-term use of two to three weeks.

Flexeril vs. Soma Side Effects

Flexeril

Most common
drowsiness (up to 39%)
dizziness (up to 11%)
headache (up to 5%)
dry mouth (up to 27%)

Soma

Most common
drowsiness (up to 17%)
dizziness (>2%)
headache (>2%)
tachycardia (post-marketing)

Flexeril vs. Soma Dosage

Flexeril

Dosage
Dosage Table
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

Soma

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 250 mg to 350 mg TID + HS At the start
Maximum dose 250 mg to 350 mg TID + HS Same as starting
Dose changes None Fixed dose

Flexeril vs. Soma Indications

Flexeril

Flexeril is FDA-approved as an adjunct to rest and physical therapy for muscle spasm caused by acute musculoskeletal conditions like strains and sprains. It is not approved for spasticity from conditions such as cerebral palsy or spinal cord injury. Some clinicians use it off-label for fibromyalgia pain and sleep problems.

  • Acute muscle spasm from strains or sprains

  • Used alongside rest and physical therapy

  • Off-label: fibromyalgia pain and sleep support

  • Not approved for CNS-related spasticity

  • Short-term use only (2-3 weeks)

Soma

Soma is FDA-approved to relieve discomfort from acute, painful musculoskeletal conditions such as back strain. It has not been shown effective for chronic musculoskeletal pain and is not approved for use in children. Its FDA-approved use is limited to short courses of two to three weeks.

  • Acute musculoskeletal discomfort

  • Used alongside rest and physical therapy

  • Not approved for chronic pain conditions

  • Not approved for pediatric patients

  • Short-term use only (2-3 weeks)

Flexeril vs. Soma Pros and Cons

Flexeril

Flexeril is not a controlled substance, so it carries less regulatory scrutiny and no federal scheduling restrictions. It does cause noticeable anticholinergic effects like dry mouth and carries specific heart-related contraindications. It has been on the market since 1977, giving prescribers decades of experience with it.

Pros

  • Not a controlled substance, easier to prescribe

  • Longer history of use, approved since 1977

  • Available in 5 mg, 7.5 mg, and 10 mg strengths

  • Off-label option for fibromyalgia symptoms

Cons

  • Causes dry mouth in up to 27% of users

  • Contraindicated with MAOIs and certain heart conditions

  • Not effective for spasticity from CNS disorders

  • More sedating than some alternatives (up to 39% drowsiness)

Soma

Soma is a Schedule IV controlled substance because of its potential for misuse and dependence, which means extra prescribing precautions and monitoring. It causes less dry mouth than some alternatives, but its active metabolite meprobamate adds its own sedative and controlled-substance profile. Like Flexeril, it is intended only for short-term relief.

Pros

  • Lower reported rate of dry mouth than Flexeril

  • Dosing includes a bedtime dose for nighttime spasm relief

  • Simple three-times-daily plus bedtime schedule

  • No cardiac contraindications listed like Flexeril's

Cons

  • Schedule IV controlled substance with abuse potential

  • Risk of withdrawal symptoms after abrupt stopping

  • Metabolite meprobamate adds sedation and its own controlled status

  • Not recommended for long-term chronic pain management

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