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SOMA (WATSON BRAND) Soma Indications This medicine is used with rest and physical therapy to treat acute, painful muscle conditions Contraindications Do not take this medication if - you are allergic to any ingredient of this medicine ... more Soma Tablets (carisoprodol) Tablets, USP DESCRIPTION `SOMA' (carisoprodol) Tablets, USP is available as 350 mg round, white tablets. Chemically, carisoprodol is N-isopropyl-2- methyl-2-propyl-1,3-propanediol dicarbamate. Carisoprodol is a white, crystalline powder, having a mild, characteristic odor and a bitter taste. It is very slightly soluble in water; freely soluble in alcohol, in chloroform, and in acetone; its solubility is practically independent of pH. Carisoprodol is present as a racemic mixture. The molecular formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: Other ingredients: alginic acid, magnesium stearate, potassium sorbate, starch, tribasic calcium phosphate. ACTIONS Carisoprodol produces muscle relaxation in animals by blocking interneuronal activity in the descending reticular formation and spinal cord. The onset of action is rapid and effects last four to six hours. INDICATIONS Carisoprodol is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of this drug has not been clearly identified, but may be related to its sedative properties. Carisoprodol does not directly relax tense skeletal muscles in man. CONTRAINDICATIONS Acute intermittent porphyria as well as allergic or idiosyncratic reactions to carisoprodol or related compounds. WARNINGS Idiosyncratic Reactions --On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic symptoms appearing within minutes or hours. Symptoms reported include: extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Symptoms usually subside over the course of the next several hours. Supportive and symptomatic therapy, including hospitalization, may be necessary. Usage in Pregnancy and Lactation --Safe usage of this drug in pregnancy or lactation has not been established. Therefore, use of this drug in pregnancy, in nursing mothers, or in women of childbearing potential requires that the potential benefits of the drug be weighed against the potential hazards to mother and child. Carisoprodol is present in breast milk of lactating mothers at concentrations two to four times that of maternal plasma. This factor should be taken into account when use of the drug is contemplated in breast-feeding patients. Usage in Children --Because of limited clinical experience, `SOMA' is not recommended for use in patients under 12 years of age. Potentially Hazardous Tasks --Patients should be warned that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Additive Effects --Since the effects of carisoprodol and alcohol or carisoprodol and other CNS depressants or psychotropic drugs may be additive, appropriate caution should be exercised with patients who take more than one of these agents simultaneously. Drug Dependence --In dogs, no withdrawal symptoms occurred after abrupt cessation of carisoprodol from dosages as high as 1 gm/kg/day. In a study in man, abrupt cessation of 100 mg/kg/day (about five times the recommended daily adult dosage) was followed in some subjects by mild withdrawal symptoms such as abdominal cramps, insomnia, chilliness, headache, and nausea. Delirium and convulsions did not occur. In clinical use, psychological dependence and abuse have been rare, and there have been no reports of significant abstinence signs. Nevertheless, the drug should be used with caution in addiction-prone individuals. PRECAUTIONS Carisoprodol is metabolized in the liver and excreted by the kidney; to avoid its excess accumulation, caution should be exercised in administration to patients with compromised liver or kidney function. ADVERSE REACTIONS Central Nervous System --Drowsiness and other CNS effects may require dosage reduction. Also observed: dizziness, vertigo, ataxia, tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia. (See also Idiosyncratic Reactions under "Warnings." ) Allergic or Idiosyncratic --Allergic or idiosyncratic reactions occasionally develop. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug. Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruption with cross reaction to meprobamate have been reported with carisoprodol. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. (See also Idiosyncratic Reactions under "Warnings." ) In case of allergic or idiosyncratic reactions to carisoprodol, discontinue the drug and initiate appropriate symptomatic therapy, which may include epinephrine, antihistamines, and in severe cases corticosteroids. In evaluating possible allergic reactions, also consider allergy to excipients (information on excipients is available to physicians on request). Cardiovascular --Tachycardia, postural hypotension, and facial flushing. Gastrointestinal --Nausea, vomiting, hiccup, and epigastric distress. Hematologic --Leukopenia, in which other drugs or viral infection may have been responsible, and pancytopenia, attributed to phenylbutazone, have been reported. No serious blood dyscrasias have been attributed to carisoprodol. DOSAGE AND ADMINISTRATION The usual adult dosage of `SOMA' (carisoprodol) Tablets, USP is one 350 mg tablet, three times daily and at bedtime. Usage in patients under age 12 is not recommended. OVERDOSAGE Overdosage of carisoprodol has produced stupor, coma, shock, respiratory depression, and, very rarely, death. The effects of an overdosage of carisoprodol and alcohol or other CNS depressants or psychotropic agents can be additive even when one of the drugs has been taken in the usual recommended dosage. Any drug remaining in the stomach should be removed and symptomatic therapy given. Should respiration or blood pressure become compromised, respiratory assistance, central nervous system stimulants, and pressor agents should be administered cautiously as indicated. Carisoprodol is metabolized in the liver and excreted by the kidney. Although carisoprodol overdosage experience is limited, the following types of treatment have been used successfully with the related drug meprobamate: diuresis, osmotic (mannitol) diuresis, peritoneal dialysis, and hemodialysis (carisoprodol is dialyzable). Careful monitoring of urinary output is necessary and caution should be taken to avoid overhydration. Observe for possible relapse due to incomplete gastric emptying and delayed absorption. Carisoprodol can be measured in biological fluids by gas chromatography (Douglas, J. F. et al.: J Pharm Sci 58: 145, 1969). HOW SUPPLIED `SOMA' (carisoprodol) Tablets, USP 350 mg: Round, convex, white tablets, inscribed with `SOMA' on one side and 37-WALLACE 2001 on the other side, are available in bottles of 100 (NDC 0037-2001-01) and 500 (NDC 0037-2001-03), and unit-dose packages of 100 (NDC 0037-2001-85). PRODUCT PHOTO(S): NOTE: These photos can be used only for identification by shape, color, and imprint. They do not depict actual or relative size. The product samples shown here have been supplied by the manufacturer and reproduced in full color by PDR as a quick-reference identification aid. While every effort has been made to assure accurate reproduction, please remember that any visual identification should be considered preliminary. In cases of poisoning or suspected overdosage, the drug's identity should be verified by chemical analysis. The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products. Are your Dyslexic? Great info on Dyslexia diagnosis, symptoms & treatments. infoscouts.com Lorazepam-Reviewed Is Lorazepam the right prescription medicine for you? Find out. ConsumerHealthDigest.com "Are you dizzy ?" You may have Labyrinthitis Find treatment and remedy options InfoForYourHealth.com Soma (Carisoprodol) on Sale Now 90 tabs $84, 180 tabs just $159. Free FedEx. Order online now. ApexOnlinePharmacy.com. www.apexonlinepharmacy.com (sponsored listing) Soma Premium tickets - lower prices. 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La aspirin actúa reduciendo las substancias en el cuerpo que causan dolor e inflamación. S... Soma Compound La aspirin está en la clase de drogas llamada salicilatos. Aspirin actúa reduciendo sustancias en el cuerpo que causan inflamación y dolor. Se usa pa... aspirin y carisoprodol La aspirin está en la clase de drogas llamada salicilatos. Aspirin actúa reduciendo sustancias en el cuerpo que causan inflamación y dolor. Se usa pa... Vanadom Carisoprodol es un relajante para los músculos. Éste actúa bloqueando los impulsos de los nervios (o sensaciones de dolor) que se mandan al cerebro. aspirin/carisoprodol/codeine La aspirin está en la clase de drogas llamada salicilatos. La aspirin actúa reduciendo las substancias en el cuerpo que causan dolor e inflamación. S... carisoprodol Carisoprodol es un relajante para los músculos. Éste actúa bloqueando los impulsos de los nervios (o sensaciones de dolor) que se mandan al cerebro. PDR Drug information for Soma Compound w/Codeine Tablets (carisoprodol, aspirin and codeine phosphate tablets, USP) carisoprodol 200 mg + aspirin 325 mg + codeine phosphate 16 mg--Warning: May be habit-forming TABLETS DESCRIPTION `Soma' Compound with Codeine is a combination product containing carisoprodol, a centrally-acting muscle relaxant, plus aspirin, an analgesic with antipyretic and anti-inflammatory properties and codeine phosphate, a centrally-acting narcotic analgesic. It is available as a two-layered, white and yellow, oval-shaped tablet for oral administration. Each tablet contains carisoprodol 200 mg, aspirin 325 mg, and codeine phosphate 16 mg. Chemically, carisoprodol is N-isopropyl-2-methyl-2-propyl-1,3-propanediol dicarbamate. Its empirical formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: Other ingredients: croscarmellose sodium, D&C Yellow #10, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, povidone, sodium metabisulfite, starch, stearic acid. CLINICAL PHARMACOLOGY Carisoprodol: Carisoprodol is a centrally-acting muscle relaxant that does not directly relax tense skeletal muscles in man. The mode of action of carisoprodol in relieving acute muscle spasm of local origin has not been clearly identified, but may be related to its sedative properties. In animals, carisoprodol has been shown to produce muscle relaxation by blocking interneuronal activity and depressing transmission of polysynaptic neurons in the spinal cord and in the descending reticular formation of the brain. The onset of action is rapid and lasts four to six hours. Carisoprodol is metabolized in the liver and is excreted by the kidneys. It is dialyzable by peritoneal and hemodialysis. Aspirin: Aspirin is a non-narcotic analgesic with anti-inflammatory and antipyretic activity. Inhibition of prostaglandin biosynthesis appears to account for most of its anti-inflammatory and for at least part of its analgesic and antipyretic properties. Aspirin is rapidly absorbed and almost totally hydrolyzed to salicylic acid following oral administration. Although aspirin has a half-life of only about 15 minutes, the apparent biologic half-life of salicylic acid in the therapeutic plasma concentration range is between 6 and 12 hours. Salicylic acid is eliminated by renal excretion and by biotransformation to inactive metabolites. Clearance of salicylic acid in the high-dose range is sensitive to urinary pH (see Drug Interactions ) and is reduced by renal dysfunction. Codeine Phosphate: Codeine phosphate is a centrally-acting narcotic-analgesic. Its actions are qualitatively similar to morphine, but its potency is substantially less. Clinical studies have shown that combining aspirin and codeine produces a significant additive effect in analgesic efficacy. INDICATIONS AND USAGE `Soma' Compound with Codeine is indicated as an adjunct to rest, physical therapy, and other measures for the relief of pain, muscle spasm, and limited mobility associated with acute, painful musculoskeletal conditions when the additional action of codeine is desired. CONTRAINDICATIONS Acute intermittent porphyria; bleeding disorders; allergic or idiosyncratic reactions to carisoprodol, aspirin, codeine, or related compounds. WARNINGS On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic reactions, with symptoms appearing within minutes or hours. These may include extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Although symptoms usually subside over the course of the next several hours, discontinue `Soma' Compound with Codeine and initiate appropriate supportive and symptomatic therapy, which may include epinephrine and/or antihistamines. In severe cases, corticosteroids may be necessary. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. The effects of carisoprodol with agents such as alcohol, other CNS depressants, or psychotropic drugs may be additive. Appropriate caution should be exercised with patients who take one or more of these agents simultaneously with Soma Compound with Codeine. Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. PRECAUTIONS General: To avoid excessive accumulation of carisoprodol, aspirin, or their metabolites, use `Soma' Compound with Codeine with caution in patients with compromised liver or kidney function, or in elderly or debilitated patients (see CLINICAL PHARMACOLOGY ). Use with caution in patients with history of gastritis or peptic ulcer, in patients on anticoagulant therapy, and in addiction-prone individuals. Information for Patients: Caution patients that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Caution patients with a predisposition for gastrointestinal bleeding that concomitant use of aspirin and alcohol may have an additive effect in this regard. Caution patients that dosage of medications used for gout, arthritis, or diabetes may have to be adjusted when aspirin is administered or discontinued (see Drug Interactions ). Each enteric, film-coated, controlled-release tablet contains paroxetine hydrochloride equivalent to paroxetine as follows: 12.5 mg-yellow, 25 mg-pink, 37.5 mg-blue. One layer of the tablet consists of a degradable barrier layer and the other contains the active material in a hydrophilic matrix. Inactive ingredients consist of hypromellose, polyvinylpyrrolidone, lactose monohydrate, magnesium stearate, colloidal silicon dioxide, glyceryl behenate, methacrylic acid copolymer type C, sodium lauryl sulfate, polysorbate 80, talc, triethyl citrate, and 1 or more of the following colorants: Yellow ferric oxide, red ferric oxide, D&C Red No. 30, D&C Yellow No. 6, D&C Yellow No. 10, FD&C Blue No. 2. CLINICAL PHARMACOLOGY Pharmacodynamics: The efficacy of paroxetine in the treatment of major depressive disorder, panic disorder, social anxiety disorder, and premenstrual dysphoric disorder (PMDD) is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of neuronal reuptake of serotonin (5-hydroxy-tryptamine, 5-HT). Studies at clinically relevant doses in humans have demonstrated that paroxetine blocks the uptake of serotonin into human platelets. In vitro studies in animals also suggest that paroxetine is a potent and highly selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. In vitro radioligand binding studies indicate that paroxetine has little affinity for muscarinic, alpha 1 -, alpha 2 -, beta-adrenergic-, dopamine (D 2 )-, 5-HT 1 -, 5-HT 2 -, and histamine (H 1 )-receptors; antagonism of muscarinic, histaminergic, and alpha 1 -adrenergic receptors has been associated with various anticholinergic, sedative, and cardiovascular effects for other psychotropic drugs. Because the relative potencies of paroxetine's major metabolites are at most 1/50 of the parent compound, they are essentially inactive. Pharmacokinetics: Tablets of PAXIL CR contain a degradable polymeric matrix (GEOMATRIX™) designed to control the dissolution rate of paroxetine over a period of approximately 4 to 5 hours. In addition to controlling the rate of drug release in vivo, an enteric coat delays the start of drug release until tablets of PAXIL CR have left the stomach. Paroxetine hydrochloride is completely absorbed after oral dosing of a solution of the hydrochloride salt. In a study in which normal male and female subjects (n = 23) received single oral doses of PAXIL CR at 4 dosage strengths (12.5 mg, 25 mg, 37.5 mg, and 50 mg), paroxetine C max and AUC 0-inf increased disproportionately with dose (as seen also with immediate-release formulations). Mean C max and AUC 0-inf values at these doses were 2.0, 5.5, 9.0, and 12.5 ng/mL, and 121, 261, 338, and 540 ng·hr./mL, respectively. T max was observed typically between 6 and 10 hours post-dose, reflecting a reduction in absorption rate compared with immediate-release formulations. The mean elimination half-life of paroxetine was 15 to 20 hours throughout this range of single doses of PAXIL CR. The bioavailability of 25 mg PAXIL CR is not affected by food. During repeated administration of PAXIL CR (25 mg once daily), steady state was reached within 2 weeks (i.e., comparable to immediate-release formulations). In a repeat-dose study in which normal male and female subjects (n = 23) received PAXIL CR (25 mg daily), mean steady state C max , C min , and AUC 0-24 values were 30 ng/mL, 20 ng/mL, and 550 ng·hr./mL, respectively. Based on studies using immediate-release formulations, steady-state drug exposure based on AUC 0-24 was several-fold greater than would have been predicted from single-dose data. The excess accumulation is a consequence of the fact that 1 of the enzymes that metabolizes paroxetine is readily saturable. In steady-state dose proportionality studies involving elderly and nonelderly patients, at doses of the immediate-release formulation of 20 mg to 40 mg daily for the elderly and 20 mg to 50 mg daily for the nonelderly, some nonlinearity was observed in both populations, again reflecting a saturable metabolic pathway. In comparison to C min values after 20 mg daily, values after 40 mg daily were only about 2 to 3 times greater than doubled. Social Anxiety Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning, with or without food. The recommended initial dose is 12.5 mg/day. Patients were dosed in a range of 12.5 mg to 37.5 mg/day in the clinical trial demonstrating the effectiveness of PAXIL CR in the treatment of social anxiety disorder. If the dose is increased, this should occur at intervals of at least 1 week, in increments of 12.5 mg/day, up to a maximum of 37.5 mg/day. Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole. Maintenance Therapy: There is no body of evidence available to answer the question of how long the patient treated with PAXIL CR should remain on it. Although the efficacy of PAXIL CR beyond 12 weeks of dosing has not been demonstrated in controlled clinical trials, social anxiety disorder is recognized as a chronic condition, and it is reasonable to consider continuation of treatment for a responding patient. Dosage adjustments should be made to maintain the patient on the lowest effective dosage, and patients should be periodically reassessed to determine the need for continued treatment. nsure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. Activated charcoal should be administered. Due to the large volume of distribution of this drug, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. No specific antidotes for paroxetine are known. A specific caution involves patients taking or recently having taken paroxetine who might ingest excessive quantities of a tricyclic antidepressant. In such a case, accumulation of the parent tricyclic and an active metabolite may increase the possibility of clinically significant sequelae and extend the time needed for close medical observation (see PRECAUTIONS -- Drugs Metabolized by Cytochrome P 450 IID 6 ). In managing overdosage, consider the possibility of multiple-drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Telephone numbers for certified poison control centers are listed in the Physicians' Desk Reference (PDR). DOSAGE AND ADMINISTRATION Major Depressive Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning, with or without food. The recommended initial dose is 25 mg/day. Patients were dosed in a range of 25 mg to 62.5 mg/day in the clinical trials demonstrating the effectiveness of PAXIL CR in the treatment of major depressive disorder. As with all drugs effective in the treatment of major depressive disorder, the full effect may be delayed. Some patients not responding to a 25-mg dose may benefit from dose increases, in 12.5-mg/day increments, up to a maximum of 62.5 mg/day. Dose changes should occur at intervals of at least 1 week. Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole. Maintenance Therapy: There is no body of evidence available to answer the question of how long the patient treated with PAXIL CR should remain on it. It is generally agreed that acute episodes of major depressive disorder require several months or longer of sustained pharmacologic therapy. Whether the dose of an antidepressant needed to induce remission is identical to the dose needed to maintain and/or sustain euthymia is unknown. Systematic evaluation of the efficacy of immediate-release paroxetine hydrochloride has shown that efficacy is maintained for periods of up to 1 year with doses that averaged about 30 mg, which corresponds to a 37.5-mg dose of PAXIL CR, based on relative bioavailability considerations (see CLINICAL PHARMACOLOGY -- Pharmacokinetics ). Panic Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning. Patients should be started on 12.5 mg/day. Dose changes should occur in 12.5-mg/day increments and at intervals of at least 1 week. Patients were dosed in a range of 12.5 to 75 mg/day in the clinical trials demonstrating the effectiveness of PAXIL CR. The maximum dosage should not exceed 75 mg/day. Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole. Maintenance Therapy: Long-term maintenance of efficacy with the immediate-release formulation of paroxetine was demonstrated in a 3-month relapse prevention trial. In this trial, patients with panic disorder assigned to immediate-release paroxetine demonstrated a lower relapse rate compared to patients on placebo. Panic disorder is a chronic condition, and it is reasonable to consider continuation for a responding patient. Dosage adjustments should be made to maintain the patient on the lowest effective dosage, and patients should be periodically reassessed to determine the need for continued treatment. Switching Patients to or From a Monoamine Oxidase Inhibitor: At least 14 days should elapse between discontinuation of an MAOI and initiation of therapy with PAXIL CR. Similarly, at least 14 days should be allowed after stopping PAXIL CR before starting an MAOI. Discontinuation of Treatment With PAXIL CR: Symptoms associated with discontinuation of immediate-release paroxetine hydrochloride or PAXIL CR have been reported (see PRECAUTIONS ). Patients should be monitored for these symptoms when discontinuing treatment, regardless of the indication for which PAXIL CR is being prescribed. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate. GEOMATRIX is a trademark of Jago Pharma, Muttenz, Switzerland. PRODUCT PHOTO(S): NOTE: These photos can be used only for identification by shape, color, and imprint. They do not depict actual or relative size. The product samples shown here have been supplied by the manufacturer and reproduced in full color by PDR as a quick-reference identification aid. While every effort has been made to assure accurate reproduction, please remember that any visual identification should be considered preliminary. In cases of poisoning or suspected overdosage, the drug's identity should be verified by chemical analysis. Premenstrual Dysphoric Disorder: Usual Initial Dosage: PAXIL CR should be administered as a single daily dose, usually in the morning, with or without food. PAXIL CR may be administered either daily throughout the menstrual cycle or limited to the luteal phase of the menstrual cycle, depending on physician assessment. The recommended initial dose is 12.5 mg/day. In clinical trials, both 12.5 mg/day and 25 mg/day were shown to be effective. Dose changes should occur at intervals of at least 1 week. Patients should be cautioned that PAXIL CR should not be chewed or crushed, and should be swallowed whole. Maintenance/Continuation Therapy: The effectiveness of PAXIL CR for a period exceeding 3 menstrual cycles has not been systematically evaluated in controlled trials. However, women commonly report that symptoms worsen with age until relieved by the onset of menopause. Therefore, it is reasonable to consider continuation of a responding patient. Patients should be periodically reassessed to determine the need for continued treatment. Never let your child stop taking an antidepressant without first talking to his or her healthcare provider. Stopping an antidepressant suddenly can cause other symptoms. There are Benefits and Risks When Using Antidepressants Antidepressants are used to treat depression and other illnesses. Depression and other illnesses can lead to suicide. In some children and teenagers, treatment with an antidepressant increases suicidal thinking or actions. It is important to discuss all the risks of treating depression and also the risks of not treating it. You and your child should discuss all treatment choices with your healthcare provider, not just the use of antidepressants. Other side effects can occur with antidepressants (see section below). Of all the antidepressants, only fluoxetine (Prozac®) * has been FDA approved to treat pediatric depression. For obsessive compulsive disorder in children and teenagers, FDA has approved only fluoxetine (Prozac®) * , ser-traline (Zoloft®) * , fluvoxamine, and clomipramine (Anafranil®) * . Your healthcare provider may suggest other antidepressants based on the past experience of your child or other family members. Is this all I need to know if my child is being prescribed an antidepressant? No. This is a warning about the risk for suicidality. Other side effects can occur with antidepressants. Be sure to ask your healthcare provider to explain all the side effects of the particular drug he or she is prescribing. Also ask about drugs to avoid when taking an antidepressant. Ask your healthcare provider or pharmacist where to find more information. *The following are registered trademarks of their respective manufacturers: Prozac®/Eli Lilly and Company; Zoloft®/Pfizer Pharmaceuticals; Anafranil®/Mallinckrodt Inc. This Medication Guide has been approved by the U.S. Food and Drug Administration for all antidepressants. The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products. Bipolar Disorder Special Populations: Treatment of Pregnant Women During the Third Trimester: Neonates exposed to PAXIL CR and other SSRIs or SNRIs, late in the third trimester have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding (see PRECAUTIONS ). When treating pregnant women with paroxetine during the third trimester, the physician should carefully consider the potential risks and benefits of treatment. The physician may consider tapering paroxetine in the third trimester. Dosage for Elderly or Debilitated Patients, and Patients With Severe Renal or Hepatic Impairment: The recommended initial dose of PAXIL CR is 12.5 mg/day for elderly patients, debilitated patients, and/or patients with severe renal or hepatic impairment. Increases may be made if indicated. Dosage should not exceed 50 mg/day. Paroxetine is extensively metabolized after oral administration. The principal metabolites are polar and conjugated products of oxidation and methylation, which are readily cleared. Conjugates with glucuronic acid and sulfate predominate, and major metabolites have been isolated and identified. Data indicate that the metabolites have no more than 1/50 the potency of the parent compound at inhibiting serotonin uptake. The metabolism of paroxetine is accomplished in part by cytochrome P 450 IID 6 . Saturation of this enzyme at clinical doses appears to account for the nonlinearity of paroxetine kinetics with increasing dose and increasing duration of treatment. The role of this enzyme in paroxetine metabolism also suggests potential drug-drug interactions (see PRECAUTIONS ). Approximately 64% of a 30-mg oral solution dose of paroxetine was excreted in the urine with 2% as the parent compound and 62% as metabolites over a 10-day post-dosing period. About 36% was excreted in the feces (probably via the bile), mostly as metabolites and less than 1% as the parent compound over the 10-day post-dosing period. Drug Interactions: Clinically important interactions may occur when certain drugs are administered concomitantly with aspirin or aspirin-containing drugs. Oral Anticoagulants -- By interfering with platelet function or decreasing plasma prothrombin concentration, aspirin enhances the potential for bleeding in patients on anticoagulants. Methotrexate -- aspirin enhances the toxic effects of this drug. Probenecid and Sulfinpyrazone -- large doses of aspirin reduce the uricosuric effect of both drugs. Renal excretion of salicylate may also be reduced. Oral Antidiabetic Drugs -- enhancement of hypoglycemia may occur. Antacids -- to the extent that they raise urinary pH, antacids may substantially decrease plasma salicylate concentrations; conversely, their withdrawal can result in a substantial increase. Ammonium Chloride -- this and other drugs that acidify a relatively alkaline urine can elevate plasma salicylate concentrations. Ethyl Alcohol -- enhanced aspirin-induced fecal blood loss has been reported. Corticosteroids -- salicylate plasma levels may be decreased when adrenal corticosteroids are given, and may be increased substantially when they are discontinued. Carcinogenesis, Mutagenesis, Impairment of Fertility: No long-term studies have been done with `Soma' Compound with Codeine. Pregnancy--Teratogenic Effects: Pregnancy Category C. Adequate animal reproduction studies have not been conducted with `Soma' Compound with Codeine. It is also not known whether `Soma' Compound with Codeine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. `Soma' Compound with Codeine should be given to a pregnant woman only if clearly needed. Studies in rodents have shown salicylates to be teratogenic when given in early gestation, and embryocidal when given in later gestation in doses considerably greater than usual therapeutic doses in humans. Studies in women who took aspirin during pregnancy have not demonstrated an increased incidence of congenital abnormalities in the offspring. Labor and Delivery: Ingestion of aspirin near term or prior to delivery may prolong delivery or lead to bleeding in mother, fetus, or neonate. Nursing Mothers: Carisoprodol is excreted in human milk in concentrations two-to-four times that in maternal plasma. Aspirin is excreted in human milk in moderate amounts and can produce a bleeding tendency in nursing infants. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Pediatric Use: Safety and effectiveness in children below the age of twelve have not been established. ADVERSE REACTIONS If severe reactions occur, discontinue `Soma' Compound with Codeine and initiate appropriate symptomatic and supportive therapy. The following side effects which have occurred with the administration of the individual ingredients alone may also occur with the combination. Carisoprodol: Central Nervous System --Drowsiness is the most frequent complaint and along with other CNS effects may require dosage reduction. Observed less frequently are dizziness, vertigo and ataxia. Tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia have been infrequent or rare. Idiosyncratic --Idiosyncratic reactions are very rare. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug (see WARNINGS ). Allergic --Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruptions with cross-reaction to meprobamate have been reported. If allergic reactions occur, discontinue `Soma' Compound with Codeine and treat symptomatically. In evaluating possible allergic reactions, also consider allergy to excipients (information on excipients is available to physicians on request). Cardiovascular --Tachycardia, postural hypotension, and facial flushing. Gastrointestinal --Nausea, vomiting, epigastric distress and hiccup. Hematologic --No serious blood dyscrasias have been attributed to carisoprodol alone. Leukopenia and pancytopenia have been reported, very rarely, in situations in which other drugs or viral infections may have been responsible. Aspirin: The most common adverse reactions associated with the use of aspirin have been gastrointestinal, including nausea, vomiting, gastritis, occult bleeding, constipation and diarrhea. Gastric erosion, angioedema, asthma, rash, pruritus and urticaria have been reported less commonly. Tinnitus is a sign of high serum salicylate levels (see OVERDOSAGE ). Aspirin Intolerance --Allergic type reactions in aspirin-sensitive individuals may involve the respiratory tract or the skin. Symptoms of the former range from rhinorrhea and shortness of breath to severe asthma, and the latter may consist of urticaria, edema, rash, or angioedema (giant hives). These may occur independently or in combination. Codeine Phosphate: Nausea, vomiting, constipation, miosis, sedation, and dizziness have been reported. DRUG ABUSE AND DEPENDENCE Controlled Substance: Schedule C-III (see PRECAUTIONS ). Soma (Sanskrit), or Haoma (Avestan), from Proto-Indo-Iranian *sauma-, was a ritual drink of importance among the early Indo-Iranians, and the later Vedic and greater Persian cultures. It is frequently mentioned in the Rigveda, which contains many hymns praising its energizing or intoxicating qualities. In the Avesta, Haoma has an entire Yasht dedicated to it. It is described as prepared by pressing juice from the stalks of a certain mountain plant, which has been variously hypothesized to be a psychedelic mushroom, cannabis, peganum harmala, or ephedra. In both Vedic and Zoroastrian tradition, the drink is identified with the plant, and also personified as a divinity, the three forming a religious or mythological unity. Contents [hide] 1 Etymology 2 Vedic Soma 2.1 In the Rigveda 2.2 In Hinduism 3 Avestan Haoma 4 Candidates for the Soma plant 5 References 6 External links [edit] Etymology Both Soma and the Avestan Haoma are derived from Proto-Indo-Iranian *sauma-. The name of the Scythian tribe Hauma-varga is related to the word, and probably connected with the ritual. The word is derived from an Indo-Iranian root *sav- (Sanskrit sav-) "to press", i.e. *sav-ma- is the drink prepared by pressing the stalks of a plant (cf. es-presso). The root is probably Proto-Indo-European (*sewh-), and also appears in son (from *suhnu-, "pressed out" i.e. "newly born"). [edit] Vedic Soma In the Vedas, Soma is portrayed as sacred and as a god (deva). The god, the drink and the plant probably referred to the same entity, or at least the differentiation was ambiguous. In this aspect, Soma is similar to the Greek ambrosia (cognate to amrita); it is what the gods drink, and what made them deities. Indra and Agni are portrayed as consuming Soma in copious quantities. The consumption of Soma by human beings, was probably under the belief that it bestowed them divine qualities. [edit] In the Rigveda The Rigveda (8.48.3, tr. Griffith) states, a apama somam amrta abhumaganma jyotir avidama devan c ki? nunam asman k??avad arati? kim u dhurtir am?ta martyasya We have drunk Soma and become immortal; we have attained the light, the Gods discovered. Now what may foeman's malice do to harm us? What, O Immortal, mortal man's deception? The Ninth Mandala of the Rigveda is known as the Soma Mandala. It consists entirely of hymns addressed to Soma Pavamana ("purified Soma"). The drink Soma was kept and distributed by the Gandharvas. The Rigveda associates the Sushoma, Arjikiya and other regions with Soma (e.g. 8.7.29; 8.64.10-11). Sharyanavat was possibly the name of a pond or lake on the banks of which Soma could be found. The plant is described as growing in the mountains (giristha, cf. Orestes), with long stalks, and of yellow or tawny (hari) colour. The drink is prepared by priests pounding the stalks with stones, an occupation that creates tapas (literally "heat", later referring to "spiritual excitement" in particular). The juice so gathered is mixed with other ingredients (including milk and honey) before it is drunk. Growing far away, in the mountains, Soma had to be purchased from travelling traders. This is connected with the Indo-Aryan migration model, i.e. the plant supposedly grew in the homeland of the Indo-Iranians, probably the Hindukush, but later migration to the Punjab removed them from the area of its occurrence, and it had to be imported. Later, knowledge of the plant was lost altogether, and Indian ritual reflects this, in expiatory prayers apologizing to the gods for the use of a substitute plant (e.g. rhubarb) because Soma had become unavailable. [edit] In Hinduism In Hindu art, the god Soma was depicted as a bull or bird, and sometimes as an embryo, but rarely as an adult human. In Hinduism, the god Soma evolved into a lunar deity, and became associated with the underworld. The moon is the cup from which the gods drink Soma, and so Soma became identified with the moon god Chandra. A waxing moon meant Soma was recreating himself, ready to be drunk again. Alternatively, Soma's twenty-seven wives were daughters of Daksha, who felt he paid too much attention to just one of his wives, Rohini. He cursed him to wither and die, but the wives intervened and the death became periodic and temporary, and is symbolized by the waxing and waning of the moon. The famous ayurvedic scholar Susruta wrote that the best Soma is found in the upper Indus and Kashmir region (Susruta Samhita: 537-538, SS.CS. 29.28-31). [edit] Avestan Haoma Main article: Haoma The continuing importance of Haoma in Zoroastrianism may be glimpsed from the Avesta (particularly in the Hom Yast, Yasna 9.11), and Avestan language *hauma also survived as middle Persian hom. The plant Haoma yielded the essential ingredient for the ritual drink, parahaoma. In the Hom yast of the Avesta, the Yazata (divine) Haoma appears to Zoroaster "at the time of pressing" (havani ratu) in the form of a beautiful man. Yasna 9.1 and 9.2 exhort him to gather and press Haoma plants. Haoma's epitheta include "the Golden-Green One" (zairi-, Sanskrit hari-), "righteous" (asavan-), "furthering righteousness" (asa-vazah-), and "of good wisdom" (hu.xratu-, Sanskrit sukratu-). In Yasna 9.22, Haoma grants "speed and strength to warriors, excellent and righteous sons to those giving birth, spiritual power and knowledge to those who apply themselves to the study of the nasks". As the religion's chief cult divinity he came to be perceived as its divine priest. In Yasna 9.26, Ahura Mazda is said to have invested him with the sacred girdle, and in Yasna 10.89, to have installed Haoma as the "swiftly sacrificing zaotar" (Sanskrit hotar) for himself and the Amesha Spenta. Haoma services were celebrated until the 1960s in a strongly conservative village near Yazd. [edit] Candidates for the Soma plant Main article: botanic identity of Soma-Haoma There has been much speculation as to the original Proto-Indo-Iranian Sauma plant. It was generally assumed to be hallucinogenic, based on RV 8.48 cited above. But note that this is the only evidence of hallucinogenic properties, in a book full of hymns to Soma. The typical description of Soma is associated with excitation and tapas. Soma is associated with the warrior-god Indra, and appears to have been drunk before battle. For these reasons, there are energizing plants as well as hallucinogenic plants among the candidates that have been suggested. In fact, several texts like the Atharva Veda extol the medicinal properties of Soma and he is regarded as the king of medicinal herbs (and also of the Brahmana class). Since the late 1700s, when Anquetil-Duperron and others made portions of the Avesta available to western scholarship, several scholars have sought a representative botanical equivalent of the haoma as described in the texts and as used in living Zoroastrian practice. Most of the proposals concentrated on either linguistic evidence or comparative pharmacology or reflected ritual use. Rarely were all three considered together, which usually resulted in such proposals being quickly rejected. In the late 19th century, the highly conservative Zoroastrians of Yazd (Iran) were found to use Ephedra (genus Ephedra), which was locally known as hum or homa and which they exported to the Indian Zoroastrians. (Aitchison, 1888) The plant, as Falk also established, requires a cool and dry climate, i.e. it does not grow in India (which is either too hot or too humid or both) but thrives in central Asia. Later, it was discovered that a number of Iranian languages and Persian dialects have hom or similar terms as the local name for some variant of Ephedra. Considered together, the linguistic and ritual evidence appeared to conclusively establish that haoma was some variant of Ephedra. [edit] References Jay, Mike: Blue Tide: The Search for Soma (Autonomedia 1999) Frawley David: The Rig Veda and the History of India, 2001.(Aditya Prakashan), ISBN 81-7742-039-9 Parpola, Asko, The problem of the Aryans and the Soma: Textual-linguistic and archaeological evidence, in: The Indo-Aryans of Ancient South Asia ed. G. Erdosy, de Gruyter (1995), 353–381. Nyberg, Harri, The problem of the Aryans and the Soma: The botanical evidence, in: The Indo-Aryans of Ancient South Asia ed. G. Erdosy, de Gruyter (1995), 382–406. Soma article from The Encyclopedia of Psychoactive Substances by Richard Rudgley Little, Brown and Company (1998) (huxley.net) PBS Secrets of the Dead. Day of the Zulu (pbs.org). Retrieved Feb. 5, 2005. Susruta Samhita. Transl. Kunjalal Bhishagratna, Varanasi: Chowkhama Sanksrit Series. 1981. Bakels, C.C. 2003. “The contents of ceramic vessels in the Bactria-Margiana Archaeological Complex, Turkmenistan.” Electronic Journal of Vedic Studies. Vol. 9. Issue 1c (May 5) http://users.primushost.com/~india/ejvs/ejvs0901/ejvs0901c.txt Swami Rama. Living with the Himalayan Masters. The Himalayan Institute Press. 1978. McDonald, A. A botanical perspective on the identity of soma (Nelumbo nucifera Gaertn.) based on scriptural and iconographic records. Econmic Botany 2004;58:S147-S173 Soma This page contains drug information on Soma. The information provided includes the following: what is Soma the possible side effects of Soma what happens if you miss a dose of Soma what happens if you overdose with Soma the most important information about Soma how to use Soma other drugs that may affect Soma what to avoid while using Soma Generic Name: carisoprodol (kar eye soe PROE dole) Brand Names: Soma, Vanadom What is the most important information I should know about carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What is carisoprodol? • Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. • Carisoprodol is used, along with rest and physical therapy, to treat injuries and other painful muscular conditions. • Carisoprodol may also be used for purposes other than those listed in this medication guide. Who should not take carisoprodol? • Do not take carisoprodol if you have acute intermittent porphyria. • Before taking carisoprodol, tell your doctor if you have kidney or liver disease. You may need a lower dose or special monitoring during your therapy. • It is not known whether carisoprodol will harm an unborn baby. Do not take carisoprodol without first talking to your doctor if you are pregnant. • It is also not known whether carisoprodol passes into breast milk. Do not take carisoprodol without first talking to your doctor if you are breast-feeding a baby. • Carisoprodol is not approved for use in children younger than 12 years of age. How should I take carisoprodol? • Take carisoprodol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each dose with a full glass of water. • The maximum amount of carisoprodol you should take in one day is 1,400 mg (4 tablets). • Store carisoprodol at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a carisoprodol overdose include low blood pressure (weakness, fainting, confusion), decreased breathing, and unconsciousness. What should I avoid while taking carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What are the possible side effects of carisoprodol? • If you experience any of the following serious side effects, stop taking carisoprodol and seek emergency medical attention: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); · paralysis (loss of feeling) or extreme weakness; · vision loss; or · agitation or tremor. • Other, less serious side effects may be more likely to occur. Continue to take carisoprodol and talk to your doctor if you experience · drowsiness or dizziness; · headache; · depression; · blurred vision; · insomnia; or · hiccups. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. Soma Compound w/Codeine Tablets (carisoprodol, aspirin and codeine phosphate tablets, USP) carisoprodol 200 mg + aspirin 325 mg + codeine phosphate 16 mg--Warning: May be habit-forming TABLETS DESCRIPTION `Soma' Compound with Codeine is a combination product containing carisoprodol, a centrally-acting muscle relaxant, plus aspirin, an analgesic with antipyretic and anti-inflammatory properties and codeine phosphate, a centrally-acting narcotic analgesic. It is available as a two-layered, white and yellow, oval-shaped tablet for oral administration. Each tablet contains carisoprodol 200 mg, aspirin 325 mg, and codeine phosphate 16 mg. Chemically, carisoprodol is N-isopropyl-2-methyl-2-propyl-1,3-propanediol dicarbamate. Its empirical formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: Other ingredients: croscarmellose sodium, D&C Yellow #10, hydroxypropyl methylcellulose, magnesium stearate, microcrystalline cellulose, povidone, sodium metabisulfite, starch, stearic acid. CLINICAL PHARMACOLOGY Carisoprodol: Carisoprodol is a centrally-acting muscle relaxant that does not directly relax tense skeletal muscles in man. The mode of action of carisoprodol in relieving acute muscle spasm of local origin has not been clearly identified, but may be related to its sedative properties. In animals, carisoprodol has been shown to produce muscle relaxation by blocking interneuronal activity and depressing transmission of polysynaptic neurons in the spinal cord and in the descending reticular formation of the brain. The onset of action is rapid and lasts four to six hours. Carisoprodol is metabolized in the liver and is excreted by the kidneys. It is dialyzable by peritoneal and hemodialysis. Aspirin: Aspirin is a non-narcotic analgesic with anti-inflammatory and antipyretic activity. Inhibition of prostaglandin biosynthesis appears to account for most of its anti-inflammatory and for at least part of its analgesic and antipyretic properties. Aspirin is rapidly absorbed and almost totally hydrolyzed to salicylic acid following oral administration. Although aspirin has a half-life of only about 15 minutes, the apparent biologic half-life of salicylic acid in the therapeutic plasma concentration range is between 6 and 12 hours. Salicylic acid is eliminated by renal excretion and by biotransformation to inactive metabolites. Clearance of salicylic acid in the high-dose range is sensitive to urinary pH (see Drug Interactions ) and is reduced by renal dysfunction. Codeine Phosphate: Codeine phosphate is a centrally-acting narcotic-analgesic. Its actions are qualitatively similar to morphine, but its potency is substantially less. Clinical studies have shown that combining aspirin and codeine produces a significant additive effect in analgesic efficacy. INDICATIONS AND USAGE `Soma' Compound with Codeine is indicated as an adjunct to rest, physical therapy, and other measures for the relief of pain, muscle spasm, and limited mobility associated with acute, painful musculoskeletal conditions when the additional action of codeine is desired. CONTRAINDICATIONS Acute intermittent porphyria; bleeding disorders; allergic or idiosyncratic reactions to carisoprodol, aspirin, codeine, or related compounds. WARNINGS On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic reactions, with symptoms appearing within minutes or hours. These may include extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Although symptoms usually subside over the course of the next several hours, discontinue `Soma' Compound with Codeine and initiate appropriate supportive and symptomatic therapy, which may include epinephrine and/or antihistamines. In severe cases, corticosteroids may be necessary. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. The effects of carisoprodol with agents such as alcohol, other CNS depressants, or psychotropic drugs may be additive. Appropriate caution should be exercised with patients who take one or more of these agents simultaneously with Soma Compound with Codeine. Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. PRECAUTIONS General: To avoid excessive accumulation of carisoprodol, aspirin, or their metabolites, use `Soma' Compound with Codeine with caution in patients with compromised liver or kidney function, or in elderly or debilitated patients (see CLINICAL PHARMACOLOGY ). Use with caution in patients with history of gastritis or peptic ulcer, in patients on anticoagulant therapy, and in addiction-prone individuals. Information for Patients: Caution patients that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Caution patients with a predisposition for gastrointestinal bleeding that concomitant use of aspirin and alcohol may have an additive effect in this regard. Caution patients that dosage of medications used for gout, arthritis, or diabetes may have to be adjusted when aspirin is administered or discontinued (see Drug Interactions ). Drug Interactions: Clinically important interactions may occur when certain drugs are administered concomitantly with aspirin or aspirin-containing drugs. Oral Anticoagulants -- By interfering with platelet function or decreasing plasma prothrombin concentration, aspirin enhances the potential for bleeding in patients on anticoagulants. Methotrexate -- aspirin enhances the toxic effects of this drug. Probenecid and Sulfinpyrazone -- large doses of aspirin reduce the uricosuric effect of both drugs. Renal excretion of salicylate may also be reduced. Oral Antidiabetic Drugs -- enhancement of hypoglycemia may occur. Antacids -- to the extent that they raise urinary pH, antacids may substantially decrease plasma salicylate concentrations; conversely, their withdrawal can result in a substantial increase. Ammonium Chloride -- this and other drugs that acidify a relatively alkaline urine can elevate plasma salicylate concentrations. Ethyl Alcohol -- enhanced aspirin-induced fecal blood loss has been reported. Corticosteroids -- salicylate plasma levels may be decreased when adrenal corticosteroids are given, and may be increased substantially when they are discontinued. Carcinogenesis, Mutagenesis, Impairment of Fertility: No long-term studies have been done with `Soma' Compound with Codeine. Pregnancy--Teratogenic Effects: Pregnancy Category C. Adequate animal reproduction studies have not been conducted with `Soma' Compound with Codeine. It is also not known whether `Soma' Compound with Codeine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. `Soma' Compound with Codeine should be given to a pregnant woman only if clearly needed. Studies in rodents have shown salicylates to be teratogenic when given in early gestation, and embryocidal when given in later gestation in doses considerably greater than usual therapeutic doses in humans. Studies in women who took aspirin during pregnancy have not demonstrated an increased incidence of congenital abnormalities in the offspring. Labor and Delivery: Ingestion of aspirin near term or prior to delivery may prolong delivery or lead to bleeding in mother, fetus, or neonate. Nursing Mothers: Carisoprodol is excreted in human milk in concentrations two-to-four times that in maternal plasma. Aspirin is excreted in human milk in moderate amounts and can produce a bleeding tendency in nursing infants. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Pediatric Use: Safety and effectiveness in children below the age of twelve have not been established. ADVERSE REACTIONS If severe reactions occur, discontinue `Soma' Compound with Codeine and initiate appropriate symptomatic and supportive therapy. The following side effects which have occurred with the administration of the individual ingredients alone may also occur with the combination. Carisoprodol: Central Nervous System --Drowsiness is the most frequent complaint and along with other CNS effects may require dosage reduction. Observed less frequently are dizziness, vertigo and ataxia. Tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia have been infrequent or rare. Idiosyncratic --Idiosyncratic reactions are very rare. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug (see WARNINGS ). Allergic --Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruptions with cross-reaction to meprobamate have been reported. If allergic reactions occur, discontinue `Soma' Compound with Codeine and treat symptomatically. In evaluating possible allergic reactions, also consider allergy to excipients (information on excipients is available to physicians on request). Cardiovascular --Tachycardia, postural hypotension, and facial flushing. Gastrointestinal --Nausea, vomiting, epigastric distress and hiccup. Hematologic --No serious blood dyscrasias have been attributed to carisoprodol alone. Leukopenia and pancytopenia have been reported, very rarely, in situations in which other drugs or viral infections may have been responsible. Aspirin: The most common adverse reactions associated with the use of aspirin have been gastrointestinal, including nausea, vomiting, gastritis, occult bleeding, constipation and diarrhea. Gastric erosion, angioedema, asthma, rash, pruritus and urticaria have been reported less commonly. Tinnitus is a sign of high serum salicylate levels (see OVERDOSAGE ). Aspirin Intolerance --Allergic type reactions in aspirin-sensitive individuals may involve the respiratory tract or the skin. Symptoms of the former range from rhinorrhea and shortness of breath to severe asthma, and the latter may consist of urticaria, edema, rash, or angioedema (giant hives). These may occur independently or in combination. Codeine Phosphate: Nausea, vomiting, constipation, miosis, sedation, and dizziness have been reported. DRUG ABUSE AND DEPENDENCE Controlled Substance: Schedule C-III (see PRECAUTIONS ). Abuse: In clinical use, abuse has been rare. Dependence: In clinical use, dependence with `Soma' Compound with Codeine has been rare and there have been no reports of significant abstinence signs. Nevertheless, the following information on the individual ingredients should be kept in mind. Carisoprodol --In dogs, no withdrawal symptoms occurred after abrupt cessation of carisoprodol from dosages as high as 1 gm/kg/day. In a study in man, abrupt cessation of 100 mg/kg/day (about five times the recommended daily adult dosage) was followed in some subjects by mild withdrawal symptoms such as abdominal cramps, insomnia, chills, headache, and nausea. Delirium and convulsions did not occur (see PRECAUTIONS ). Codeine Phosphate-- Drug dependence of the morphine type may result. OVERDOSAGE Signs and Symptoms: Any of the following which have been reported with the individual ingredients may occur and may be modified to a varying degree by the effects of the other ingredients present in `Soma' Compound with Codeine. Carisoprodol --Stupor, coma, shock, respiratory depression and, very rarely, death. Overdosage with carisoprodol in combination with alcohol, other CNS depressants, or psychotropic agents can have additive effects, even when one of the agents has been taken in the usually recommended dosage. Aspirin --Headache, tinnitus, hearing difficulty, dim vision, dizziness, lassitude, hyperpnea, rapid breathing, thirst, nausea, vomiting, sweating and occasionally diarrhea are characteristic of mild to moderate salicylate poisoning. Salicylate poisoning should be considered in children with symptoms of vomiting, hyperpnea, and hyperthermia. Hyperpnea is an early sign of salicylate poisoning, but dyspnea supervenes at plasma levels above 50 mg/dl. These respiratory changes eventually lead to serious acid-base disturbances. Metabolic acidosis is a constant finding in infants but occurs in older children only with severe poisoning; adults usually exhibit respiratory alkalosis initially and acidosis terminally. Other symptoms of severe salicylate poisoning include hyperthermia, dehydration, delirium, and mental disturbances. Skin eruptions, GI hemorrhage, or pulmonary edema are less common. Early CNS stimulation is replaced by increasing depression, stupor, and coma. Death is usually due to respiratory failure or cardiovascular collapse. Codeine Phosphate-- pinpoint pupils, CNS depression, coma, respiratory depression, and shock. Treatment: General --Provide symptomatic and supportive treatment, as indicated. Any drug remaining in the stomach should be removed using appropriate procedures and caution to protect the airway and prevent aspiration, especially in the stuporous or comatose patient. Incomplete gastric emptying with delayed absorption of carisoprodol has been reported as a cause for relapse. Should respiration or blood pressure become compromised, respiratory assistance, central nervous system stimulants, and pressor agents should be administered cautiously, as indicated. Carisoprodol --The following have been used successfully in overdosage with the related drug meprobamate: diuretics, osmotic (mannitol) diuresis, peritoneal dialysis, and hemodialysis (see CLINICAL PHARMACOLOGY ). Careful monitoring of urinary output is necessary and caution should be taken to avoid overhydration. Carisoprodol can be measured in biological fluid by gas chromatography (Douglas, J. F., et al: J Pharm Sci 58: 145, 1969). Aspirin --Since there are no specific antidotes for salicylate poisoning, the aim of treatment is to enhance elimination of salicylate and prevent or reduce further absorption; to correct any fluid, electrolyte or metabolic imbalance; and to provide general and cardiorespiratory support. If acidosis is present, intravenous sodium bicarbonate must be given, along with adequate hydration, until salicylate levels decrease to within the therapeutic range. To enhance elimination, forced diuresis and alkalinization of the urine may be beneficial. The need for hemoperfusion or hemodialysis is rare and should be used only when other measures have failed. Codeine Phosphate-- Narcotic antagonists, such as nalorphine and levallorphan, may be indicated. DOSAGE AND ADMINISTRATION Usual Adult Dosage: 1 or 2 tablets, four times daily. Not recommended for use in children under age twelve. HOW SUPPLIED `Soma' Compound with Codeine Tablets (carisoprodol, USP 200 mg, aspirin 325 mg, and codeine phosphate, USP 16 mg) are oval, convex, two-layered and inscribed on the white layer with SOMA CC and on the yellow layer with WALLACE 2403. The tablets are available in bottles of 100 (NDC 0037-2403-01). Storage: Store at controlled room temperature 15°-30°C (59°-86°F). Protect from moisture. Dispense in a tight container. Wallace Pharmaceuticals MedPointe Healthcare Inc. Somerset, NJ 08873 IN-095E2-12 Rev. 9/93 Patent No. 4534974 PRODUCT PHOTO(S): NOTE: These photos can be used only for identification by shape, color, and imprint. They do not depict actual or relative size. The product samples shown here have been supplied by the manufacturer and reproduced in full color by PDR as a quick-reference identification aid. While every effort has been made to assure accurate reproduction, please remember that any visual identification should be considered preliminary. In cases of poisoning or suspected overdosage, the drug's identity should be verified by chemical analysis. -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products. SOMA's interdisciplinary team approach brings a unique perspective to each project combining real world, academic and regulatory experience. For more in-depth information regarding our staff members contact SOMA. Areas of Expertise of SOMA Staff &Associates • Occupational Medicine • Industrial Hygiene/Exposure Modeling • Occupational Health Nursing • Information Science • Neurology/Neuropsychology/Psychiatry • Pulmonology Animal Toxicology • Risk Assessment • Dermatology • Allergy/lmmunology • Epidemiology/Biostatistics • Pathology • Oncology • Radiology • Gastroenterology • Cardiology • Endocrinology • Orthopedics Buy Soma online Learn more about usage, cautions, and possible side effects. Prescription Soma Tablets Chemical Name: CARISOPRODOL (kar-eye-soe-PROE-dole) Common uses of prescription Soma containing Carisoprodol Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. Soma drugs / carisoprodol may also be used for purposes other than those listed in this medication guide. return to top Before using Prescription Soma Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. USE OF SOMA DRUGS is not recommended if you are also taking cyclobenzaprine or medicine for depression or other emotional or mood disorders. If you are taking any of these medicines, be sure your doctor knows. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking bupropion, narcotic analgesics, carbamazepine, or have a history of seizures. Inform your doctor of any other medical conditions, allergies, pregnancy, or breast-feeding. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine. Use caution when driving, operating machinery, or performing other hazardous activities. soma / carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking soma / carisoprodol. Also, in combination with aspirin, alcohol can be very damaging to your stomach. Watch for bloody, black, or tarry stools or blood in your vomit. This could mean damage to your stomach. Never take more of this medication than is prescribed for you. If your pain is not being adequately treated, talk to your doctor. return to top Directions Follow the directions for using this medicine provided by your doctor. STORE THIS MEDICINE at room temperature, away from heat and light. IF YOU MISS A DOSE OF THIS MEDICINE, take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of soma / carisoprodol. Keep your doses at least 4 hours apart from one another.take it as soon as possible. Do NOT take 2 doses at once. return to top Cautions DO NOT EXCEED THE RECOMMENDED DOSE OR TAKE THIS MEDICINE for longer than prescribed. IF YOU EXPERIENCE difficulty breathing or tightness of chest; swelling of eyelids, face, or lips; or develop a rash or hives, tell your doctor immediately. Do not take any more of this medicine unless your doctor tells you to do so. AVOID ALCOHOL while you are using this medicine. This medicine will add to the effects of alcohol and other depressants. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. Caution should be used in the elderly since they may be more sensitive to the effects of this drug. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. THIS MEDICINE IS EXCRETED IN BREAST MILK. DO NOT BREAST-FEED while taking this medicine. Do not take soma / carisoprodol if you have acute intermittent porphyria. Codeine is habit forming and should only be used under close supervision if you have an alcohol or drug addiction. Before taking this medication, tell your doctor if you have: kidney disease liver disease an ulcer in your stomach or intestines a bleeding or blood-clotting disorder urinary retention an enlarged prostate hypothyroidism a head injury addison's disease You may not be able to take soma / carisoprodol, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above. It is not known whether soma / carisoprodol will harm an unborn baby. Do not take soma / carisoprodol without first talking to your doctor if you are pregnant. It is also not known whether soma / carisoprodol passes into breast milk. Do not take soma / carisoprodol without first talking to your doctor if you are breast-feeding a baby. Soma / carisoprodol is not approved for use in children younger than 12 years of age. return to top Possible side effects If you experience any of the following serious side effects, stop taking soma / carisoprodol and seek emergency medical attention: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); paralysis (loss of feeling) or extreme weakness vision loss agitation or tremor red, black, or bloody stools blood in your vomit other, less serious side effects may be more likely to occur Continue to take soma / carisoprodol and talk to your doctor if you experience: drowsiness or dizziness headache depression blurred vision or small pupils insomnia; hiccups faint ringing in the ears nausea, vomiting, or constipation Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. return to top Drug interactions Many drugs can increase the effects of soma / carisoprodol and lead to heavy sedation. Before taking this medication, tell your doctor if you are taking any of the following medicines: antihistamines such as brompheniramine (Dimetane, Bromfed, others) chlorpheniramine (Chlor-Trimeton Teldrin, others) azatadine (Optimine) clemastine (Tavist) narcotics (pain killers) such as meperidine (Demerol) morphine (MS Contin, MSIR, others) propoxyphene (Darvon, Darvocet) hydrocodone (Lorcet, Vicodin) oxycodone (Percocet, Percodan) fentanyl (Duragesic) codeine (Fiorinal, Fioricet, Tylenol #3, others) sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal) secobarbital (Seconal) phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin) mesoridazine (Serentil) perphenazine (Trilafon) prochlorperazine (Compazine) thioridazine (Mellaril), and trifluoperazine (Stelazine) antidepressants such as doxepin (Sinequan) imipramine (Tofranil) nortriptyline (Pamelor) fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) phenelzine (Nardil) tranylcypromine (Parnate) Other over-the-counter and prescription drugs may increase the effects of aspirin and cause dangerous side effects: oral anticoagulants such as warfarin (Coumadin) nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Rufen, others) ketoprofen (Orudis, Oruvail) naproxen (Anaprox, Naprosyn, Aleve) other commonly used NSAIDs, including diclofenac (Voltaren, Cataflam), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin) other salicylates (forms of aspirin) such as salsalate (Disalcid), choline salicylate, and magnesium salicylate bismuth subsalicylate in drugs such as Pepto-Bismol; and calcium supplements and antacids. other drugs that should not be combined with aspirin and carisoprodol include steroids such as prednisone (Deltasone) oral antidiabetic drugs such as glipizide (Glucotrol) and glyburide (Micronase, Diabeta) alcohol lithium (Lithobid, Eskalith, others) cyclosporine (Sandimmune) Drugs other than those listed here may also interact with soma / carisoprodol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. return to top If you take too much If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include cold and clammy skin, low body temperature, slowed breathing, slowed heartbeat, drowsiness, dizziness, lightheadedness, seizures, deep sleep, and loss of consciousness. Seek emergency medical attention. Symptoms of an aspirin soma / carisoprodol overdose include: headache ringing in the ears dim vision small pupils nausea vomiting diarrhea sweating increased thirst low blood pressure (weakness, fainting, confusion) decreased breathing unconsciousness. return to top Additional information DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out. Soma This page contains drug information on Soma. The information provided includes the following: what is Soma the possible side effects of Soma what happens if you miss a dose of Soma what happens if you overdose with Soma the most important information about Soma how to use Soma other drugs that may affect Soma what to avoid while using Soma Generic Name: carisoprodol (kar eye soe PROE dole) Brand Names: Soma, Vanadom What is the most important information I should know about carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What is carisoprodol? • Carisoprodol is a muscle relaxant. It works by blocking nerve impulses (or pain sensations) that are sent to your brain. • Carisoprodol is used, along with rest and physical therapy, to treat injuries and other painful muscular conditions. • Carisoprodol may also be used for purposes other than those listed in this medication guide. Who should not take carisoprodol? • Do not take carisoprodol if you have acute intermittent porphyria. • Before taking carisoprodol, tell your doctor if you have kidney or liver disease. You may need a lower dose or special monitoring during your therapy. • It is not known whether carisoprodol will harm an unborn baby. Do not take carisoprodol without first talking to your doctor if you are pregnant. • It is also not known whether carisoprodol passes into breast milk. Do not take carisoprodol without first talking to your doctor if you are breast-feeding a baby. • Carisoprodol is not approved for use in children younger than 12 years of age. How should I take carisoprodol? • Take carisoprodol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. • Take each dose with a full glass of water. • The maximum amount of carisoprodol you should take in one day is 1,400 mg (4 tablets). • Store carisoprodol at room temperature away from moisture and heat. What happens if I miss a dose? • Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart. What happens if I overdose? • Seek emergency medical attention. • Symptoms of a carisoprodol overdose include low blood pressure (weakness, fainting, confusion), decreased breathing, and unconsciousness. What should I avoid while taking carisoprodol? • Use caution when driving, operating machinery, or performing other hazardous activities. Carisoprodol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. • Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking carisoprodol. What are the possible side effects of carisoprodol? • If you experience any of the following serious side effects, stop taking carisoprodol and seek emergency medical attention: · an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); · paralysis (loss of feeling) or extreme weakness; · vision loss; or · agitation or tremor. • Other, less serious side effects may be more likely to occur. Continue to take carisoprodol and talk to your doctor if you experience · drowsiness or dizziness; · headache; · depression; · blurred vision; · insomnia; or · hiccups. • Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. What other drugs will affect carisoprodol? • Many drugs can increase the effects of carisoprodol, which can lead to heavy sedation. Before taking this medication, tell your doctor if you are taking any of the following medicines: · antihistamines such as brompheniramine (Dimetane, Bromfed, others), chlorpheniramine (Chlor-Trimeton, Teldrin, others), azatadine (Optimine), clemastine (Tavist), and many others; · narcotics (pain killers) such as meperidine (Demerol), morphine (MS Contin, MSIR, others), propoxyphene (Darvon, Darvocet), hydrocodone (Lorcet, Vicodin), oxycodone (Percocet, Percodan), fentanyl (Duragesic), and codeine (Fiorinal, Fioricet, Tylenol #3, others); · sedatives such as phenobarbital (Solfoton, Luminal), amobarbital (Amytal), and secobarbital (Seconal); · phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), mesoridazine (Serentil), perphenazine (Trilafon), prochlorperazine (Compazine), thioridazine (Mellaril), and trifluoperazine (Stelazine); or · antidepressants such as doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Pamelor), fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), phenelzine (Nardil), and tranylcypromine (Parnate). • Drugs other than those listed here may also interact with carisoprodol. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines. Where can I get more information? • Your pharmacist has more information about carisoprodol written for health professionals that you may read. Soma is a medication that acts as a muscle relaxant, usually for the purpose of helping patients deal with the pain associated with injury. On our site, generic Soma (known as Carisoprodol) is made available to consumers for the lowest prices online. The reason so many people decide to purchase their Soma online from our website is the service that we offer, and our low prices. That, combined with the convenience of online ordering, and not needing a prior prescription make ordering your Soma online from us an easy decision for you to make. If you are in the process of recovering from an injury, and need Carisoprodol to help during the recovery period, you can buy it online here and have it in your hands in as little as one or two business days. Keep in mind that Soma is not intended to directly heal the injury you have suffered. Rather, it works to temporarily suppress the pain so that you can more comfortably go on with your normal daily activities. Although, it is usually regarded as best to rest an injury such as that as much as possible. A good amount of rest, supervised physical therapy, and your daily dosages of Soma will often form a good plan for getting through and past a muscular injury. Soma is taken orally. A single pill is ingested, three times a day. It is recommended that you take it with food, or with milk, to minimize the likelihood that you will suffer an upset stomach as a result of taking the medication. When taking Carisoprodol, you should be very careful if you intend to ingest alcohol or alcoholic beverages. This medication may very well intensify the effects of the alcohol you ingest. In addition, you should refrain from operating dangerous machinery or from operating an automobile until you have an understanding of how having this medication in your system will effect your ability to perform the mental or physical tasks necessary for those activities. As always, keep this and all other medications (prescription, as well as over the counter) stored safely out of the reach of children. Soma, or its generic form called Carisoprodol is a muscle relaxant which works by blocking nerve impulses that are sent to your brain. Many poeple use Soma to treat injuries and other painful muscular conditions. It has the best results when taken in combination with rest, physical therapy and other measures. Although people find it benificial to use for other purposes, it is mainly meant to treat pain and stiffness of muscle injuries including the following: strains sprains and muscle spasms Take Soma exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.Take each dose with a full glass of water.The maximum amount of Soma you should take in one day is 1,400 mg (4 tablets).Store Soma at room temperature away from moisture and heat.Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication. Try to keep your doses at least 4 hours apart. Carisoprodol belongs to the category of drugs known as muscle relaxants. These drugs directly react on the Central Nervous System to reduce pain. Soma is known to produce very few side effects which is why doctors prefer prescribing soma instead of other muscle-relaxants. The side effects from Soma are known to emerge as soon as you start taking the medication. In the starting days you may encounter problems like headache, body ache and other troubles. But once your body adapts to the medication, these side effects usually go away. You should continue using Soma even after you see few side effects during the early stages. However if any of the problem remains for longer than expected period you should contact your doctor immediately. It may happen sometime that drug may affect some patients adversely. The following is a list of side effects that may occur in the beginning stages of using Soma: SOMA' (carisoprodol) Tablets, USP is available as 350 mg round, white tablets. Chemically, carisoprodol is N-isopropyl-2- methyl-2-propyl-1,3-propanediol dicarbamate. Carisoprodol is a white, crystalline powder, having a mild, characteristic odor and a bitter taste. It is very slightly soluble in water; freely soluble in alcohol, in chloroform, and in acetone; its solubility is practically independent of pH. Carisoprodol is present as a racemic mixture. The molecular formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: Carisoprodol produces muscle relaxation in animals by blocking interneuronal activity in the descending reticular formation and spinal cord. The onset of action is rapid and effects last four to six hours. INDICATIONS Carisoprodol is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions. The mode of action of this drug has not been clearly identified, but may be related to its sedative properties. Carisoprodol does not directly relax tense skeletal muscles in man. CONTRAINDICATIONS Acute intermittent porphyria as well as allergic or idiosyncratic reactions to carisoprodol or related compounds. WARNINGS Idiosyncratic Reactions --On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic symptoms appearing within minutes or hours. Symptoms reported include: extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Symptoms usually subside over the course of the next several hours. Supportive and symptomatic therapy, including hospitalization, may be necessary. Usage in Pregnancy and Lactation --Safe usage of this drug in pregnancy or lactation has not been established. Therefore, use of this drug in pregnancy, in nursing mothers, or in women of childbearing potential requires that the potential benefits of the drug be weighed against the potential hazards to mother and child. Carisoprodol is present in breast milk of lactating mothers at concentrations two to four times that of maternal plasma. This factor should be taken into account when use of the drug is contemplated in breast-feeding patients. Usage in Children --Because of limited clinical experience, `SOMA' is not recommended for use in patients under 12 years of age. Potentially Hazardous Tasks --Patients should be warned that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Additive Effects --Since the effects of carisoprodol and alcohol or carisoprodol and other CNS depressants or psychotropic drugs may be additive, appropriate caution should be exercised with patients who take more than one of these agents simultaneously. Drug Dependence --In dogs, no withdrawal symptoms occurred after abrupt cessation of carisoprodol from dosages as high as 1 gm/kg/day. In a study in man, abrupt cessation of 100 mg/kg/day (about five times the recommended daily adult dosage) was followed in some subjects by mild withdrawal symptoms such as abdominal cramps, insomnia, chilliness, headache, and nausea. Delirium and convulsions did not occur. In clinical use, psychological dependence and abuse have been rare, and there have been no reports of significant abstinence signs. Nevertheless, the drug should be used with caution in addiction-prone individuals. PRECAUTIONS Carisoprodol is metabolized in the liver and excreted by the kidney; to avoid its excess accumulation, caution should be exercised in administration to patients with compromised liver or kidney function. ADVERSE REACTIONS Central Nervous System --Drowsiness and other CNS effects may require dosage reduction. Also observed: dizziness, vertigo, ataxia, tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia. (See also Idiosyncratic Reactions under "Warnings." ) Allergic or Idiosyncratic --Allergic or idiosyncratic reactions occasionally develop. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug. Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruption with cross reaction to meprobamate have been reported with carisoprodol. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. (See also Idiosyncratic Reactions under "Warnings." ) In case of allergic or idiosyncratic reactions to carisoprodol, discontinue the drug and initiate appropriate symptomatic therapy, which may include epinephrine, antihistamines, and in severe cases corticosteroids. In evaluating possible allergic reactions, also consider allergy to excipients (information on excipients is available to physicians on request). Cardiovascular --Tachycardia, postural hypotension, and facial flushing. Gastrointestinal --Nausea, vomiting, hiccup, and epigastric distress. Hematologic --Leukopenia, in which other drugs or viral infection may have been responsible, and pancytopenia, attributed to phenylbutazone, have been reported. No serious blood dyscrasias have been attributed to carisoprodol. DOSAGE AND ADMINISTRATION The usual adult dosage of `SOMA' (carisoprodol) Tablets, USP is one 350 mg tablet, three times daily and at bedtime. Usage in patients under age 12 is not recommended. OVERDOSAGE Overdosage of carisoprodol has produced stupor, coma, shock, respiratory depression, and, very rarely, death. The effects of an overdosage of carisoprodol and alcohol or other CNS depressants or psychotropic agents can be additive even when one of the drugs has been taken in the usual recommended dosage. Any drug remaining in the stomach should be removed and symptomatic therapy given. Should respiration or blood pressure become compromised, respiratory assistance, central nervous system stimulants, and pressor agents should be administered cautiously as indicated. Carisoprodol is metabolized in the liver and excreted by the kidney. Although carisoprodol overdosage experience is limited, the following types of treatment have been used successfully with the related drug meprobamate: diuresis, osmotic (mannitol) diuresis, peritoneal dialysis, and hemodialysis (carisoprodol is dialyzable). Careful monitoring of urinary output is necessary and caution should be taken to avoid overhydration. Observe for possible relapse due to incomplete gastric emptying and delayed absorption. Carisoprodol can be measured in biological fluids by gas chromatography (Douglas, J. F. et al.: J Pharm Sci 58: 145, 1969). Carisoprodol, or Generic Soma, (generic for Soma) is a muscle relaxant recommended for muscle injury, musculoskeletal condition, and muscle related spasm. It is combined therapy of rest, exercise and medication. The drug directly affects the Central Nervous System (CNS). It blocks the pain receptors from reaching the brain thus relieving the pain. Carisoprodol is relatively potent and also brings down the possibility of side effects. Soma' Compound with Codeine is a combination product containing carisoprodol, a centrally-acting muscle relaxant, plus aspirin, an analgesic with antipyretic and anti-inflammatory properties and codeine phosphate, a centrally-acting narcotic analgesic. It is available as a two-layered, white and yellow, oval-shaped tablet for oral administration. Each tablet contains carisoprodol 200 mg, aspirin 325 mg, and codeine phosphate 16 mg. Chemically, carisoprodol is N-isopropyl-2-methyl-2-propyl-1,3-propanediol dicarbamate. Its empirical formula is C 12 H 24 N 2 O 4 , with a molecular weight of 260.33. The structural formula is: CLINICAL PHARMACOLOGY Carisoprodol: Carisoprodol is a centrally-acting muscle relaxant that does not directly relax tense skeletal muscles in man. The mode of action of carisoprodol in relieving acute muscle spasm of local origin has not been clearly identified, but may be related to its sedative properties. In animals, carisoprodol has been shown to produce muscle relaxation by blocking interneuronal activity and depressing transmission of polysynaptic neurons in the spinal cord and in the descending reticular formation of the brain. The onset of action is rapid and lasts four to six hours. Carisoprodol is metabolized in the liver and is excreted by the kidneys. It is dialyzable by peritoneal and hemodialysis. Aspirin: Aspirin is a non-narcotic analgesic with anti-inflammatory and antipyretic activity. Inhibition of prostaglandin biosynthesis appears to account for most of its anti-inflammatory and for at least part of its analgesic and antipyretic properties. Aspirin is rapidly absorbed and almost totally hydrolyzed to salicylic acid following oral administration. Although aspirin has a half-life of only about 15 minutes, the apparent biologic half-life of salicylic acid in the therapeutic plasma concentration range is between 6 and 12 hours. Salicylic acid is eliminated by renal excretion and by biotransformation to inactive metabolites. Clearance of salicylic acid in the high-dose range is sensitive to urinary pH (see Drug Interactions ) and is reduced by renal dysfunction. Codeine Phosphate: Codeine phosphate is a centrally-acting narcotic-analgesic. Its actions are qualitatively similar to morphine, but its potency is substantially less. Clinical studies have shown that combining aspirin and codeine produces a significant additive effect in analgesic efficacy. INDICATIONS AND USAGE `Soma' Compound with Codeine is indicated as an adjunct to rest, physical therapy, and other measures for the relief of pain, muscle spasm, and limited mobility associated with acute, painful musculoskeletal conditions when the additional action of codeine is desired. CONTRAINDICATIONS Acute intermittent porphyria; bleeding disorders; allergic or idiosyncratic reactions to carisoprodol, aspirin, codeine, or related compounds. WARNINGS On very rare occasions, the first dose of carisoprodol has been followed by idiosyncratic reactions, with symptoms appearing within minutes or hours. These may include extreme weakness, transient quadriplegia, dizziness, ataxia, temporary loss of vision, diplopia, mydriasis, dysarthria, agitation, euphoria, confusion, and disorientation. Although symptoms usually subside over the course of the next several hours, discontinue `Soma' Compound with Codeine and initiate appropriate supportive and symptomatic therapy, which may include epinephrine and/or antihistamines. In severe cases, corticosteroids may be necessary. Severe reactions have been manifested by asthmatic episodes, fever, weakness, dizziness, angioneurotic edema, smarting eyes, hypotension, and anaphylactoid shock. The effects of carisoprodol with agents such as alcohol, other CNS depressants, or psychotropic drugs may be additive. Appropriate caution should be exercised with patients who take one or more of these agents simultaneously with Soma Compound with Codeine. Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. PRECAUTIONS General: To avoid excessive accumulation of carisoprodol, aspirin, or their metabolites, use `Soma' Compound with Codeine with caution in patients with compromised liver or kidney function, or in elderly or debilitated patients (see CLINICAL PHARMACOLOGY ). Use with caution in patients with history of gastritis or peptic ulcer, in patients on anticoagulant therapy, and in addiction-prone individuals. Information for Patients: Caution patients that this drug may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a motor vehicle or operating machinery. Caution patients with a predisposition for gastrointestinal bleeding that concomitant use of aspirin and alcohol may have an additive effect in this regard. Caution patients that dosage of medications used for gout, arthritis, or diabetes may have to be adjusted when aspirin is administered or discontinued (see Drug Interactions ). Drug Interactions: Clinically important interactions may occur when certain drugs are administered concomitantly with aspirin or aspirin-containing drugs. Oral Anticoagulants -- By interfering with platelet function or decreasing plasma prothrombin concentration, aspirin enhances the potential for bleeding in patients on anticoagulants. Methotrexate -- aspirin enhances the toxic effects of this drug. Probenecid and Sulfinpyrazone -- large doses of aspirin reduce the uricosuric effect of both drugs. Renal excretion of salicylate may also be reduced. Oral Antidiabetic Drugs -- enhancement of hypoglycemia may occur. Antacids -- to the extent that they raise urinary pH, antacids may substantially decrease plasma salicylate concentrations; conversely, their withdrawal can result in a substantial increase. Ammonium Chloride -- this and other drugs that acidify a relatively alkaline urine can elevate plasma salicylate concentrations. Ethyl Alcohol -- enhanced aspirin-induced fecal blood loss has been reported. Corticosteroids -- salicylate plasma levels may be decreased when adrenal corticosteroids are given, and may be increased substantially when they are discontinued. Carcinogenesis, Mutagenesis, Impairment of Fertility: No long-term studies have been done with `Soma' Compound with Codeine. Pregnancy--Teratogenic Effects: Pregnancy Category C. Adequate animal reproduction studies have not been conducted with `Soma' Compound with Codeine. It is also not known whether `Soma' Compound with Codeine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. `Soma' Compound with Codeine should be given to a pregnant woman only if clearly needed. Studies in rodents have shown salicylates to be teratogenic when given in early gestation, and embryocidal when given in later gestation in doses considerably greater than usual therapeutic doses in humans. Studies in women who took aspirin during pregnancy have not demonstrated an increased incidence of congenital abnormalities in the offspring. Labor and Delivery: Ingestion of aspirin near term or prior to delivery may prolong delivery or lead to bleeding in mother, fetus, or neonate. Nursing Mothers: Carisoprodol is excreted in human milk in concentrations two-to-four times that in maternal plasma. Aspirin is excreted in human milk in moderate amounts and can produce a bleeding tendency in nursing infants. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Pediatric Use: Safety and effectiveness in children below the age of twelve have not been established. ADVERSE REACTIONS If severe reactions occur, discontinue `Soma' Compound with Codeine and initiate appropriate symptomatic and supportive therapy. The following side effects which have occurred with the administration of the individual ingredients alone may also occur with the combination. Carisoprodol: Central Nervous System --Drowsiness is the most frequent complaint and along with other CNS effects may require dosage reduction. Observed less frequently are dizziness, vertigo and ataxia. Tremor, agitation, irritability, headache, depressive reactions, syncope, and insomnia have been infrequent or rare. Idiosyncratic --Idiosyncratic reactions are very rare. They are usually seen within the period of the first to fourth dose in patients having had no previous contact with the drug (see WARNINGS ). Allergic --Skin rash, erythema multiforme, pruritus, eosinophilia, and fixed drug eruptions with cross-reaction to meprobamate have been reported. If allergic reactions occur, discontinue `Soma' Compound with Codeine and treat symptomatically. In evaluating possible allergic reactions, also consider allergy to excipients (information on excipients is available to physicians on request). Cardiovascular --Tachycardia, postural hypotension, and facial flushing. Gastrointestinal --Nausea, vomiting, epigastric distress and hiccup. Hematologic --No serious blood dyscrasias have been attributed to carisoprodol alone. Leukopenia and pancytopenia have been reported, very rarely, in situations in which other drugs or viral infections may have been responsible. Aspirin: The most common adverse reactions associated with the use of aspirin have been gastrointestinal, including nausea, vomiting, gastritis, occult bleeding, constipation and diarrhea. Gastric erosion, angioedema, asthma, rash, pruritus and urticaria have been reported less commonly. Tinnitus is a sign of high serum salicylate levels (see OVERDOSAGE ). Aspirin Intolerance --Allergic type reactions in aspirin-sensitive individuals may involve the respiratory tract or the skin. Symptoms of the former range from rhinorrhea and shortness of breath to severe asthma, and the latter may consist of urticaria, edema, rash, or angioedema (giant hives). These may occur independently or in combination. Codeine Phosphate: Nausea, vomiting, constipation, miosis, sedation, and dizziness have been reported. DRUG ABUSE AND DEPENDENCE Controlled Substance: Schedule C-III (see PRECAUTIONS ). Abuse: In clinical use, abuse has been rare. Dependence: In clinical use, dependence with `Soma' Compound with Codeine has been rare and there have been no reports of significant abstinence signs. Nevertheless, the following information on the individual ingredients should be kept in mind. Carisoprodol --In dogs, no withdrawal symptoms occurred after abrupt cessation of carisoprodol from dosages as high as 1 gm/kg/day. In a study in man, abrupt cessation of 100 mg/kg/day (about five times the recommended daily adult dosage) was followed in some subjects by mild withdrawal symptoms such as abdominal cramps, insomnia, chills, headache, and nausea. Delirium and convulsions did not occur (see PRECAUTIONS ). Codeine Phosphate-- Drug dependence of the morphine type may result. OVERDOSAGE Signs and Symptoms: Any of the following which have been reported with the individual ingredients may occur and may be modified to a varying degree by the effects of the other ingredients present in `Soma' Compound with Codeine. Carisoprodol --Stupor, coma, shock, respiratory depression and, very rarely, death. Overdosage with carisoprodol in combination with alcohol, other CNS depressants, or psychotropic agents can have additive effects, even when one of the agents has been taken in the usually recommended dosage. Aspirin --Headache, tinnitus, hearing difficulty, dim vision, dizziness, lassitude, hyperpnea, rapid breathing, thirst, nausea, vomiting, sweating and occasionally diarrhea are characteristic of mild to moderate salicylate poisoning. Salicylate poisoning should be considered in children with symptoms of vomiting, hyperpnea, and hyperthermia. Hyperpnea is an early sign of salicylate poisoning, but dyspnea supervenes at plasma levels above 50 mg/dl. These respiratory changes eventually lead to serious acid-base disturbances. Metabolic acidosis is a constant finding in infants but occurs in older children only with severe poisoning; adults usually exhibit respiratory alkalosis initially and acidosis terminally. Other symptoms of severe salicylate poisoning include hyperthermia, dehydration, delirium, and mental disturbances. Skin eruptions, GI hemorrhage, or pulmonary edema are less common. Early CNS stimulation is replaced by increasing depression, stupor, and coma. Death is usually due to respiratory failure or cardiovascular collapse. Codeine Phosphate-- pinpoint pupils, CNS depression, coma, respiratory depression, and shock. Treatment: General --Provide symptomatic and supportive treatment, as indicated. Any drug remaining in the stomach should be removed using appropriate procedures and caution to protect the airway and prevent aspiration, especially in the stuporous or comatose patient. Incomplete gastric emptying with delayed absorption of carisoprodol has been reported as a cause for relapse. Should respiration or blood pressure become compromised, respiratory assistance, central nervous system stimulants, and pressor agents should be administered cautiously, as indicated. Carisoprodol --The following have been used successfully in overdosage with the related drug meprobamate: diuretics, osmotic (mannitol) diuresis, peritoneal dialysis, and hemodialysis (see CLINICAL PHARMACOLOGY ). Careful monitoring of urinary output is necessary and caution should be taken to avoid overhydration. Carisoprodol can be measured in biological fluid by gas chromatography (Douglas, J. F., et al: J Pharm Sci 58: 145, 1969). Aspirin --Since there are no specific antidotes for salicylate poisoning, the aim of treatment is to enhance elimination of salicylate and prevent or reduce further absorption; to correct any fluid, electrolyte or metabolic imbalance; and to provide general and cardiorespiratory support. If acidosis is present, intravenous sodium bicarbonate must be given, along with adequate hydration, until salicylate levels decrease to within the therapeutic range. To enhance elimination, forced diuresis and alkalinization of the urine may be beneficial. The need for hemoperfusion or hemodialysis is rare and should be used only when other measures have failed. Codeine Phosphate-- Narcotic antagonists, such as nalorphine and levallorphan, may be indicated. DOSAGE AND ADMINISTRATION Usual Adult Dosage: 1 or 2 tablets, four times daily. Not recommended for use in children under age twelve. HOW SUPPLIED `Soma' Compound with Codeine Tablets (carisoprodol, USP 200 mg, aspirin 325 mg, and codeine phosphate, USP 16 mg) are oval, convex, two-layered and inscribed on the white layer with SOMA CC and on the yellow layer with WALLACE 2403. The tablets are available in bottles of 100 (NDC 0037-2403-01). Welcome to the online pharmacy for Soma and Carisoprodol that you can trust. Through this website, you will be able to find all the information you need on Soma, Generic Soma, and Carisoprodol online. You can order Soma or Carisoprodol at the best prices online from the comfort of your own home. This website will allow you to avoid the problems of making an appointment with your Doctor just to get a prescription for soma. Our website allows you to order soma, or carisoprodol, with no prior prescription and have it delivered right to your office or home. No prior prescription needed No waiting rooms No appointments No consultation fees We offer discreet packaging and Overnight shipping Prescriptions filled by US-licensed pharmacies Prescriptions made only by US-licensed physicians If you are planning to buy Soma or Carisoprodol online, this is the right place for you. We offer the best prices for Soma and Carisoprodol you can find anywhere on the internet. Carisoprodol is a skeletal muscle relaxant whose active metabolite is meprobamate. Although several case reports have shown that carisoprodol has abuse potential, it continues to be widely prescribed (not so in the United Kingdom where use of benzodiazepines is preferred). Carisoprodol is a colorless, crystalline powder, having a mild, characteristic odor and a bitter taste. It is slightly soluble in water and freely soluble in alcohol, chloroform and acetone. Its solubility is practically independent of pH. It is marketed in the United States under the brand name Soma, and in the United Kingdom and other countries under the brand name Carisoma. This medication may be habit-forming and should be used only by the person it was prescribed for. Carisoprodol should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. You may have withdrawal symptoms when you stop using carisoprodol after using it over a long period of time. Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. Carisoprodol can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase drowsiness and dizziness caused by carisoprodol. This medication may be habit-forming and should be used only by the person it was prescribed for. Carisoprodol should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. You may have withdrawal symptoms when you stop using carisoprodol after using it over a long period of time. Withdrawal symptoms include stomach pain, sleep problems, headache, nausea, and seizure (convulsions). Do not stop using this medication suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether carisoprodol passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Do not give this medication to a child younger than 12 years old.. IMPORTANT NOTE: The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug. CARISOPRODOL - ORAL (kar-iss-oh-PRO-dole) COMMON BRAND NAME(S): Soma USES: This medication relaxes muscles and relieves pain and discomfort associated with strains, sprains, spasms or other muscle injuries. Muscle relaxers are for specific muscle injury and pain and should not be used for general body aches and pains. HOW TO USE: This medication may be taken with food or immediately after meals to prevent stomach upset. Take this as directed. Do not increase your dose or take it more often than prescribed. This medication provides temporary relief and must be used in addition to rest, physical therapy and other measures. Because this medication makes an injury temporarily feel better, do not attempt to lift or exercise too soon. Follow your doctor's instructions for recovery. SIDE EFFECTS: This medication may cause stomach upset, heartburn, headache, dizziness or drowsiness. If these symptoms persist or worsen, notify your doctor promptly. Inform your doctor promptly if you develop: persistent stomach pain, rapid heart rate. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist. PRECAUTIONS: Tell your doctor your medical history, especially of: any liver or kidney disease, blood disorders, porphyria, asthma, any allergies. When rising quickly from a sitting or lying position, dizziness or lightheadedness may occur. Change positions slowly. Use caution engaging in activities requiring alertness (such as driving) if this drug makes you dizzy or drowsy. Limit alcohol intake while taking this medication. This drug should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. Carisoprodol is excreted into breast milk. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Tell your doctor of all over-the-counter and prescription medication you may take including: sedatives, tranquilizers, sleeping pills, narcotic pain relievers, medication for depression, certain antihistamines (e.g., diphenhydramine). Many cough-and-cold products contain antihistamines which can cause drowsiness. Check labels carefully and consult your pharmacist if you have any questions. Do not start or |