Meprobamate

Generic name:

Meprobamate

Drug class:

Centrally acting skeletal muscle relaxant; anxiolytic (carbamate derivative)

Dosage form:

Tablets (200 mg, 400 mg), Oral solution (100 mg/mL)

Route of administration:

Oral

Dose:

Adults: 400–800 mg orally three to four times daily (total up to 5,400 mg/day). Variations by indication and age; consult label.

Elderly: Lower end of dosing range; titrate based on response and tolerability. Pediatric use: Varies by indication; consult label.

Mechanism of action:

Enhances GABA_A receptor–mediated inhibitory neurotransmission by binding to an allosteric site, leading to anxiolytic and muscle relaxant effects.

Drug usage cases:

• Generalized anxiety disorder
• Tension and muscle spasm
• Trigeminal neuralgia
• Off-label: acute musculoskeletal pain
• Off-label: benign essential tremor
• Off-label: temporomandibular joint disorder

Drug contra indications:

• Hypersensitivity to meprobamate, barbiturates, or other carbamates
• Severe respiratory depression or sleep apnea
• Acute or severe hepatic impairment
• Severe renal impairment
• Myasthenia gravis
• Porphyria

Side effects:

• Drowsiness, sedation
• Dizziness, ataxia, impaired coordination
• Headache
• Nausea, vomiting, constipation
• Skin reactions: rash, urticaria
• Cognitive impairment, confusion, depression
• Hypotension, bradycardia
• Respiratory depression (especially at high doses or with CNS depressants)
• Dependence, tolerance, withdrawal symptoms (e.g., tremors, seizures)
• Blood dyscrasias (rare)

Warnings:

• Risk of dependence, abuse, and tolerance; limit duration of therapy
• Abrupt discontinuation may precipitate withdrawal (e.g., restlessness, seizures)
• Use with caution in respiratory disease and hepatic or renal impairment
• May impair mental and/or physical abilities; avoid driving or hazardous tasks
• Additive CNS depression with alcohol, opioids, sedatives, and other depressants
• Use caution in elderly and debilitated patients due to increased sensitivity
• Monitor for signs of misuse, abuse, and diversion

Use during pregnancy or breastfeeding:

Pregnancy: Category D. Evidence of human fetal risk exists. Use only if potential benefit justifies the potential risk. Associated with congenital malformations and neonatal withdrawal.

Breastfeeding: Excreted in breast milk; may cause sedation or respiratory depression in the infant. Weigh benefits of breastfeeding against maternal need for treatment and potential adverse effects.