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Metaxalone for Muscle Pain: Dosage, Side Effects, & Interactions

Metaxalone for Muscle Pain: Dosage, Side Effects, & Interactions

Key Takeaways

  • The muscle relaxant metaxalone is prescribed to treat muscle pain and discomfort caused by various musculoskeletal conditions by blocking the nerve signals in the brain, helping the muscles relax. 

  • Common side effects of metaxalone include headache, dizziness, drowsiness, and feeling jittery. 

  • Avoid opioid pain medications, sedatives, and CNS depressants (central nervous system depressants) while taking metaxalone, as they may cause increased drowsiness and dizziness.

Metaxalone (brand name: Skelaxin) is a muscle relaxer used to relieve pain and discomfort caused by musculoskeletal conditions. Metaxalone is available as 400 mg and 800 mg oral tablets. 

Please continue reading to learn more about metaxalone, including what it’s used for, recommended dosages, along with side effects, and drug interactions.

Musculoskeletal conditions

Metaxalone, a skeletal muscle relaxant, is prescribed to treat muscle pain and discomfort caused by musculoskeletal conditions. Healthcare professionals prescribe metaxalone as part of a comprehensive treatment regimen, including rest, physical therapy, and exercises to treat painful musculoskeletal conditions. 

The musculoskeletal system comprises the body’s muscles, ligaments, tendons, bones, and other components. 

Metaxalone with physical therapy

Physical therapy is also used to manage musculoskeletal problems and to improve muscle strength and flexibility. Taking metaxalone exactly as prescribed while adhering to your physical therapist’s instructions is important for your recovery process. 

How metaxalone works 

The exact mechanism behind how metaxalone treats musculoskeletal pain has yet to be fully understood. However, it is believed metaxalone interferes with the central nervous system to suppress nerve impulses. As a result, this medication induces muscle relaxation and provides overall pain relief

Muscle spasms are involuntary, sudden contractions of muscle fibers that can be painful and disruptive.

Metaxalone relieves pain and discomfort caused by muscle spasms so you can engage in rehabilitation activities such as physical therapy and conditioning exercises recommended by healthcare providers.  

Recommended Dosage

Metaxalone is available as 400 mg and 800 mg oral tablets. 

Your health care professional will typically prescribe 800 mg of metaxalone, to be taken by mouth three to four times daily. Avoid exceeding a total daily dosage of 3200 mg. Follow the prescription label and your healthcare provider's instructions.

It is essential to adhere to the treatment plan prescribed by the healthcare provider. Maintaining a regular dosing schedule ensures the efficacy and safety of metaxalone. It also minimizes the risk of potential side effects. 

A regular schedule maintains consistent levels of the drug in the body to help manage pain more effectively.

Dose Adjustments

Healthcare providers typically use a lowered dose of metaxalone in elderly patients. In some cases, metaxalone should be avoided altogether in elderly patients. 

Dosage adjustments are required for people with mild kidney disease or liver disease. The use of metaxalone is contraindicated in people with severe kidney disease or severe liver disease. 

Caution should be exercised in these populations because their bodies are not able to eliminate metaxalone as well as healthy or younger people; this can lead to an accumulation of metaxalone in the blood, causing worsening side effects.  

Missed Dose

If you forget to take your dose of metaxalone, take the medicine as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and take the next metaxalone dose at the regular time. Do not take a double dose to make up for the missed dose. 

Side effects 

Common side effects of metaxalone include headache, drowsiness, dizziness, upset stomach, nausea, vomiting, irritability, or feeling anxious. 

Though rare, severe allergic reactions can happen. Symptoms of allergic reactions include swelling of the face, tongue, and throat, shortness of breath, and difficulty breathing.

When used in combination with other serotonergic agents, such as antidepressants,  certain pain medications, and herbal supplements, metaxalone can increase the risk of serotonin syndrome. Serotonin syndrome is characterized by tremors, fever, muscle stiffness, rapid heartbeat, confusion, and hallucinations. This is a medical emergency that can be fatal if left untreated. 

Contact your healthcare professional immediately if you develop symptoms of serotonin syndrome or allergic reaction or if you experience unusual changes in mood or behavior, such as extreme agitation, aggression, or confusion when using metaxalone.


Before taking metaxalone, let your doctor know if you have the following conditions:

  • Severe kidney disease

  • Severe liver disease

  • Anemia (low red blood cells)

When used in combination with other medications or supplements that can increase serotonin levels, metaxalone can contribute to the risk of serotonin syndrome, a potentially life-threatening complication. 

Metaxalone is metabolized by both the kidneys and liver, therefore, if you have kidney or liver impairment, metaxalone levels can accumulate causing harmful side effects. Let your doctor know immediately if you experience the following signs and symptoms:

  • Unusual tiredness, upper stomach pain, yellowing of the skin or the whites of the eyes, nausea, vomiting, loss of appetite, dark-colored urine

  • Weakness, feeling like you may pass out

  • Fever, lethargy, confusion

  • Shallow breathing

Metaxalone is not approved to be used by children younger than 12 years old.

Drug interactions and warnings 

To prevent worsening drowsiness and dizziness while taking metaxalone, avoid opioid pain medications, CNS depressants, and any sedating agents such as medication for anxiety, seizure treatments, and sleep medicines. 

Don’t drink alcohol while you take metaxalone as alcohol is a CNS depressant. You should avoid driving or operating machinery until you know how your body reacts to this medication. 

Metaxalone can impair your ability to concentrate and think clearly. This effect is generally worse if you are 65 years and older or if your kidneys and liver do not work as well. Also, keep in mind that taking metaxalone with food can also intensify this medication’s side effects. 

Tell your doctor about all your medications, including prescription and over-the-counter medications, dietary supplements, and herbal remedies, before taking metaxalone. 

Metaxalone can be taken with or without food. However, taking this medication with food will increase its absorption. Therefore, side effects like dizziness and drowsiness may worsen if you take metaxalone with food.

Metaxalone can interfere with certain medical tests, such as certain urine glucose tests, leading to false or inaccurate test results. For accurate results on certain medical tests, let your healthcare professional and lab personnel know that you are taking metaxalone beforehand.

Follow all the instructions related to the recommended dosage, follow-up, duration, and treatment plan while using metaxalone.

Tell your doctor about any concerns about the benefits and risks of using metaxalone. 

Pregnancy and breastfeeding

The effects of metaxalone on pregnancy and fetal development are not fully understood. Therefore, consult your healthcare providers for guidance and potential alternative muscle relaxants if you are pregnant or planning to become pregnant.

Metaxalone can potentially be excreted into breast milk. Consult your healthcare providers if you are breastfeeding


Metaxalone is a commonly prescribed muscle relaxant used to relieve musculoskeletal pain and discomfort. While metaxalone relieves pain caused by conditions related to bones and muscles, this medication is not classified as a pain reliever. Keep in mind that metaxalone is not effective in treating nerve pain or inflammatory pain. 

Follow the guidelines provided by your healthcare provider about proper dosage and other precautions to ensure the safe and effective use of metaxalone.

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