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 (except 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.

History

Meprobamate and other muscle relaxing drugs often were subjects of misuse and abuse in the 1950s and 1960s. Overdose cases were reported as early as 1957 and have been reported on several occasions since then.

On June 1, 1959 several American pharmacologists convened at Wayne State University in Detroit, Michigan to discuss a new drug. The drug, originally thought to have antiseptic properties, was found to have central muscle relaxing properties. It had been developed by Dr. Frank M. Berger at Wallace laboratories and had been named carisoprodol (trade name Soma).

Carisoprodol was developed on the basis of meprobamate, in the hope that it would have better muscle relaxing properties, less potential for abuse, and less risk of overdose than meprobamate. The substitution of one hydrogen atom with an isopropyl group on one of the carbamyl nitrogens was intended to yield a molecule with new pharmacological properties.

Chemistry

It is a carbamic acid ester. Carisoprodol is a racemic mixture of two stereoisomers.

Effects
Analgesia
Relief from hypertonia

Side effects

These are somewhat rare when used at normal doses.
Somnolence
Ataxia

Pharmacokinetics

Carisoprodol has a rapid, 30 minute onset of action, with the aforementioned effects lasting for approximately 2–6 hours. It is metabolized in the liver via the cytochrome P450 oxidase isozyme CYP2C19, excreted by the kidneys and has an approximate 8 hour half-life. A considerable proportion of carisoprodol is metabolized to meprobamate, which is a known drug of abuse and dependence; this could account for the abuse potential of carisoprodol.

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