Soma dosage, forms, and strengths

Soma is a brand-name prescription skeletal muscle relaxant that helps people recover from acute musculoskeletal pain associated with sprains and strains. The active ingredient is carisoprodol, a powerful drug that works directly on the spinal cord rather than the muscles. The effects of carisoprodol work quickly but fade quickly, too. People must take three doses daily and a final dose at bedtime to manage their muscle pain effectively. Carisoprodol is a Schedule IV controlled substance because of the potential for drug abuse and dependency. For this reason, as well as possible adverse reactions, healthcare professionals prescribe Soma for only two or three weeks of treatment.

Soma forms and strengths

• Tablets: 250 mg, 350 mg

Soma dosage for adults

The U.S. Food and Drug Administration (FDA) has approved Soma in adults as a short-term treatment, alongside rest and physical therapy for muscle pain bouts. Most adults can take Soma for muscle pain, but the drug is never used in people diagnosed with the rare disorder porphyria.

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Soma dosage for acute musculoskeletal pain

Carisoprodol is a powerful muscle relaxant that helps control muscle pain caused by various conditions, including injury, sprains, spinal problems, back pain, and other issues. Instead of working directly on the muscles or the nerves that connect to them, carisoprodol acts more like a tranquilizer. It primarily affects the spinal cord, slowing down nerve impulses responsible for muscle pain. However, its precise mechanism of action isn’t fully understood. 

After the body breaks down carisoprodol, Soma is broken down further for continued pain relief. The body breaks down carisoprodol into another drug called meprobamate, an anxiolytic medication similar to a benzodiazepine. Like carisoprodol, meprobamate slows down nerve signals, providing relief from pain.

Due to the high risk of dependence, treatment duration is limited to two to three weeks. Muscle pain usually decreases during that period. If not, healthcare providers will likely switch to other treatments.

• Adult dosage for the relief of pain and stiffness due to musculoskeletal conditions: 250–350 mg taken three times per day and at bedtime for 2–3 weeks

• Maximum adult dosage: 1,400 mg per day

Soma dosage for children

The FDA does not approve Soma for use in children or teens 16 years or younger.

Soma dosage restrictions

Soma has no recommended dosage restrictions. However, healthcare providers are asked to use caution when prescribing Soma to people with renal impairment (kidney dysfunction) or hepatic impairment (liver dysfunction). 

Some people called “poor CYP2C19 metabolizers” are born with a deficient ability to break down carisoprodol, increasing the risk of side effects. Healthcare providers watch closely for adverse effects in these people rather than adjusting the dose of Soma.

Although use in older adult patients is not contraindicated, the Beers criteria consider it an inappropriate drug for use in older adults. Because of its soothing properties, carisoprodol puts older adults and seniors at higher risk for falls and injuries.

Soma dosage for pets

Veterinarians can prescribe Soma for pets. Some veterinary pharmacies sell human-strength carisoprodol. However, carisoprodol is not a drug of choice in veterinary medicine. There are no definitive studies or recommended doses. Veterinarians most commonly treat pets suffering from muscle pain with methocarbamol. Depending on the pet's condition, they are also likely to use guaifenesin, benzodiazepines, dantrolene, or baclofen.

How to take Soma

Soma is only available as tablets. People take Soma tablets several times daily, making it easy to miss a dose. If you miss a dose, wait until the next scheduled time to take Soma. Do not take an extra dose. Consider using an alarm or pill reminder to help remember doses. Most importantly, remember that the last dose is always taken right before bed.

• Your doctor will tell you how much medicine to use. Do not use more than directed.

• This medicine should not be used for longer than three weeks.

• Soma tablets can be taken with or without food.

• To avoid stomach upset, take this medicine with food or milk.

• Swallow the tablet whole with a glass of water.

• Soma tablets should be stored in a closed container at room temperature, securely out of the reach of children and pets.

Soma dosage FAQs

How long does it take Soma to work?

Carisoprodol begins to work fairly quickly after a tablet has been swallowed. The drug reaches its peak concentration in the blood in about an hour to an hour and a half after swallowing a tablet. The body then breaks it down into a second sedating drug called meprobamate. That drug hits its maximum concentration in the blood about 3.5 hours after a dose.

How long does Soma stay in your system?

Although Soma contains carisoprodol as its active ingredient, the body breaks carisoprodol down into meprobamate, a powerful sedative. 

After a tablet is taken, the body breaks down half the dose of carisoprodol in about two hours. That means it will take around 10 hours to eliminate the carisoprodol dose from the body. That’s about the same amount of time it takes the body to break down half the dose of meprobamate, so people might continue to feel dizzy when the carisoprodol is cleared. The body will take two days or so to eliminate the meprobamate.

What happens if I miss a dose of Soma?

If a dose of Soma is forgotten or missed, take it as soon as it’s remembered. However, if it’s almost time for the next dose, skip the missed dose and take the next dose as scheduled. Never double a dose to make up for a missed dose. 

Remember that the last dose is always taken right before bedtime. Ask the prescribing healthcare provider what to do if that dose is missed.

How long can you take Soma?

The FDA advises that Soma be prescribed for short-term use only, typically two to three weeks. In any case, no one should take Soma for longer than three weeks. Healthcare providers don't know if taking Soma for longer than three weeks is safe, but the risk of drug dependence increases.

How do I stop taking Soma?

When taken for a short time, most people should be able to stop taking Soma without withdrawal symptoms or other problems. If the drug has been taken for a long time, the healthcare provider may need to taper the dose, but the FDA discourages long-term use of Soma.

What is the maximum dosage for Soma?

The maximum dosage for Soma is 1,400 mg per day. That’s three 350 mg tablets taken throughout the day, with one 350 mg tablet taken at bedtime.

Can you overdose on Soma?

Do not exceed the prescribed or recommended dose of Soma. Carisoprodol is a powerful sedative that slows down the central nervous system. If too much carisoprodol is taken, the central nervous system will slow down too much, leading to a potentially life-threatening condition called central nervous system depression. This can cause coma, slowed breathing, respiratory arrest, and even death. 

You can overdose on Soma by taking too many tablets or taking it too often. Another way to overdose on Soma is to take it along with other drugs that have sedative effects, such as alcohol or opioids. Get immediate medical care if too much carisoprodol is taken or if there are signs of an overdose, including sleepiness, incoordination, low blood pressure (hypotension), euphoria, rigidity, blurred vision, hallucinations, delirium, seizures, or coma. 

What interacts with Soma?

Because of possible drug interactions, tell the healthcare provider prescribing Soma about all the prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies that you are using before you start this drug.

Healthcare providers worry about two major types of carisoprodol drug interactions. Some drugs block the body’s ability to break down carisoprodol, increasing the risk of severe side effects. Other drugs work just like carisoprodol and slow down the nervous system, increasing the risk of sedative side effects, some of which may be life-threatening emergencies.

When carisoprodol and medicines that block or speed up its metabolism are prescribed, the healthcare provider will need to adjust the doses. These drugs include:

• The stomach acid reducer omeprazole

• The antidepressants Prozac (fluoxetine) and Zoloft (sertraline)

• The OCD medication fluvoxamine

• Tricyclic antidepressants

• The anticonvulsant and migraine medication topiramate

• The tuberculosis drug rifampin

• The anticlotting medication ticlopidine

• The herbal supplement St. John's wort

Soma can be hazardous when used with other CNS depressants. Not only will this worsen many of the common side effects of carisoprodol, like sleepiness and dizziness, but the combination could cause serious side effects such as hallucinations, severe impairment, slowed breathing, coma, and even death. When prescribing Soma, doctors will want patients to avoid drugs like:

• Opioids like codeine or oxycodone

• Sedatives (benzodiazepines)

• Barbiturates

• Other muscle relaxants

• Alcohol

What happens when you mix Soma and alcohol?

It is not safe to mix Soma with alcohol. The combination will increase drowsiness and impairment and could cause serious adverse effects.

Is it safe to take Soma during pregnancy?

Healthcare providers prescribe Soma to pregnant women only when it is necessary. Animal studies suggest there is a potential risk that carisoprodol will affect fetal development. A healthcare provider can provide medical advice about alternative therapies to pregnant women who are concerned.

Is it safe to take Soma while breastfeeding?

Healthcare providers prescribe soma to breastfeeding mothers when necessary. Carisoprodol is present in breast milk in small amounts. There is some evidence that it can cause minor sedation in a nursing infant, particularly newborns that have not been exposed to the drug in the uterus.

Sources

• Carisoprodol, Drugs and Lactation Database

• Carisoprodol, StatPearls

• Soma carisoprodol tablet, DailyMed (NIH National Library of Medicine)

• Soma drug summary, Prescriber’s Digital Reference (PDR)