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Expert Answer: Muscle Relaxants & Migraine

Question: Any advice on the best time of day to take Flexeril for migraine? I am on 10 mg to avoid grinding/clenching, especially at night, and I have such a bad hangover effect in the morning it’s a herculean effort to actually get up. Any advice on the best time to take Flexeril so it’s still effective but I can still function normally before, say, noon??

Great question! Flexeril (cyclobenzaprine) has a fairly long half-life of 18 hours.

That means that half of it is gone from your system in 18 hours. With the way half-lives work, that means it takes 90 hours a single dose to be totally clear of your system, though the greatest impact will be during those first 18 hours. Thus, it’s not exactly a “hangover effect” in the morning, it’s still the effects of the Flexeril because you’re still within that first half-life.


One reason Flexeril isn’t used more for Migraine is that it does tend to make many people drowsy. Taking it earlier would be one option, but that might result in your being groggy more of the day — a trade-off of drowsiness between the time you take it and the time you go to bed instead of the next morning. You might talk with your doctor and see if a 5 mg dose would help you as much as the 10 mg you’re currently taking.

Another option would be a similar medication with a shorter half-life. I know quite a few patients (myself included) who use Zanaflex (tizanidine) at night for various issues from sleep disorders, to insomnia, to night-time bruxism (grinding) and jaw clenching. It has a much shorter half-life of just 2.5 hours, and most people wake with no grogginess or drowsiness. It comes in 2 mg and 4 mg tablets, which are scored and can be split, and 2 mg, 4 mg, and 6 mg capsules. This makes customizing the dosage to patient needs fairly easy.

I’ve been using Zanaflex for a sleep disorder, periodic limb movement disorder, for several years now, and it’s been a great help. On those rare occasions when I wake before morning and have trouble sleeping again, as long as I can sleep three more hours, my doctor has told me that I can take another dose. When I’ve done this, I’ve slept well again through the rest of the night.

Of course, Zanaflex is just one other option, but it’s one I wanted to share with you. I hope this helps!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Christine Novatkoski Transue
    6 years ago

    I’ve been using Zanaflex nightly as a preventative for about 4 months now. Previously, I had an increase in the frequency of migraine or some type of headache (more days a month than not) and have been getting migraines for 30 years. I have seen about an 85% improvement! I can function again! It does make me drowsy within an hour after taking it but I am not groggy in the morning.

  • lisakovach
    7 years ago

    I have been on Zanaflex for a few years for my back and find it also helps when I have a bad migraine nd have trouble sleeping and all the above the Terry listed such as clenching and grogginess the next morning. Lisa

  • kaysus1973
    7 years ago

    My pain specialist used to have me on Robaxin (muscle relaxer). My headache specialist axed that really quick – she said that it can cause rebound. So I take Zanaflex. It doesn’t work as well, but I need to do the right thing because I don’t want to get in a cycle that I will have to get infusions to break!

  • Karen Klein Crow
    7 years ago

    Is there any muscle relaxer that has a half life of, oh, say closer to 8 hours? I find that with the tizanidine, I am waking around the 2.5-3 hour mark, and then again every 2 – 3 hours after that…..I need better sleep!

  • Karen Klein Crow
    7 years ago

    Aileen S. Miyahira As I said…I CANNOT TAKE NSAIDs (Ibuprofen) or anything with Codeine, so those options are out. Besides, Ibuprofen is NOT a muscle relaxer.

  • Aileen S. Miyahira
    7 years ago

    Ibuprofen (Inflamation a must) there are several others, Flexeril (muscle relaxer) & Tylenol w/COD #4. It is important you understand when the nervers are irritated, you need an Anti-Inflamatory (Inflamation,) then Flexeril or others like Soma (stronger) to relax the muscles & last Tylenol w/COD #4 , (pain) as needed, depending on how well you know your body, always better to start @ low dosage & adjust 1 medication at a time so you’ll know what works, drug interaction, etc.

  • Karen Klein Crow
    7 years ago

    I can’t take NSAIDs or codeine, and I have had issues with insomnia since before starting Cymbalta, Lyrica, or Savella. I recently got off of Lyrica, and have been on Savella only since Dec. I have been on tizanidine since 2009, and I am finding that it is not helping me anymore. I have been able to get myself down to waking only 2 times a night now, but waking up in my sleep is a migraine trigger for me…I do take melatonin at bedtime, as well as making sure that my room is comfortably cool, dark, and sleep with a mouth guard in because I grind my teeth in my sleep.

  • Aileen S. Miyahira
    7 years ago

    I recently got off of Savella & because 1 of “FM’s problem is Insomnia” & one of “Savella’s possible side effects is Insomnia”. At the start of Savella, it worked well, except 2 of it’s side affects is Insomnia, “the minimum Insomnia time lasted 40+ hrs,” I’m back to taking meds. prior to the FM meds. Lyrica, Cymbalta & Savella. When I was diagnosed in 1998 I took Ibuprofen 800mg. 2 x daily (inflamation) still taking it, never stopped, wish I could take more but Lab report showed in danger of damaging liver & kidneys, so I’ve stayed at 1 tab 2 x daily. Flexeril 10 mg. (muscle relaxer) before or after dinner I take 6 tabs, this is dbl the recomended dose, my Dr knows, must follow with lab work, & Tylenol w/COD #4 (pain) I use to take 4 at bedtime before the FM meds came out, now I take only as needed.

  • Janice Worden Lamb Clemens
    7 years ago

    zanaflex is a great drug, and I can take it and still work. Can’t say it helps a lot but does take the edge off the pain.

  • Kathy Jo Horton Bishop
    7 years ago

    My youngest daughter was prescribed zanaflex it has worked wonders with her migraines and she is able to get up every morning for school no problem…..thinking about speaking with my doctor about this as an option for me I’m currently using robaxin 750 and don’t feel they are all that effective….

  • Sandy Laskey
    7 years ago

    I take 4mg zanaflex and it helps tremendously.

  • Laura Cramer
    7 years ago

    I used to take zanaflex an it was very sedating, but maybe if my doctor had suggested a lower dose it would’ve worked better

  • Berteena Wilson
    8 years ago

    It’s to the point I would take anything (HELP!) to relieve migraine pain. I would let them take a piece of my brain out with an ice-cream scoop if they could cure me and help anyone else who’s suffering like this.

  • Tara Lane
    8 years ago

    Is this a good replacement for Midrin?

  • Maggie McNeely
    7 years ago

    Actually Midrin is available again but it is not recommended for people who are looking to relax the muscles, as it has the opposite effect. So if clenching/grinding/stiff swollen muscles are the problem then Midrin is not a good way to go.

  • Teri Robert
    8 years ago

    Tara, not sure what you’re asking about – muscle relaxants or the valerian the the poster before you mentioned. In either case, the answer is no. Midrin was a Migraine abortive medication. The abortive meds left on the market are the triptans (Imitrex, Maxalt, Zomig, etc.) and ergotamines (DHE-45, Migranal Nasal Spray, etc.)

  • taralane
    8 years ago

    Is this a good replacement for Midrin?

  • Suz
    8 years ago

    I was prescribed Orphenadrine ER 100mg(muscle relaxer)by my neurologist to take as needed for my migraines. I found that taking it on a regular basis, one when I wake up and one when I go to bed, workes much better for the “tension” beginning migraines. I’ve been on it approximately 9 months and have had no side effects. Maybe this medication will help someone else.

  • cybrsistr
    8 years ago

    Flexeril has a long half-life. It takes the average person about 18 hours to get HALF the drug out of the system (the half-life). Multiply 18 hrs by 4, and that’s how long it takes to totally excrete the drug. That’s why you feel hung over. Baclofen is the drug I switched to because I was also feeling groggy until about 5 pm. Bacolofen’s half-life is about 4 hours.Viola! No drug hangover for me.

  • Molly Sweeny
    8 years ago

    has anyone tried Valerian Root?

  • Karen Spann Lee
    7 years ago

    Yes, and it didn’t do anything.

  • Teena Riley-Braun
    7 years ago

    I have but many years ago

  • 'Whanau Whittaker
    8 years ago

    My cousin, a pharmacist, suggests: take half a tablet of muscle relaxant only when you need to – not every day. If it works (does what it’s meant to), then just take the half – about 7-8pm after dinner.

  • 'Whanau Whittaker
    8 years ago

    Molly Sweeny – On the nights I use it (about once a month?) I may even take only 1/3 a tablet. The next day is a ‘quiet’ day but I’m not drowsy or groggy. (My chn are 11+13)

  • Molly Sweeny
    8 years ago

    ‘Whanau Whittaker i liked amitriptyline but i couldn’t get out of bed in the morning – and couldn’t get to the kids if they needed me at night. i hope it’s working for you.

  • 'Whanau Whittaker
    8 years ago

    I use amitriptyline (sorry about spelling).

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