Carisoprodol intoxication: a comprehensive review

Abstract

Carisoprodol has been widely used as a muscle relaxant agent. In Indonesia, carisoprodol is well-known as carnophene/zenith. Many retailers sell this drug illegally, especially to sex workers to make them feel more relaxed. Due to high incidence of carisoprodol abuse, Drug Enforcement Administration (DEA) categorized it into Schedule IV. Knowledge about pharmacokinetic and pharmacodynamic of carisoprodol are essential to be understood for proper diagnosis and management. Until now, there are only a few case reports about carisoprodol intoxication and no guideline has been published. This article aims to provide an overview about carisoprodol intoxication, starting from the mechanism of action to its management. In the body, carisoprodol is metabolized to meprobamate by CYP2C19 liver enzyme. Diagnosis of carisoprodol intoxication is challenging because carisoprodol and meprobamate have opposite effect. Gastric lavage, administration of flumazenil and bemegride may be effective for acute intoxication case.