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For individuals considering the use of metaxalone, it is crucial to be aware of important safety information and potential risks associated with this medication. Below are key warnings and contraindications to consider:

• Serotonin Syndrome Risk: There is a possibility of developing serotonin syndrome, a serious condition caused by excess serotonin in the brain, when taking metaxalone, especially in combination with other medications affecting serotonin levels. It is important to consult with your healthcare provider if you are taking other serotonergic drugs.

• Impact on Driving and Concentration: Metaxalone may cause drowsiness and impair concentration, particularly in individuals over 65 or when taken with a full meal. These effects can be exacerbated by alcohol, illicit substances, or other medications that induce drowsiness. Exercise caution when engaging in activities requiring alertness, such as driving.

• Use in Individuals with Liver or Kidney Issues: Those with liver or kidney problems should exercise caution when taking metaxalone, as the medication is metabolized by these organs. Impaired liver or kidney function can lead to an accumulation of the drug, increasing the risk of adverse effects, including serotonin syndrome. Discuss with your healthcare provider if you have a history of liver or kidney issues.

Contraindications specify conditions under which metaxalone should not be used, as it may pose significant health risks:

• Severe kidney problems
• Severe liver problems
• History of anemia

Always consult your healthcare provider if any of these conditions apply to you before starting metaxalone. Your safety is of utmost importance, so please review these warnings and contraindications carefully.

Common side effects:

• Dizziness
• Drowsiness
• Headaches
• Nervousness
• Irritability
• Nausea
• Vomiting
• Upset stomach

Less common but important to monitor:

• Confusion
• Persistent sore throat
• Fever
• Yellowing of the skin or eyes
• Unusual tiredness
• Dark urine

Serious side effects:

• Serotonin syndrome
• Hypertensive crisis
• Severe allergic reaction

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine)
• drugs that increase serotonin (e.g., MDMA, St. John's wort, SSRIs such as Fluoxetine/paroxetine, SNRIs such as Duloxetine/Venlafaxine)
• substances that may cause hypertensive crisis (e.g., ephedra/ma huang, phenylephrine, pseudoephedrine, amphetamines, ephedrine, Epinephrine, phenylalanine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• opioid pain relievers (such as Fentanyl, Meperidine, methadone, tapentadol)
• drugs for Parkinson's disease (such as Entacapone, Levodopa, Tolcapone)
• tricyclic antidepressants (such as Amitriptyline, Doxepin)
• triptans for migraine (such as Rizatriptan, Sumatriptan, Zolmitriptan)

Interactions with low risk that usually do not require a change in therapy:

• alcohol
• marijuana (cannabis)
• drugs for sleep or anxiety (such as Alprazolam, Lorazepam, Zolpidem)
• other muscle relaxants (such as Carisoprodol, Cyclobenzaprine)
• antihistamines (such as Cetirizine, diphenhydramine)