Movax

Movax is a short-acting drug for the management of spasticity. Movax is an agonist at a2-adrenergic receptor sites and presumably reduces spasticity by increasing presynaptic inhibition of motor neurons. In animal models, Movax has no direct effect on skeletal muscle fibers or the neuromuscular junction, and no major effect on monosynaptic spinal reflexes. The effects of Movax are greatest on polysynaptic pathways. The overall effect of these actions is thought to reduce facilitation of spinal motor neurons.

Movax is a central alpha-2-adrenergic agonist indicated for the management of spasticity. Because of the short duration of therapeutic effect, treatment with Movax should be reserved for those daily activities and times when relief of spasticity is most important.

Movax (Movax) is a short-acting muscle relaxer. It works by blocking nerve impulses (pain sensations) that are sent to your brain.

Movax is used to treat spasticity by temporarily relaxing muscle tone.

Movax may also be used for purposes other than those listed in this medication guide.

Generic name: Movax HYDROCHLORIDE 4mg

Dosage form: tablet

See also:

• Movax capsule

Medically reviewed on March 9, 2018.

Dosing Information

Movax Capsules ® or Movax ® tablets may be prescribed with or without food. Once the formulation has been selected and the decision to take with or without food has been made, this regimen should not be altered.

Food has complex effects on Movax pharmacokinetics, which differ with the different formulations. Movax Capsules and Movax tablets are bioequivalent to each other under fasting conditions (more than 3 hours after a meal), but not under fed conditions (within 30 minutes of a meal). These pharmacokinetic differences may result in clinically significant differences when switching administration of tablet and capsules and when switching administration between the fed or fasted state. These changes may result in increased adverse events, or delayed or more rapid onset of activity, depending upon the nature of the switch. For this reason, the prescriber should be thoroughly familiar with the changes in kinetics associated with these different conditions [ see Clinical Pharmacology (12.3)].

The recommended starting dose is 2 mg. Because the effect of Movax peaks at approximately 1 to 2 hours post-dose and dissipates between 3 to 6 hours post-dose, treatment can be repeated at 6 to 8 hour intervals, as needed, to a maximum of three doses in 24 hours.

Dosage can be gradually increased by 2 mg to 4 mg at each dose, with 1 to 4 days between dosage increases, until a satisfactory reduction of muscle tone is achieved. The total daily dose should not exceed 36 mg. Single doses greater than 16 mg have not been studied.

Dosing in Patients with Renal Impairment

Movax should be used with caution in patients with renal insufficiency (creatinine clearance < 25 mL/min), as clearance is reduced by more than 50%. In these patients, during titration, the individual doses should be reduced. If higher doses are required, individual doses rather than dosing frequency should be increased [ see Warnings and Precautions (5.7)].

Dosing in Patients with Hepatic Impairment

Movax should be used with caution in patients with any hepatic impairment. In these patients, during titration, the individual doses should be reduced. If higher doses are required, individual doses rather than dosing frequency should be increased. Monitoring of aminotransferase levels is recommended for baseline and 1 month after maximum dose is achieved, or if hepatic injury is suspected. [ see Use in Specific Populations (8.7)]

Drug Discontinuation

If therapy needs to be discontinued, particularly in patients who have been receiving high doses (20 mg to 36 mg daily) for long periods (9 weeks or more) or who may be on concomitant treatment with narcotics, the dose should be decreased slowly (2 mg to 4 mg per day) to minimize the risk of withdrawal and rebound hypertension, tachycardia, and hypertonia [ see Drug Abuse and Dependence (9.3)].

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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More about Movax (Movax)

• Movax Side Effects
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• Dosage Information
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• Drug class: skeletal muscle relaxants

Consumer resources

• Movax
• Movax (Advanced Reading)

Professional resources

• Movax (AHFS Monograph)
• Movax (FDA)
• Movax Tablets (FDA)

Related treatment guides

• Muscle Spasm
• Cluster Headaches

See also:
What is the most important information I should know about Movax?

Movax is a short-acting medication that should be taken only for daily activities that require relief from muscle spasticity.

Do not take Movax if you are also taking the antidepressant fluvoxamine (Luvox), or the antibiotic ciprofloxacin (Cipro).

Do not use Movax at a time when muscle tone is needed to assure safe balance and movement for certain activities. In some situations, it may endanger your physical safety to be in a state of reduced muscle tone.

Switching between Movax tablets and capsules, or changing the way you take it with regard to eating, can cause an increase in side effects or a decrease in therapeutic effect. Follow your doctor's instructions carefully. After making any changes in how you take Movax, contact your doctor if you notice any change in how well the medicine works or if it causes increased side effects.

Do not take more than three doses (36 mg) of Movax in a 24-hour period. Too much of this medication can damage your liver.

Cold or allergy medicine, narcotic pain medicine, sleeping pills, other muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Movax. Tell your doctor if you need to use any of these other medicines together with Movax.

Avoid drinking alcohol. It can increase some of the side effects of Movax.

Use Movax as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Movax by mouth.
• Food can change the way your body absorbs and uses Movax. Be sure to discuss this with your doctor to determine the best way to take your dose, especially when changes to your dose are being considered, or if you are being prescribed a different dose form of Movax (eg, tablets or capsules).
• Do not suddenly stop taking Movax. If you need to stop Movax, your doctor will gradually lower your dose to prevent symptoms of withdrawal, including high blood pressure, fast heartbeat, tremor, anxiety, and muscle tension.
• If you miss a dose of Movax, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Movax.

This medication is used to treat muscle spasms caused by certain conditions (such as multiple sclerosis, spinal cord injury). It works by helping to relax the muscles.

How to use Movax

Take this medication by mouth as directed by your doctor, usually every 6 to 8 hours.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Do not take more than 36 milligrams a day or more than 3 doses in a 24-hour period.

Your body will absorb this medication differently depending on whether you take it as a tablet or capsule, whether you take it with food or on an empty stomach, or if you sprinkle the contents of the capsule on food. Be sure to discuss with your doctor how to take this medication to determine the best way to take your dose, especially when changes to your dose are being considered or if your doctor prescribes a different form of Movax (such as tablet or capsule).

This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as anxiety, tremor, increased blood pressure/heart rate/muscle tenseness) may occur if you suddenly stop using this medication. Do not stop taking this medication without consulting your doctor. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions right away.

Tell your doctor if your condition does not improve or if it worsens.

See also:
What other drugs will affect Movax?

Fluvoxamine

Concomitant use of fluvoxamine and Movax is contraindicated. Changes in pharmacokinetics of Movax when administered with fluvoxamine resulted in significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment.

Ciprofloxacin

Concomitant use of ciprofoxacin and Movax is contraindicated. Changes in pharmacokinetics of Movax when administered with ciprofloxacin resulted in significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment

CYP1A2 Inhibitors other than Fluvoxamine and Ciprofloxacin

Because of potential drug interactions, concomitant use of Movax with other CYP1A2 inhibitors, such as zileuton, fluoroquinolones other than strong CYP1A2 inhibitors (which are contraindicated), antiarrythmics (amiodarone, mexiletine, propafenone, and verapamil), cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine) should be avoided. If their use is clinically necessary, therapy should be initiated with 2 mg dose and increased in 2–4 mg steps daily based on patient response to therapy. If adverse reactions such as hypotension, bradycardia, or excessive drowsiness occur, reduce or discontinue Movax therapy.

Oral Contraceptives

Concomitant use of Movax with oral contraceptives is not recommended. However, if concomitant use is clinically necessary, initiate Movax with a single 2 mg dose and increase in 2–4 mg steps daily based on patient response to therapy. If adverse reactions such as hypotension, bradycardia, or excessive drowsiness occur, reduce or discontinue Movax therapy.

Alcohol

Alcohol increases the overall amount of drug in the bloodstream after a dose of Movax. This was associated with an increase in adverse reactions of Movax. The CNS depressant effects of Movax and alcohol are additive.

Other CNS Depressants

The sedative effects of Movax with CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants) may be additive. Monitor patients who take Movax with another CNS depressant for symptoms of excess sedation.

α2-adrenergic agonists

Because hypotensive effects may be cumulative, it is not recommended that Movax be used with other α2-adrenergic agonists.

Drug Abuse And Dependence

Abuse

Abuse potential was not evaluated in human studies. Rats were able to distinguish Movax from saline in a standard discrimination paradigm, after training, but failed to generalize the effects of morphine, cocaine, diazepam, or phenobarbital to Movax.

Dependence

Movax is closely related to clonidine, which is often abused in combination with narcotics and is known to cause symptoms of rebound upon abrupt withdrawal. Three cases of rebound symptoms on sudden withdrawal of Movax have been reported. The case reports suggest that these patients were also misusing narcotics. Withdrawal symptoms included hypertension, tachycardia, hypertonia, tremor, and anxiety. Withdrawal symptoms are more likely to occur in cases where high doses are used, especially for prolonged periods, or with concomitant use of narcotics. If therapy needs to be discontinued, the dose should be decreased slowly to minimize the risk of withdrawal symptoms.

Monkeys were shown to self-administer Movax in a dose-dependent manner, and abrupt cessation of Movax produced transient signs of withdrawal at doses > 35 times the maximum recommended human dose on a mg/m² basis. These transient withdrawal signs (increased locomotion, body twitching, and aversive behavior toward the observer) were not reversed by naloxone administration.

See also:
What are the possible side effects of Movax?

Applies to Movax: oral capsule, oral tablet

As well as its needed effects, Movax (the active ingredient contained in Movax) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking Movax, check with your doctor immediately:

More common:

• Chest pain or discomfort
• fever or chills
• nausea or vomiting
• nervousness
• pain or burning while urinating
• unusual tiredness

• Blurred vision
• flu-like symptoms
• irregular heartbeat
• itching skin
• kidney stones
• right upper stomach tenderness
• seeing things that are not there
• shortness of breath
• weight gain

• Continuing vomiting
• general feeling of tiredness or weakness
• headache
• light-colored stools

If any of the following symptoms of overdose occur while taking Movax, get emergency help immediately:

Symptoms of overdose:

• Blurred vision
• change in consciousness
• chest pain or discomfort
• confusion
• decreased awareness or responsiveness
• difficult or troubled breathing
• dizziness, faintness or lightheadedness when getting up from a lying position
• irregular, fast or slow, or shallow breathing
• lightheadedness, dizziness, or fainting
• loss of consciousness
• pale or blue lips, fingernails, or skin
• severe sleepiness
• sleepiness or unusual drowsiness
• slow or irregular heartbeat
• sweating
• unusual tiredness or weakness

Minor Side Effects

Some Movax side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:

• Dizziness or lightheadedness, especially when getting up from a lying or sitting position
• drowsiness
• dry mouth
• fatigue
• sleepiness
• weakness

• Constipation
• nervousness
• sore throat