NHS Dudley Health Economy Medicines Formulary
Home > 10 Musculoskeletal and joint diseases > 10.2 Drugs used in neuromuscular disorders > 10.2.2 Skeletal muscle relaxants

10.2.2 Skeletal muscle relaxants

General Guidance

  • These drugs should not be used for the management of spasm associated with minor injuries.
  • The underlying case of spasticity should be sought and treated before resorting to antispasmodic drug therapy. Aggravating factors (e.g. pressure sores, infections) should also be sought and eliminated if possible.
  • These drugs are generally effective, however, this effect can lead to greater disability due to reduction in leg or arm muscle tome with a subsequent reduction in limb flexor ability.
  • Tizanidine should generally be reserved for use when other agents are either unsuitable or not sufficiently efficacious.

Preparation of choice:

Quinine sulphate

Recommended drugs





ACE non-approved drugs

Cannabis Extract (Sativex)


Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary


Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low



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