Thiocolchicoside for back pain: safety profile

Back pain is one of the leading causes of visits to the doctor and disability worldwide. Patients with acute, subacute, or exacerbated chronic back pain are prescribed non-steroidal anti-inflammatory drugs, and muscle relaxants as co-analgesics. Thiocolchicoside is an effective muscle relaxant widely known worldwide, whose action is realized through effects on GABA-A and glycinergic receptors and modulation of spinal neural circuits. Thiocolchicoside is not metabolized by the CYP450 cytochrome, which results in a low risk of pharmacokinetic drug interactions, and it has an optimal safety profile: it does not have a pronounced sedative effect, does not cause arterial hypotension, and does not increase the risk of genotoxicity. Depending on the clinical situation, a patient with back pain and a painful muscle spasm may be prescribed various dosages and formulations of thiocolchicoside: capsules containing 4–8 mg orally twice a day for 7 days, or intramuscular injections of thiocolchicoside containing 4 mg (2 ml) twice a day for 5 days.