In low back pain, thiocolchicoside is efficacious in reducing pain intensity, improving physical flexibility as seen in decreasing the distance from the hands to the floor when leaning forward without bending the knees (finger-floor distance), and reducing the total consumption ofparacetamol.[12] Thiocolchicoside administration also leads to a reduction in muscle spasm during palpation, an improvement in the overall assessment of patients with low back pain, and an enhancement in their ability to perform daily activities.[12][13]
When thiocolchicoside is added to standardnonsteroidal anti-inflammatory drug (NSAID) therapy in lower back pain, such therapy reduces pain intensity and improves functional status according to the average estimates ofvisual analogue scale (VAS) and life disorders questionnaires. The use of thiocolchicoside in combination with NSAIDs results in a more pronounced decrease in pain when assessed by VAS, as well as an increase in functional activity based on an estimate of the distance from the fingertips to the floor by the 7th day of therapy (but not by the 3rd) compared with the use of NSAIDs alone.[12][13]
Several medicines, includingtolperisone,aceclofenac plustizanidine, andpregabalin, are effective in reducing pain intensity. Another comparative study found thateperisone withdiclofenac was more effective in terms of finger-floor distance and improvement inLasegue's sign (straight leg raise angle lying on back), VAS score, and global assessment scale than thiocolchicoside with diclofenac.[12][13][14]
Side effects of thiocolchicoside can include nausea, allergy andvasovagal reactions.[15]Liver injury,pancreatitis, seizures, blood cell disorders,severe cutaneous disorders,rhabdomyolysis, and reproductive disorders have all been recorded in the French and Europeanpharmacovigilance databases and in the periodic updates that the companies concerned submit to regulatory agencies. These data do not specify the frequency of the disorders nor do they identify the most susceptible patient populations. Thiocolchicoside isteratogenic in experimental animals and also damages chromosomes. Human data are limited to a follow-up of about 30 pregnant women (no major malformations) and reports of altered spermatogenesis, including cases ofazoospermia. In practice, there is no justification for exposing patients to the adverse effects of thiocolchicoside. It is better to use an effective, well-known analgesic for patients complaining of muscle pain, starting withparacetamol.[16]
Although muscle relaxants may have the major side effect of sedation, thiocolchicoside is free from sedation effects, likely due to its lack of potentiation ofGABAA receptors.[7]
Thiocolchicoside is broken down in the body to ametabolite called3-demethylthiocolchicine (also known as SL59.0955 or M2) that could damage dividing cells therefore inducing toxicity in the embryo, neoplastic changes and fertility reduction in males.[17] Therefore, recommended oral dose should not exceed 7 days and intramuscular dose duration should not exceed 5 days.[18] Local skin preparations are less toxic.[medical citation needed]
^abPerucca E, Poitou P, Pifferi G (1995). "Comparative pharmacokinetics and bioavailability of two oral formulations of thiocolchicoside, a GABA-mimetic muscle relaxant drug, in normal volunteers".European Journal of Drug Metabolism and Pharmacokinetics.20 (4):301–5.doi:10.1007/bf03190249.PMID8983937.S2CID13325496.
^Sandouk P, Bouvier d'Yvoire M, Chretien P, Tillement JP, Scherrmann JM (January 1994). "Single-dose bioavailability of oral and intramuscular thiocolchicoside in healthy volunteers".Biopharmaceutics & Drug Disposition.15 (1):87–92.doi:10.1002/bdd.2510150108.PMID8161719.S2CID6712875.
^Tüzün F, Unalan H, Oner N, Ozgüzel H, Kirazli Y, Içağasioğlu A, Kuran B, Tüzün S, Başar G (September 2003). "Multicenter, randomized, double-blinded, placebo-controlled trial of thiocolchicoside in acute low back pain".Joint, Bone, Spine.70 (5):356–61.doi:10.1016/S1297-319X(03)00075-7.PMID14563464.
^Soonawalla DF, Joshi N (May 2008). "Efficacy of thiocolchicoside in Indian patients suffering from low back pain associated with muscle spasm".Journal of the Indian Medical Association.106 (5):331–5.PMID18839644.
^abCarta M, Murru L, Botta P, Talani G, Sechi G, De Riu P, Sanna E, Biggio G (September 2006). "The muscle relaxant thiocolchicoside is an agonist of GABAA receptor function in the central nervous system".Neuropharmacology.51 (4):805–15.doi:10.1016/j.neuropharm.2006.05.023.PMID16806306.S2CID11390033.
^Mascia MP, Bachis E, Obili N, Maciocco E, Cocco GA, Sechi GP, Biggio G (March 2007). "Thiocolchicoside inhibits the activity of various subtypes of recombinant GABA(A) receptors expressed in Xenopus laevis oocytes".European Journal of Pharmacology.558 (1–3):37–42.doi:10.1016/j.ejphar.2006.11.076.PMID17234181.
^abcPetousis S, Margioula-Siarkou C, Kalogiannidis I (April 2016). "Effectiveness of Tocolytic Agents on Prevention of Preterm Delivery, Neonatal Morbidity, and Mortality: Is There a Consensus? A Review of the Literature".Obstet Gynecol Surv.71 (4):243–52.doi:10.1097/OGX.0000000000000302.PMID27065070.
N
Y (what is this?) (verify)
