Alternatives to Orphenadrine XR If You Can't Fill Your Prescription

If your pharmacy doesn't have Orphenadrine XR in stock — or if you're experiencing side effects that make it a poor fit — there are several well-established alternatives your doctor can prescribe. All of the options below are FDA-approved skeletal muscle relaxants used for similar conditions. Which one is right for you depends on your health history, other medications, and how you tolerate each drug's side effects.

Important: Never switch medications without talking to your prescriber first. Some alternatives have different dosing schedules, interactions, and side effect profiles.

1. Cyclobenzaprine (Flexeril) — Most Commonly Prescribed

Cyclobenzaprine is the most heavily studied skeletal muscle relaxant in the U.S. and is often the first choice for acute muscle pain and spasm. It is available as a 5 mg or 10 mg immediate-release tablet (taken 3 times per day) or as a 15 mg or 30 mg extended-release capsule (taken once daily).

Pros: Widely available, well-studied, inexpensive, widely stocked

Cons: Significant sedation; structurally related to tricyclic antidepressants; not recommended for patients with heart conditions or in combination with MAO inhibitors; generally avoided in patients over 65

Best for: Patients who need short-term (up to 3 weeks) relief from acute back or neck spasm; those who don't mind sedation

2. Methocarbamol (Robaxin) — Least Sedating Option

Methocarbamol is a muscle relaxant with a relatively low side-effect burden compared to others in its class. It's taken 4 times per day for the first 48–72 hours, then as needed. It's available as 500 mg and 750 mg tablets and is one of the least expensive muscle relaxants on the market.

Pros: Less sedating than cyclobenzaprine or orphenadrine; no significant anticholinergic effects; low cost

Cons: Requires more frequent dosing; limited evidence from modern clinical trials; may turn urine brown, green, or black (harmless)

Best for: Patients who need to remain alert during the day; those who cannot tolerate the anticholinergic side effects of orphenadrine (dry mouth, urinary retention, blurred vision)

3. Tizanidine (Zanaflex) — Good for Spasm with Sedation Benefit

Tizanidine is a short-acting centrally acting alpha-2 adrenergic agonist. It's FDA-approved for both spasticity and musculoskeletal conditions. It comes in 2 mg, 4 mg, and 6 mg tablets or capsules taken every 6–8 hours as needed. Tizanidine has a strong evidence base compared to most muscle relaxants.

Pros: Strong evidence base; works for both musculoskeletal and neurological spasticity; sedation can be beneficial for nighttime use

Cons: Significant sedation and dry mouth; can cause hypotension (low blood pressure); must avoid with fluvoxamine and ciprofloxacin; requires liver monitoring with long-term use

Best for: Patients with significant spasm-related sleep disruption; those who also have spasticity from neurological conditions

4. Metaxalone (Skelaxin) — Least Sedating, But More Expensive

Metaxalone is generally considered to produce less sedation and CNS depression than other muscle relaxants. It's taken as 800 mg tablets 3–4 times daily. It is available as a generic, though it tends to cost more than cyclobenzaprine or methocarbamol.

Pros: Less sedating; no significant anticholinergic side effects; good tolerability profile

Cons: Higher cost; contraindicated in liver or kidney disease; limited modern clinical trial data

Best for: Working adults who cannot afford significant sedation during the day; patients who are sensitive to anticholinergic drugs

Comparing Orphenadrine XR to Its Alternatives

Here's a quick side-by-side comparison of the key features:

Orphenadrine XR 100 mg: Twice daily, strong anticholinergic, not controlled, $11–$50/month

Cyclobenzaprine 5–10 mg: Three times daily, highly sedating, not controlled, $5–$20/month

Methocarbamol 750 mg: Four times daily, mildly sedating, not controlled, $10–$25/month

Tizanidine 4 mg: Every 6–8 hours, very sedating, not controlled, $10–$30/month

Metaxalone 800 mg: Three to four times daily, least sedating, not controlled, $20–$60/month

Talk to Your Doctor Before Switching

Each muscle relaxant has a unique side-effect profile, and the best choice depends on your age, other medications, and any underlying health conditions. Your prescriber can review your situation and recommend the most appropriate alternative. In the meantime, check our guide on why Orphenadrine XR is hard to find — you may find it's more available than you think.