Comprehensive medication guide to Metaxalone including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$20–$60 copay with commercial insurance; generic Metaxalone is typically Tier 2–3 on most formularies and may require prior authorization; some Medicare Part D plans do not cover it.
Estimated Cash Pricing
$109–$184 retail for generic Metaxalone 800 mg (30 tablets); as low as $20.10 with a GoodRx coupon or $22.95 with SingleCare for a 30-day supply.
Medfinder Findability Score
78/100
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Metaxalone (brand name Skelaxin) is a prescription centrally acting skeletal muscle relaxant first approved by the FDA in 1962. It is used as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions such as muscle strains, sprains, and back spasms.
Metaxalone is distinctive within the muscle relaxant class because it is generally considered the least sedating option available. This makes it particularly valuable for active patients who need to maintain cognitive function and alertness during the day. It is available as brand-name Skelaxin and as a generic, manufactured by companies including Teva Pharmaceuticals and Lannett.
The standard dosage is 800 mg taken three to four times daily for adults and children 13 years of age and older. A 640 mg generic-only formulation also exists but is not interchangeable with the 800 mg tablets on a milligram-for-milligram basis.
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Despite being used for over 60 years, Metaxalone's precise mechanism of action remains incompletely understood. What is clear is that it works centrally — in the brain and spinal cord — rather than by directly acting on muscle tissue. It does not depress neuronal conduction, neuromuscular transmission, or muscle excitability at the peripheral level.
Metaxalone produces CNS (central nervous system) depression, which reduces the neural signals driving muscle spasm and pain. The beneficial muscle-relaxing effect is likely related to its sedative properties. Recent research also suggests that Metaxalone may inhibit monoamine oxidase A (MAO-A), an enzyme that breaks down serotonin — which may contribute to both its therapeutic effects and its known serotonin syndrome risk when combined with serotonergic medications.
The drug is extensively metabolized by the liver via CYP enzymes (CYP1A2, 2D6, 2E1, 3A4) and excreted in urine. Its effects begin within about 1 hour, peak at approximately 3 hours, and last 4–6 hours — which is why it's taken 3–4 times per day. Bioavailability increases significantly when taken with food, which can enhance CNS effects.
800 mg — tablet
Standard dose: 800 mg orally three to four times daily for adults and patients 13 years and older. Maximum 3,200 mg/day.
640 mg — tablet
Generic-only formulation. NOT interchangeable with 800 mg tablets on a mg-for-mg basis due to different bioavailability profiles. Follow FDA switching protocol if transitioning between formulations.
As of 2026, Metaxalone is not listed on the FDA's official drug shortage database. Multiple generic manufacturers produce it, and it is stocked by most major pharmacy chains. This distinguishes it from some other muscle relaxants (like cyclobenzaprine) that have experienced intermittent supply disruptions in recent years.
However, patients still encounter access barriers — primarily due to insurance formulary restrictions, prior authorization requirements, and the higher retail cash price compared to alternatives. Individual pharmacies may also be temporarily out of stock if they don't dispense Metaxalone frequently. Localized stock-outs can occur at chain pharmacies that rely on centralized distribution.
If your pharmacy is out of stock, medfinder can help. medfinder calls pharmacies near you to check current Metaxalone inventory and texts you the results — so you can head straight to the pharmacy that can fill your prescription.
Because Metaxalone is not a DEA-controlled substance, any licensed prescriber with standard prescribing authority can write a prescription. There are no special DEA registration requirements or controlled substance restrictions. This also means prescriptions can be sent electronically and filled at any pharmacy without the additional friction associated with controlled substances.
Types of providers who commonly prescribe Metaxalone:
Since Metaxalone is not a controlled substance, it can be prescribed via telehealth visits in all 50 states — no in-person examination is federally required. Patients can use their existing primary care doctor's telehealth portal, urgent care telehealth services, or platforms like Teladoc, MDLive, or Doctor On Demand to receive a Metaxalone prescription for an acute musculoskeletal complaint.
No. Metaxalone is not a DEA-controlled substance. It is not classified under any federal schedule (Schedule I through V). This is an important distinction from carisoprodol (Soma), which is a Schedule IV controlled substance.
Because Metaxalone is not controlled, it can be prescribed via telehealth in all states without the additional restrictions that apply to controlled medications. Prescriptions can be sent electronically, refills can be called in or sent electronically, and there are no quantity limits or state prescription monitoring program (PMP) requirements associated with its non-controlled status. Any licensed prescriber with prescribing authority (MDs, DOs, NPs, PAs) can write a Metaxalone prescription without special DEA authorization for controlled substances.
Most side effects of Metaxalone are related to its CNS depressant activity. Common side effects include:
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Cyclobenzaprine (Flexeril)
Most commonly prescribed muscle relaxant; more sedating than Metaxalone; very affordable generic ($4–$9 with coupon); structurally similar to TCAs.
Methocarbamol (Robaxin)
Well-tolerated; moderately sedating; very affordable generic ($8–$30); widely available; not on Beers Criteria unlike cyclobenzaprine.
Tizanidine (Zanaflex)
Alpha-2 adrenergic agonist; short-acting; useful for spasticity; requires liver function monitoring; significant interaction with fluvoxamine and ciprofloxacin.
Baclofen
GABA-B receptor agonist; especially effective for neurological spasticity; must be tapered slowly; not ideal for short-term musculoskeletal pain.
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SSRIs (fluoxetine, sertraline, paroxetine, escitalopram)
majorRisk of serotonin syndrome when combined with Metaxalone. Monitor closely; discontinue if serotonin syndrome suspected.
SNRIs (duloxetine, venlafaxine)
majorRisk of serotonin syndrome. Screen for serotonergic co-medications before prescribing Metaxalone.
MAO Inhibitors (phenelzine, selegiline, linezolid, methylene blue)
majorRisk of serious or fatal serotonin syndrome. Avoid Metaxalone within 2 weeks of MAO inhibitor use.
Opioids (fentanyl, meperidine, methadone, tramadol)
majorAdditive CNS and respiratory depression, plus serotonin syndrome risk with certain opioids (tramadol, fentanyl, methadone). Use with extreme caution.
Alcohol
moderateAdditive CNS depression; significantly enhances sedation and impairment. Avoid alcohol entirely while taking Metaxalone.
Benzodiazepines (alprazolam, diazepam, clonazepam)
moderateAdditive CNS and respiratory depression. Monitor closely if co-administration is necessary.
Tricyclic antidepressants (amitriptyline, nortriptyline)
majorAdditive CNS depression plus serotonin syndrome risk. Screen carefully before co-prescribing.
Triptans (sumatriptan, rizatriptan)
moderateIncreased serotonin syndrome risk when combined with Metaxalone.
St. John's Wort
moderateHerbal supplement that increases serotonin; serotonin syndrome risk when combined with Metaxalone.
Other CNS depressants (sleep aids, antihistamines, sedatives)
moderateAdditive CNS depression; check OTC cold/allergy product labels for sedating antihistamines.
Metaxalone (Skelaxin) is a well-established muscle relaxant with a key clinical advantage: it causes significantly less sedation than most alternatives, making it the preferred choice for patients who need to stay alert during the day. While it is not in a formal FDA shortage, patients may still encounter access barriers due to insurance formulary restrictions and a higher cash price compared to cyclobenzaprine and methocarbamol.
The most important safety considerations with Metaxalone are the risk of serotonin syndrome when combined with serotonergic medications (SSRIs, SNRIs, TCAs, opioids, MAOIs), and additive CNS depression when combined with alcohol or other sedating drugs. Be sure to give your prescriber and pharmacist a complete medication list before starting Metaxalone.
If you're having trouble finding Metaxalone at your local pharmacy, medfinder can help. medfinder calls pharmacies near you to check which ones have your medication in stock and texts you the results — so you can get your prescription filled without wasting time and energy searching.
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Medfinder is actively checking pharmacy inventory for Metaxalone. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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