Cyclobenzaprine

Generic name: cyclobenzaprine hydrochloride tablets, USP · Brand names: No brand tablet found in the DailyMed list. Amrix (extended-release capsule, Cephalon) and Tonmya (orally disintegrating tablet, Tonix) are different products.

Quick facts

Drug class
Cyclobenzaprine is a skeletal muscle relaxant that the label says is closely related to tricyclic antidepressants. The label does not name a formal pharmacologic class.
Section
WARNINGS
Source text (exact source wording)
Cyclobenzaprine is closely related to the tricyclic antidepressants, e.g., amitriptyline and imipramine.
Rx or otc
Prescription (label states 'Rx only')
Forms and strengths
  • 5 mg: round, white, film-coated tablets debossed W51 on one side and TV on the other side
  • 7.5 mg: round, white, film-coated tablets debossed W52 on one side and TV on the other side
  • 10 mg: round, white, film-coated tablets debossed W53 on one side and TV on the other side
Generic available
Value
Yes. Marketing category ANDA (ANDA071611) per the label's Marketing Information.
Source
https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=1d9e34cc-eee9-4147-abf8-c810a80e39d2&type=display
Common use one line
Short-term relief of muscle spasm from acute, painful muscle and bone conditions, along with rest and physical therapy.

What it is used for

Cyclobenzaprine is used with rest and physical therapy to relieve muscle spasm from sudden, painful muscle and bone problems. It should be used only for short periods, up to two or three weeks. It has not been found effective for spasticity from brain or spinal cord disease or in children with cerebral palsy.
Section
INDICATIONS AND USAGE
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl is indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions. Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living. Cyclobenzaprine HCl should be used only for short periods (up to two or three weeks) because adequate evidence of effectiveness for more prolonged use is not available and because muscle spasm associated with acute, painful musculoskeletal conditions is generally of short duration and specific therapy for longer periods is seldom warranted. Cyclobenzaprine HCl has not been found effective in the treatment of spasticity associated with cerebral or spinal cord disease, or in children with cerebral palsy.

How it works

Cyclobenzaprine relieves muscle spasm of local origin. In animal studies it acted mainly in the central nervous system at the brain stem, not directly on the muscle or at the nerve-muscle junction. The net effect is less tonic motor activity.
Section
CLINICAL PHARMACOLOGY
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl relieves skeletal muscle spasm of local origin without interfering with muscle function. It is ineffective in muscle spasm due to central nervous system disease. Animal studies indicate that cyclobenzaprine does not act at the neuromuscular junction or directly on skeletal muscle. Such studies show that cyclobenzaprine acts primarily within the central nervous system at brain stem as opposed to spinal cord levels, although its action on the latter may contribute to its overall skeletal muscle relaxant activity. Evidence suggests that the net effect of cyclobenzaprine is a reduction of tonic somatic motor activity, influencing both gamma (γ) and alpha (α) motor systems.

Dosage: adults

Most people take 5 mg three times a day. Depending on response, the dose may be raised to 7.5 mg or 10 mg three times a day. Use beyond two or three weeks is not recommended.
Section
DOSAGE AND ADMINISTRATION
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
For most patients, the recommended dose of cyclobenzaprine HCl is 5 mg three times a day. Based on individual patient response, the dose may be increased to either 7.5 mg or 10 mg three times a day. Use of cyclobenzaprine HCl for periods longer than two or three weeks is not recommended.

Dosage: children

Safety and effectiveness have not been established in children under 15 years.
Section
PRECAUTIONS, Pediatric Use
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Safety and effectiveness of cyclobenzaprine HCl in pediatric patients below 15 years of age have not been established.

Dosage adjustments

Drug interaction caps
Section
n/a
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Kidney
Section
n/a
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Liver
With mild liver impairment, use caution, start at 5 mg and increase slowly. Use in moderate to severe liver impairment is not recommended.
Section
PRECAUTIONS, Impaired Hepatic Function
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl should be used with caution in subjects with mild hepatic impairment starting with a 5 mg dose and titrating slowly upward. Due to the lack of data in subjects with more severe hepatic insufficiency, the use of cyclobenzaprine HCl in subjects with moderate to severe impairment is not recommended.
Elderly
Older adults should use it only if clearly needed, starting at 5 mg and increasing slowly. Less frequent dosing should be considered.
Section
PRECAUTIONS, Use in the Elderly; DOSAGE AND ADMINISTRATION
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
For these reasons, in the elderly, cyclobenzaprine should be used only if clearly needed. In such patients cyclobenzaprine HCl should be initiated with a 5 mg dose and titrated slowly upward. Less frequent dosing should be considered for hepatically impaired or elderly patients

Missed dose

Section
n/a
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)

Overdose

Overdose can be deadly, though this is rare. Signs can start quickly and hospital monitoring is needed. The most common effects are drowsiness and fast heartbeat. Call poison control: 1-800-222-1222 (RxDiff rule).
Section
OVERDOSAGE
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Although rare, deaths may occur from overdosage with cyclobenzaprine HCl. Multiple drug ingestion (including alcohol) is common in deliberate cyclobenzaprine overdose. As management of overdose is complex and changing, it is recommended that the physician contact a poison control center for current information on treatment. Signs and symptoms of toxicity may develop rapidly after cyclobenzaprine overdose; therefore, hospital monitoring is required as soon as possible. The most common effects associated with cyclobenzaprine overdose are drowsiness and tachycardia. Less frequent manifestations include tremor, agitation, coma, ataxia, hypertension, slurred speech, confusion, dizziness, nausea, vomiting, and hallucinations. Rare but potentially critical manifestations of overdose are cardiac arrest, chest pain, cardiac dysrhythmias, severe hypotension, seizures, and neuroleptic malignant syndrome.

Storage

Store at room temperature, 20 to 25 degrees C (68 to 77 degrees F), in a well-closed container. Teva label; others may differ.
Section
HOW SUPPLIED
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Dispense in a well-closed container with child-resistant closure. Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature].

Boxed warning

NONE (no boxed warning appears in the label text read)

Contraindications

Do not use if you are allergic to any ingredient.
Section
CONTRAINDICATIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Hypersensitivity to any component of this product.
Do not use with MAO inhibitors or within 14 days after stopping them. Seizures and deaths have occurred.
Section
CONTRAINDICATIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Concomitant use of monoamine oxidase (MAO) inhibitors or within 14 days after their discontinuation. Hyperpyretic crisis seizures, and deaths have occurred in patients receiving cyclobenzaprine (or structurally similar tricyclic antidepressants) concomitantly with MAO inhibitor drugs.
Do not use right after a heart attack, or with arrhythmias, heart block or conduction problems, or congestive heart failure.
Section
CONTRAINDICATIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Acute recovery phase of myocardial infarction, and patients with arrhythmias, heart block or conduction disturbances, or congestive heart failure.
Do not use with hyperthyroidism.
Section
CONTRAINDICATIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Hyperthyroidism.

Warnings and precautions

Used with certain other drugs it can cause serotonin syndrome, which can be life-threatening. Symptoms include confusion, agitation, hallucinations, sweating, fast heartbeat, shaking, muscle stiffness, nausea, vomiting and diarrhea.
Heading
WARNINGS: Serotonin Syndrome
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
The development of a potentially life-threatening serotonin syndrome has been reported with Cyclobenzaprine Hydrochloride when used in combination with other drugs, such as selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), tramadol, bupropion, meperidine, verapamil, or MAO inhibitors. Serotonin syndrome symptoms may include mental status changes (e.g., confusion, agitation, hallucinations), autonomic instability (e.g., diaphoresis, tachycardia, labile blood pressure, hyperthermia), neuromuscular abnormalities (e.g., tremor, ataxia, hyperreflexia, clonus, muscle rigidity), and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
Tricyclic antidepressants have been reported to cause heart rhythm problems, heart attack and stroke. Cyclobenzaprine may boost the effects of alcohol, barbiturates and other CNS depressants.
Heading
WARNINGS: Relation to tricyclic antidepressants
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Tricyclic antidepressants have been reported to produce arrhythmias, sinus tachycardia, prolongation of the conduction time leading to myocardial infarction and stroke. Cyclobenzaprine HCl may enhance the effects of alcohol, barbiturates, and other CNS depressants.
Use caution with a history of urinary retention, angle-closure glaucoma or high eye pressure, or when taking anticholinergic medicine.
Heading
PRECAUTIONS: General
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Because of its atropine-like action, cyclobenzaprine HCl should be used with caution in patients with a history of urinary retention, angle-closure glaucoma, increased intraocular pressure, and in patients taking anticholinergic medication.
It can impair your ability to drive or operate machinery, especially with alcohol or other CNS depressants.
Heading
PRECAUTIONS: Information for Patients
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl, especially when used with alcohol or other CNS depressants, may impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle.

Pregnancy and breastfeeding

Animal studies showed no harm to the fetus, but there are no adequate studies in pregnant women, so use in pregnancy only if clearly needed. It is not known if it passes into breast milk. Caution is advised for nursing women.
Section
PRECAUTIONS, Pregnancy and Nursing Mothers
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Reproduction studies have been performed in rats, mice and rabbits at doses up to 20 times the human dose, and have revealed no evidence of impaired fertility or harm to the fetus due to cyclobenzaprine HCl. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. [Pregnancy] It is not known whether this drug is excreted in human milk. Because cyclobenzaprine is closely related to the tricyclic antidepressants, some of which are known to be excreted in human milk, caution should be exercised when cyclobenzaprine HCl is administered to a nursing woman. [Nursing Mothers]

Side effects

Common
Drowsiness (29% on 5 mg, 38% on 10 mg, 10% on placebo), dry mouth (21%, 32%, 7%), fatigue (6%, 6%, 3%) and headache (5%, 5%, 8%) were the most common.
Threshold
Label: incidence of > 3% on cyclobenzaprine HCl 5 mg in the 2 double-blind, placebo-controlled 5 mg studies
Section
ADVERSE REACTIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Incidence of most common adverse reactions in the 2 double- blind ‡, placebo-controlled 5 mg studies (incidence of > 3% on cyclobenzaprine HCl 5 mg): Cyclobenzaprine HCl Tablets 5 mg (N=464) / Cyclobenzaprine HCl Tablets 10 mg (N=249) / Placebo (N=469): Drowsiness 29% 38% 10%; Dry Mouth 21% 32% 7%; Fatigue 6% 6% 3%; Headache 5% 5% 8%. ‡ Note: Cyclobenzaprine HCl Tablets 10 mg data are from one clinical trial. Cyclobenzaprine HCl Tablets 5 mg and placebo data are from two studies.
Less common
Reported in 1% to 3% of patients: stomach pain, acid regurgitation, constipation, diarrhea, dizziness, nausea, irritability, reduced mental sharpness, nervousness, upper respiratory infection and sore throat. With the 10 mg tablet, drowsiness was 39% in clinical studies versus 16% in the surveillance program, dry mouth 27% versus 7%, and dizziness 11% versus 3%. The label has no discontinuation table.
Section
ADVERSE REACTIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Adverse reactions which were reported in 1% to 3% of the patients were: abdominal pain, acid regurgitation, constipation, diarrhea, dizziness, nausea, irritability, mental acuity decreased, nervousness, upper respiratory infection, and pharyngitis. [5 mg placebo-controlled studies] In the 10 mg clinical studies versus the surveillance program: Drowsiness 39% vs 16%; Dry mouth 27% vs 7%; Dizziness 11% vs 3%. Adverse reactions which were reported in 1% to 3% of the patients were: fatigue/tiredness, asthenia, nausea, constipation, dyspepsia, unpleasant taste, blurred vision, headache, nervousness, and confusion.
Serious
Rarer reports include severe allergic reactions, heart rhythm changes, liver problems, seizures, hallucinations and serotonin syndrome.
Label source text (exact source wording)
Hypersensitivity: Anaphylaxis; angioedema; pruritus; facial edema; urticaria; rash. Cardiovascular: Tachycardia; arrhythmia; vasodilatation; palpitation; hypotension. Digestive: ... abnormal liver function and rare reports of hepatitis, jaundice and cholestasis. Nervous System and Psychiatric: Seizures, ataxia; vertigo; dysarthria; tremors; hypertonia; convulsions; muscle twitching; disorientation; insomnia; depressed mood; abnormal sensations; anxiety; agitation; psychosis, abnormal thinking and dreaming; hallucinations; excitement; paresthesia; diplopia, serotonin syndrome. (reported in postmarketing experience or with an incidence of less than 1% of patients in clinical trials with the 10 mg tablet; partial copy)
Medlineplus source text (exact source wording)
not retrieved (MedlinePlus not opened in this run)

Interactions

Drugs
Can have life-threatening interactions with MAO inhibitors.
Name
MAO inhibitors
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl may have life-threatening interactions with MAO inhibitors (see CONTRAINDICATIONS).
Serotonin syndrome has been reported when combined with these drugs. If used together, careful observation is advised.
Name
Serotonergic drugs (SSRIs, SNRIs, TCAs, tramadol, bupropion, meperidine, verapamil)
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Postmarketing cases of serotonin syndrome have been reported during combined use of Cyclobenzaprine Hydrochloride and other drugs, such as SSRIs, SNRIs, TCAs, tramadol, bupropion, meperidine, verapamil, or MAO inhibitors. If concomitant treatment with Cyclobenzaprine Hydrochloride and other serotonergic drugs is clinically warranted, careful observation is advised, particularly during treatment initiation or dose increases
Tricyclic antidepressants may block guanethidine's blood-pressure effect.
Name
Guanethidine and similar drugs
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Tricyclic antidepressants may block the antihypertensive action of guanethidine and similarly acting compounds.
Tricyclic antidepressants may raise seizure risk with tramadol.
Name
Tramadol
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Tricyclic antidepressants may enhance the seizure risk in patients taking tramadol.
May boost the effects of barbiturates and other CNS depressants.
Name
Barbiturates and other CNS depressants
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl may enhance the effects of alcohol, barbiturates, and other CNS depressants.
Use caution if you take anticholinergic medicine.
Name
Anticholinergic medication
Section
PRECAUTIONS, General
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
patients taking anticholinergic medication [use with caution]
Food and alcohol
Alcohol's effects may be increased.
Name
Alcohol
Section
PRECAUTIONS, Drug Interactions
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl may enhance the effects of alcohol, barbiturates, and other CNS depressants.
Name
Food / grapefruit
Section
n/a
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Other
not applicable
Name
Liverpool HIV/HEP checkers
Section
n/a
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
not applicable: label lists no antiviral interactions

Patient tips

Label
Do not drive or use machinery until you know how it affects you, especially with alcohol or other CNS depressants. Older adults have more side effects. Seek care at once for serotonin syndrome symptoms. Stopping suddenly after long use rarely causes nausea, headache and feeling unwell.
Section
PRECAUTIONS, Information for Patients; DRUG ABUSE AND DEPENDENCE
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Source text (exact source wording)
Cyclobenzaprine HCl, especially when used with alcohol or other CNS depressants, may impair mental and/or physical abilities required for performance of hazardous tasks, such as operating machinery or driving a motor vehicle. In the elderly, the frequency and severity of adverse events associated with the use of cyclobenzaprine, with or without concomitant medications, is increased. Patients should be advised of the signs and symptoms of serotonin syndrome, and be instructed to seek medical care immediately if they experience these symptoms. Abrupt cessation of treatment after prolonged administration rarely may produce nausea, headache, and malaise. These are not indicative of addiction.

Alternatives

Class source
Label does not state a formal pharmacologic class; it says cyclobenzaprine is closely related to tricyclic antidepressants. openFDA not checked.
Note
No recommendation made.

Frequently asked questions

Question
What is cyclobenzaprine used for?
Answer
It is used with rest and physical therapy to relieve muscle spasm from sudden, painful muscle and bone conditions, for short periods of up to two or three weeks.
Source section
INDICATIONS AND USAGE
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
How do I take it?
Answer
Most people take 5 mg three times a day. The dose may be raised to 7.5 mg or 10 mg three times a day. Use longer than two or three weeks is not recommended.
Source section
DOSAGE AND ADMINISTRATION
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
What are the most common side effects?
Answer
Drowsiness (29% on 5 mg), dry mouth (21%), fatigue (6%) and headache (5%) were the most common in the 5 mg studies.
Source section
ADVERSE REACTIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
Can I drink alcohol with it?
Answer
The label says it may enhance the effects of alcohol and other CNS depressants and may impair driving and machinery use.
Source section
PRECAUTIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
What medicines should I not combine with it?
Answer
Do not use with MAO inhibitors or within 14 days after stopping them. Serotonin syndrome has been reported with SSRIs, SNRIs, tricyclic antidepressants, tramadol, bupropion, meperidine and verapamil.
Source section
CONTRAINDICATIONS; WARNINGS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
Is it safe in pregnancy or breastfeeding?
Answer
Animal studies showed no harm to the fetus, but there are no adequate studies in pregnant women, so use only if clearly needed. It is not known whether it passes into breast milk and caution is advised.
Source section
PRECAUTIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
Is it okay for older adults?
Answer
Older adults have higher blood levels and more side effects. The label says use only if clearly needed, starting at 5 mg and increasing slowly.
Source section
PRECAUTIONS, Use in the Elderly
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)
Question
Who should not take it?
Answer
People who are allergic to it, who take MAO inhibitors, who are in the recovery phase of a heart attack, have arrhythmias, heart block, conduction problems or congestive heart failure, or have hyperthyroidism.
Source section
CONTRAINDICATIONS
Source
Teva cyclobenzaprine hydrochloride tablets label (1d9e34cc-eee9-4147-abf8-c810a80e39d2)

Sources

Information is taken from the cited sources and is for general reference only. It is not medical advice. Report side effects to FDA MedWatch at 1-800-FDA-1088. For a poison emergency call 1-800-222-1222. See prices for this drug