Efficacy and safety of tolperisone versus baclofen among Chinese patients with spasticity associated with spinal cord injury: a non-randomized retrospective study

There are many medications available to treat spasticity, but the tolerability of medications is the main issue for choosing the best treatment. The objectives of this study were to compare the efficacy and adverse effects of tolperisone compared to baclofen among patients with spasticity associated with spinal cord injury. Patients received baclofen plus physical therapy (BAF+PT, n=135) or tolperisone plus physical therapy (TOL+PT, n=116), or physical therapy alone (PT, n=180). The modified Ashworth scale score, the modified Medical Research Council score, the Barthel Index score, and the Disability Assessment scale score were improved (P<0.05 for all) in all the patients at the end of 6 weeks compared to before interventions. After 6 weeks, the overall coefficient of efficacy of the intervention(s) in the BAF+PT, TOL+PT, and PT groups were 1.15, 0.45, and 0.05, respectively. The patients of the BAF+PT group reported asthenia, drowsiness, and sleepiness and those of the TOL+PT group reported dyspepsia and epigastric pain as adverse effects. When comparing drug interventions to physical therapy alone, both baclofen plus physical therapy and tolperisone plus physical therapy played a significant role in the improvement of daily activities of patients. Nonetheless, baclofen plus physical therapy was tentatively effective. Tolperisone plus physical therapy was slightly effective. In addition, baclofen caused adverse effects related to the sedative manifestation (Level of Evidence: III; Technical Efficacy Stage: 4).

Clinical Comparative Study: Efficacy and Tolerability of Tolperisone and Thiocolchicoside in Acute Low Back Pain and Spinal Muscle Spasticity

STUDY DESIGN: We performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days. PURPOSE: To assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles. OVERVIEW OF LITERATURE: No head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done. METHODS: The assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score. RESULTS: The improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001). CONCLUSIONS: Tolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.

The Clinical Evaluation Of Eperisone Hydrochloride (Mulex) / 대한류마티스학회지

Conservative treatment is the main therapy for cervicobrachial syndrome, scapulohumeral periarthritis, and lumbago as diseases with both pain and myotonia. The-conservative treatment mainly consists of medication, physiotherapy, and kinesiotherapy. In the recent years, attempts have been made to give relief to myotonia through combination therapy with antiinflammatory analgesics and muscle relaxants. The muscle relaxants using in general are tolperisone hydrochloride, chlormezanone, and diazepam. Eperizone hydrochloride(Mulex tablet) is a beta-propriophenone derivatives and a central acting muscle relaxant, And it benefited subjective symptoms such as muscular pain (lumbago, neck pain) and a stiff muscle sensation (shoulder tension, tension feeling of lower limb). Among 22 patients, there were 14 lumbagos, two cephalobrachial syndromes, one scapulohumeral periarthritis, and five combined patients were chosen and duration of symptom was 5 years (3months-15years) in average. Mulex tablet was administered in a dose of 3 tablets (150rag) per day in 22 patients for 6 weeks prospectively. We analysed general improvement rating (GIR), general usefulness rating(GUR), and overall safety rating. The general improvement rate was 78% and the aggravation rate was 4%. The complication after, madication was infrequently gastrointestinal trouble. Incidence of side effect was 22%, but all these complications were insignificant. Hematology, blood chemistry, and urinalysis after medication were normal.

Estudio clínico de una nueva asociación (tolperisona + acetaminofén) en contractura de los músculos maseteros / Clinical study of a new association (tolperisone and acetaminophen) in the contracture of masseter muscles

Se estudiaron los efectos de la combinación del clorhidrato de tolperisona, como relajante muscular, y acetaminofén, cuyo efecto es analgésico, en 32 pacientes adultos que presentaban contractura muscular de los maseteros, acompañada de dolor. Los pacientes no habían recibido tratamiento alguno durante las 72 horas anteriories; la dosificación empleada fue de una cápsula cada 8 horas por un periodo de 3 a 5 días. Los efectos secundarios fueron mínimos, sólo 2 pacientes acusaron náusea que se corrigió al ajustar la dosis. En ningún caso hubo necesidad de suspender el tratamiento. Los autores consideran de utilidad la asociación terapéutica mencionada, en el posoperatorio de cirugía bucal