Which skeletal muscle relaxant is Beers Criteria appropriate to avoid for older adults?

• A. Carisoprodol
• B. Cyclobenzaprine
• C. Methocarbamol
• D. Orphenadrine

Answer: (C)

Beers Criteria flags medications for older adults when the risks outweigh the benefits, focusing on things like excessive sedation, confusion, dizziness, and increased fall risk. Skeletal muscle relaxants fall into this category because their central nervous system depressant effects can be especially hard on an aging brain and balance system. Methocarbamol is singled out because its CNS depressant effects commonly lead to confusion, sedation, and impaired motor coordination in older adults, raising the likelihood of delirium and falls. For this reason, it’s considered appropriate to avoid methocarbamol in older patients by Beers Criteria. In practice, if a muscle relaxant is ever considered, clinicians weigh safer options, minimize sedative burden, and emphasize nonpharmacologic management and non-sedating analgesics whenever possible.