Curious what medication to discuss with doctor regarding fibromyalgia
I’ve had whole body pain most of my life but managed. Had back surgery in 2023 for sciatica pain. Got diagnosed with hoshimotos/hypothyroidism. Now just diagnosed in 2025 with fibromyalgia. I see a therapist and psychiatrist for cptsd and sorts. Had a nerve function test and it showed damage (failed surgery) carpal tunnel, nerve damage from head to toe. So the question is what’s a good medicine to start with for fibromyalgia? I’ve been on a couple of medications for pain. Not looking for medication with a dependence. Any suggestions I’d gladly take
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@cyndigarrison they gave me pregabalin. Just started this, so far I stay active for my job. I heard about the weight gain. Just using caution. Wish me luck
@4corazon
As someone already pointed out, Tonmya is nothing more than cyclobenzaprine (aka Flexeril) that has been reformulated to be a lower dose and taken subliminally rather than as a pill you swallow. By reformulating the drug, the drug company can charge lots more money. (I take a 5mg tablet of cyclobenzaprine before bed. I think it helps with sleep and pain.). It's a shame that no one can come up with a drug to help with Fibromyalgia without addictive properties and bad side effects. The current 3 drugs approved by the FDA are only effective for about 30% of the people who take them, and the relief they provide is often minimal.
@4corazon
Please see the replies to the above comment regarding Tomya.
@daisy17 In my experience, because I also have ME/CFS, most of my meds are low dose. Sometimes they work differently if they are low dose rather than normal dose. For example, LDN (low-dose naltrexone) is 4.5 mg, but Naltrexone normal dose is 50 mg. This LDN helps with my pain.
It appears that, if I were able to take Tonmya, as a geriatric patient my dose would be 2.8mg. I see that the daily dose for Flexeril is 30 mg. So it appears this is a very low dose. However, I am not a candidate, from what I read, as I do have CHF, heart block, and heart rhthym disturbances. So, as excited as I was to see this med for fibro, I don't think I can get it. At least it would be covered by my insurance, whereas the LDN is not--it has to be compounded. Darn! I will ask my cardiologist though because I will see him at Mayo Clinic Phoenix in December. Perhaps this low dose would not be a problem, whereas the regular dose of cyclobenzaprine would.
@hudson757 I wish you the best of luck. And it really did help my pain. It was better than I could have imagined. Hopefully it will be for you as well.
@4corazon
The maximum daily dose for Flexeril may be 30mg, but it can be prescribed in 5mg tablets, which is what I take at night. I am curious what the price will be for Tonma, I assume it will be expensive where Flexeral is now available in a generic which is inexpensive, and also covered by insurance.
@daisy17 Good to know. Is the 5 mg tab large enough for me to cut in 1/2? I would probably start with that. But only if my cardiologist approves, for my heart issues. Do you think the 5 mg is helping you?
@daisy17
Re the price. I just read an article about Tonmya vs cyclobenzaprine (Flexeril), written by a Dr P Chopra, who says that the generic 5 mg costs pennies and if you cut in 1/2, even less, whereas the patented (until 2034) Tonmya will charge much more.
He says that there is "no meaningfully significant difference between oral cyclobenzaprine & this new drug." The benefit of the way it is administered, sublingually with the Tonmya vs oral with Flexeril, means it is absorbed faster & bypasses some liver effects, but he says nothing significant. It does appear to have some very bothersome mouth effects that Flexeril doesnt.
However, I did then read an article by Health Rising blog (re ME/CFS & Fibro), says Dr Clauw, Director of the Pain & Fibro Clinic at UM, seems to think that Tonmya WILL be better for Fibro patients.