@nannybb Tonmya is a reformulation of the muscle relaxant cyclobenzaprine (aka Flexeril). It contains a lower dose and is taken subliminally rather than as a pill you swallow. By reformulating the drug, the drug company can charge lots more money. I did a google search and found: "Tonmya has a wholesale acquisition cost of $1,860 per month for 60 tablets, which will be reduced to $930 for older patients and those with mild liver impairment." The cost of cyclobenzaprine 10 mg can vary, but without insurance, it typically ranges from about $4.77 for a few tablets to around $20 for a 30-tablet supply. When I have a fibre flare, I take a 5mg tablet of cyclobenzaprine before bed and it helps with sleep and pain.

An article by Pradeep Chopra, MD (a Harvard-trained pain medicine specialist with over 25 years of experience treating complex chronic pain and multisystem disorders.) has this Summary: "In summary, sublingual cyclobenzaprine (Tonmya) is essentially a repackaged low‑dose formulation of cyclobenzaprine, marketed as a novel drug through its patented delivery system. Its pharmacokinetic differences are small, its clinical benefit is modest and comparable to existing oral formulations, and its unique adverse effects may outweigh the theoretical advantage of reduced metabolite formation. Clinicians should therefore critically evaluate manufacturer claims and consider whether simple, low‑dose oral cyclobenzaprine would provide equivalent benefit at far lower cost.”

In summary, the report concludes that Tonmya’s sublingual delivery offers only minor pharmacokinetic differences compared to oral cyclobenzaprine. Despite claims of reduced metabolite formation, the active metabolite norcyclobenzaprine remains pharmacologically relevant and may contribute to therapeutic effects. The analysis shows that dosing, rather than delivery route, largely explains any variation in drug exposure. It highlights that low-dose oral cyclobenzaprine already achieves similar outcomes and underscores that Tonmya’s modest pain reduction and unique oral adverse effects do not justify its higher cost or novelty. The conclusion advises clinicians to weigh claims critically and consider low-dose oral formulations as cost-effective alternatives.”

However, some have commented that it does help them more than the generic of Flexeril.