Tizanidine

Tizanidine is a prescription medication used to relieve spasms and increased muscle tone caused by multiple sclerosis, stroke, or brain or spinal injury. Tizanidine belongs to a group of drugs called skeletal muscle relaxants, which work by slowing action in the brain and nervous system to allow the muscles to relax.

This medication comes in tablet and capsule forms and is taken up to 3 times a day, with or without food. It should always be taken consistently with food or without food, though.

Common side effects of tizanidine include dry mouth, weakness, drowsiness, and dizziness. Do not drive or operate heavy machinery until you know how tizanidine affects you.

Tizanidine is a prescription medication used to relieve spasms and increased muscle tone caused by multiple sclerosis, stroke, or brain or spinal injury.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Tizanidine may be found in some form under the following brand names:

• Zanaflex

Serious side effects have been reported with tizanidine. See the “Drug Precautions” section.

Common side effects of tizanidine include the following:

• dry mouth
• drowsiness
• weakness
• tiredness

This is not a complete list of tizanidine side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• alcohol
• baclofen (Lioresal)
• benzodiazepines such as triazolam (Halcion), alprazolam (Xanax), and diazepam (Valium)
• medications that block the enzyme CYP1A2 such as zileuton (Zyflo), amiodarone (Cordarone, Pacerone), mexiletine (Mexitil), propafenone (Rythmol), verapamil (Calan, Covera, Isoptin), cimetidine (Tagamet), famotidine (Pepcid), birth control pills, acyclovir (Zovirax), ticlopidine (Ticlid), ciprofloxacin (Cipro), and fluvoxamine (Luvox)

This is not a complete list of tizanidine drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with tizanidine including:

• rebound hypertension (high blood pressure) and tachycardia (fast heart rate). Do not stop taking tizanidine suddenly, as rebound hypertension and tachycardia can occur.
• liver injury. This may occur with use of tizanidine, but has been shown to resolve once use of this medication is stopped. It is recommended that liver function monitoring should be done for the first 6 months of treatment and periodically afterwards.
• low blood pressure. There is a possibility that tizanidine may lower your blood pressure. Exercise caution with standing from a sitting position, as dizziness may occur due to a lowered blood pressure.
• sedation

Tizanidine can cause dizziness and drowsiness. Do not drive or operate heavy machinery until you know how tizanidine affects you.

Do not take tizanidine if you:

• are allergic to tizanidine or to any of its ingredients
• are taking medications that are strong blockers of CYP1A2 medications, including fluvoxamine (Luvox) and ciprofloxacin (Cipro, Proquin)

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of tizanidine, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking tizanidine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to tizanidine or to any of its ingredients
• have liver problems
• have kidney problems
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Tizanidine falls into category C. In animals studies, pregnant animals were given this medication and had some babies born with problems. There are no well-controlled studies that have been done in humans with tizanidine though. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if tizanidine crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using tizanidine.

Take tizanidine exactly as prescribed.

This medication comes in tablet and capsule forms and is taken up to 3 times a day, with or without food.

You may sprinkle the contents of the capsule into a soft food such as applesauce or pudding. Be sure to consume the contents of this mixture completely.

The ability of the body to absorb tizanidine if taken with food differs if taken without food. Be sure to be consistent and either take only with food or only take without food.

The ability of the body to absorb tizanidine capsules and tablets differ. Switching between the two forms will cause a difference in therapeutic levels of tizanidine in the body.

Alcohol may intensify some of the side effects of this medication.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of tizanidine at the same time.

Take tizanidine exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The tizanidine dose your doctor recommends will be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your liver function
• your kidney function

The recommended dose range for tizanidine is 12 mg to 24 mg, divided into even doses and given up to 3 times a day. Doses above 24 mg per day is not advised.

If you take too much tizanidine, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If tizanidine is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store tizanidine at room temperature between 15–30°C (59–86°F).
• Dispense in containers with child resistant closure.
• Keep this and all medicines out of the reach of children.