Tizanidine

💊 What is Tizanidine used for?

• •The label says tizanidine is used for the management of spasticity, which is muscle stiffness and tightness.

How it works

The label describes tizanidine as a central alpha-2-adrenergic agonist. It says the effect peaks about 1 to 2 hours after a dose and wears off between 3 and 6 hours after a dose. Because of this short effect, the label notes that doses may be repeated at set intervals as needed.

How it is usually taken

• •The label says tablets may be taken with or without food, but once the choice is made, the way it is taken should not be changed. The label says not to switch between tablets and capsules, because they can act differently. The label says not to take more than prescribed. It also says the medicine should not be stopped suddenly; the dose is decreased slowly. Follow the instructions from your prescriber or pharmacist.

Comes as

• •2 mg tablets: white to off-white, round, flat, uncoated, with a product code of 502 on one side
• •4 mg tablets: white to off-white, round, flat, uncoated, with a product code of 503 on one side

⚠️ Tizanidine side effects

🛑 Who should not take Tizanidine, and who should be careful

The label says not to take it if

• 🚨You are taking fluvoxamine. The label says this combination is contraindicated because of the risk of severe low blood pressure and sedation.
• 🚨You are taking ciprofloxacin. The label says this combination is contraindicated for the same reasons.

Tell your doctor before taking it if

• •Tell your doctor or pharmacist about every medicine you take, including ones you buy without a prescription, because the label warns of serious interactions.
• •Tell your prescriber if you have liver problems, since the label says it should be used with caution in people with any liver impairment.
• •Tell your prescriber if you have kidney problems, since the label says it should be used with caution when kidney clearance is low.
• •The label says older adults should use it with caution because the body clears it more slowly.
• •Be careful when you stand up from lying or sitting, because the label warns of low blood pressure.
• •Do not drive or use machinery until you know how the medicine affects you, because it can cause sleepiness.
• •Tell your prescriber if you have hallucinations or other mental changes while taking this medicine.
• •Tell your prescriber if you depend on spasticity to help you stand, keep your balance, or walk, since the label says caution is needed in that case.

🔀 Tizanidine with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Fluvoxamine: contraindicated. The label says it can lead to significantly decreased blood pressure, increased drowsiness, and increased impaired coordination and thinking.
• •Ciprofloxacin: contraindicated. The label describes the same kinds of risks as fluvoxamine.
• •Other CYP1A2 inhibitors, such as zileuton, other fluoroquinolones, certain heart rhythm medicines (amiodarone, mexiletine, propafenone, verapamil), cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine: the label says these should be avoided when possible. If they must be used, the prescriber should watch for low blood pressure, slow heart rate, or excessive drowsiness.
• •Oral contraceptives: the label says concomitant use is not recommended, but may be considered if clinically necessary, with close monitoring.
• •Alcohol: the label says alcohol increases the amount of the drug in the bloodstream and that the sedating effects add together.
• •Other CNS depressants, such as benzodiazepines, opioids, tricyclic antidepressants, and baclofen: the label says sedation may add together, so the prescriber should watch for excess sedation.
• •Blood pressure medicines (antihypertensives): the label says blood pressure should be monitored when used together.
• •Other alpha-2-adrenergic agonists: the label says they should not be used together with tizanidine.

Alcohol and food

The label says alcohol increases the amount of tizanidine in the blood and adds to sedation, which can increase side effects. The label also says food affects how tizanidine is absorbed, and that tablets and capsules behave differently with food. Keep the same routine with or without food, as the label advises.

🤰 Tizanidine in pregnancy and breastfeeding

Pregnancy

The label says tizanidine has not been studied in pregnant women. It says it should be given to pregnant women only if the benefit outweighs the risk to the unborn baby. Animal studies suggest it may cause fetal harm.

Breastfeeding

The label says it is not known whether this drug passes into human breast milk. Because many drugs do, the label says caution is advised when giving it to a nursing mother.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 25°C (77°F), with short excursions permitted between 15°C and 30°C (59°F to 86°F). It also says the medicine comes in child-resistant containers.

If a dose is missed

The label does not say.

If too much is taken

The label says overdoses have occurred and some have been fatal, often when combined with other sedating medicines. Symptoms can include decreased alertness, lethargy, sleepiness, confusion, coma, slow heart rate, low blood pressure, and slowed breathing. The label says that if an overdose occurs, the airway should be secured and the heart and breathing monitored. Seek emergency medical help right away if an overdose is suspected.

🗒️ Questions to ask about Tizanidine

• Is any of my other medicine a fluvoxamine or ciprofloxacin, or a similar medicine the label warns about?
• Should I take this with food or without food, and should I keep the same routine?
• What should I do if I feel dizzy when I stand up?
• How will my liver be checked while I take this medicine?
• How should the dose be lowered if I need to stop taking it?
• Is it safe to drive or operate machinery while taking this medicine?
• What should I do if I think I took too much?

❓ Tizanidine: frequently asked questions