Tizanidine for muscle spasm (Zanaflex)

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When you first start taking tizanidine, your doctor will give you a small dose. Your dose will then be increased at 3- to 4-day intervals until you are on a dose that suits your condition.

Tizanidine can make you feel sleepy or dizzy. It can slow your reactions, so please take care if you are using tools or machines, or if you drive.

Continue to take the tablets unless your doctor tells you otherwise. Do not suddenly stop taking tizanidine tablets.

Type of medicineA muscle relaxant
Used forMuscle spasticity in adults
Also calledZanaflex®
Available asTablets

Tizanidine belongs to a group of medicines called muscle relaxants. Muscle relaxants are medicines that are used to prevent or reduce muscle spasms and spasticity. Spasticity occurs when muscles contract tightly and become stiff and harder to use. It often causes pain and discomfort.

Tizanidine is used to relieve spasticity which results from long-term conditions such as multiple sclerosis and following long-term injuries to the head or back. It works on the nerves in your brain and spine to help relax affected muscles.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking tizanidine it is important that your doctor knows:

  • If you have any problems with the way your liver works, or any problems with the way your kidneys work.
  • If you are pregnant or breast-feeding.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tizanidine and will provide you with a full list of the side-effects which you may experience from taking it.
  • When starting the treatment, your doctor will give you a small dose (usually 2 mg once daily) and will then gradually increase your dose at 3- to 4-day intervals. This allows your doctor to make sure that you have the dose that helps your condition but avoids any unwanted symptoms. Tizanidine tablets have a relatively short time of action, so you will be prescribed several doses to take each day once you are on a maintenance dose.
  • Swallow the tablet with a drink of water. You can take tizanidine either before or after meals.
  • Continue to take tizanidine exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what your doctor said to you. Once you are established on a regular dose of tizanidine, try to take your doses at the same times of day each day, as this will help you to remember to take them.
  • If you do forget to take a dose, take it when you remember unless your next dose is about due. If it is nearly time for your next dose then take the next dose when it is due but leave out the forgotten dose. Do not take two doses together to make up for a missed dose.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have some blood tests from time to time to check that your liver is working properly.
  • Tizanidine can cause drowsiness and may affect your reactions. Be careful this does not put you at risk if you are using any tools or machines, or if you drive.
  • It is recommended that you do not drink alcohol while you are on tizanidine. This is because the risk of side-effects, such as feeling sleepy and dizzy, is increased.
  • Continue to take the tablets unless your doctor tells you otherwise - treatment with tizanidine is usually long-term. Suddenly stopping treatment can cause problems, so your doctor will want you to reduce your dose gradually if this becomes necessary.
  • If you are due to have an operation or dental treatment, please tell the person carrying out the treatment which medicines you are taking.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with tizanidine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common tizanidine side-effects (these affect more than 1 in 10 people)What can I do if I experience this?
Feeling drowsy, dizzy, tired, or weakIf this happens, do not drive or use tools or machines. Do not drink alcohol
Dry mouthTry chewing sugar-free gum or sucking sugar-free sweets
Feeling sick, upset stomachEat simple meals - avoid rich or spicy foods
Common tizanidine side-effects (these affect less than 1 in 10 people)What can I do if I experience this?
Feeling light-headed, especially when you stand up (due to low blood pressure)Moving more slowly may help
Difficulty sleepingIf troublesome, speak with your doctor

Important: a few people have developed problems with their liver whilst taking tizanidine. Although your doctor will check for this, you should speak with your doctor as soon as possible if you have any unexplained sickness, loss of weight, or feel extremely tired.

If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Do not give it to other people even if their condition appears to be the same as yours.

If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Zanaflex® 2 and 4 mg tablets; Cephalon (UK) Limited, The electronic Medicines Compendium. Dated March 2012.
  • British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Dr Helen Huins
Document ID:
3755 (v25)
Last Checked:
21/05/2015
Next Review:
20/05/2018
The Information Standard - certified member

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