Tizanidine for muscle spasm
Tizagelan
Peer reviewed by Sid DajaniLast updated by Michael Stewart, MRPharmSLast updated 9 Jun 2024
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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.
At a glance
Tizanidine is a muscle relaxant used to treat muscle spasticity in adults.
It helps to relax stiff and painful muscles, for example, due to multiple sclerosis.
Your doctor will gradually increase your dose to find what works best for you.
Common side-effects include drowsiness, dizziness, dry mouth, and feeling light-headed.
Do not drive or operate machinery if you feel drowsy or dizzy.
Do not drink alcohol while taking tizanidine as it can increase side-effects.
Tell your doctor if you experience unexplained sickness, yellow skin/eyes, weight loss, or extreme tiredness.
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About tizanidine
Type of medicine | A muscle relaxant |
Used for | Muscle spasticity in adults |
Also called | Tizagelan® |
Available as | Tablets |
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.
Before taking tizanidine
Back to contentsSome 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 breastfeeding.
If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
If you have ever had an allergic reaction to a medicine.
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How to take tizanidine
Back to contentsBefore 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.
Getting the most from your treatment
Back to contentsTry 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.
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Can tizanidine cause problems?
Back to contentsAlong 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.
Common tizanidine side-effects (these affect fewer than 1 in 10 people) | What can I do if I experience this? |
Feeling drowsy, dizzy or tired | If this happens, do not drive and do not use tools or machines. Do not drink alcohol |
Dry mouth | Try chewing sugar-free gum or sucking sugar-free sweets |
Feeling light-headed, especially when you stand up (due to low blood pressure) | Moving more slowly may help |
A slower heart beat | This is not usually problematic but speak with your doctor if you have any concerns |
Important: a few people have developed problems with their liver whilst taking this medicine. Although your doctor will check for this, you should speak with your doctor as soon as possible if you have any unexplained sickness (nausea or vomiting), yellowing of skin or eyes (jaundice), 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.
How to store tizanidine
Back to contentsKeep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Back to contentsImportant information about all medicines
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.
MHRA - Reporting adverse reactions
Report suspected side effects to medicines, vaccines, e-cigarettes, medical device incidents, defective or falsified (fake) products to the Medicines and Healthcare products Regulatory Agency to ensure safe and effective use.

Unsure about mixing medicines?
Check for possible interactions between medicines, supplements and foods before taking them together.
Frequently asked questions
Can I take tizanidine with other medications?
You should always inform your doctor about all other medicines you are taking, including those bought without a prescription, as well as herbal and complementary medicines. This is important because some medicines are not suitable to be taken together, or may require extra care.
How will my doctor determine the correct dose of tizanidine for me?
When starting treatment, your doctor will begin with a small dose, usually 2 mg once daily. They will then gradually increase your dose at 3- to 4-day intervals. This careful approach ensures that you receive the most effective dose for your condition while minimising unwanted side-effects.
What should I do if I feel light-headed when standing up after taking tizanidine?
Tizanidine can sometimes cause you to feel light-headed, especially when standing up, due to a drop in blood pressure. If this happens, moving more slowly can be helpful. If it continues to be troublesome, you should speak with your doctor or pharmacist for advice.
What are the common side effects of tizanidine and how can I manage them?
Some common side-effects include feeling drowsy, dizzy, or tired, experiencing a dry mouth, and feeling light-headed when standing up due to low blood pressure. If you feel drowsy or dizzy, you should avoid driving or using tools/machines and not drink alcohol. For a dry mouth, try chewing sugar-free gum or sucking sugar-free sweets. If feeling light-headed, moving more slowly may help. Most of these effects often improve as your body adjusts. If any side effects persist or become bothersome, speak with your doctor or pharmacist.
What should I do if I notice any signs of liver problems while taking tizanidine?
It's important to be aware that a few people on tizanidine have developed liver problems. Although your doctor will monitor this with blood tests, you must speak with your doctor as soon as possible if you experience any unexplained sickness (nausea or vomiting), yellowing of your skin or eyes (jaundice), unexplained weight loss, or feel extremely tired. These could be signs of liver issues.
Further reading and references
- Manufacturer's PIL, Tizagelan® 2 mg and 4 mg tablets; G.L Pharma UK Limited. Dated August 2021.
- Medicines Complete BNF 89th Edition; British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Article history
The information on this page is written and peer reviewed by qualified clinicians.
Next review due: 30 May 2027
9 Jun 2024 | Latest version

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