Formulary
Tizanidine: Indications, Dosing, Side Effects and Interactions
Tizanidine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Tizanidine: Indications, Dosing, Side Effects and Interactions
Tizanidine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Spasticity associated with multiple sclerosis or spinal cord injury or disease**
- **Adult** (By Mouth): Initially 2 mg daily, then increased in steps of 2 mg daily in divided doses, increased at intervals of at least 3-4 days and adjust according to response; usual dose up to 24 mg daily in 3-4 divided doses; maximum 36 mg per day.
Cautions
Elderly
Side effects
Common or very common Arrhythmias; dizziness; drowsiness; dry mouth; fatigue; hypotension; rebound hypertension Rare or very rare Gastrointestinal disorder; hallucination; hepatic disorders; muscle weakness; nausea; sleep disorders Frequency not known Abdominal pain; accommodation disorder; anxiety; appetite decreased; confusion; headache; QT interval prolongation; skin reactions; vomiting; withdrawal syndrome Side-effects, further information Treatment should be discontinued if liver enzymes are persistently raised-consult product literature.
Interactions
**Other interactions (14):**
- Therefore, the concomitant administration of maribavir and medicinal products that are sensitive substrates of CYP1A2 with a narrow therapeutic window (e.g., tizanidine and theophylline) should be...
- Muscle relaxants : Enhanced hypotensive effect may occur with tizanidine.
- Accordingly, plasma and tissue concentrations may either increase (e.g.
- Therapeutic monitoring of CYP1A2 substrates with narrow therapeutic index (e.g., theophylline and tizanidine) is recommended.
- Therefore, medicinal products metabolised by CYP1A2 (such as duloxetine, alosetron, theophylline and tizanidine) should be used with caution during treatment, as it could lead to the reduction of...
- For substances that are predominantly metabolised by CYP1A2 and that have a narrow therapeutic index (e.g.
Pregnancy
Avoid (toxicity in animal studies).
Breast feeding
Avoid (present in milk in animal studies).
Hepatic impairment
Manufacturer advises avoid in significant impairment.
Renal impairment
Use with caution if creatinine clearance less than 25 mL/minute. M Dose adjustments Consider slower dose titration if creatinine clearance less than 25 mL/minute (consult product literature). M See Prescribing in renal impairment .
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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