Tizanidine

pronounced as (tye zan' i deen)

Brand Name(s): Ontralfy®, Zanaflex®

Why is this medicine prescribed?

Tizanidine is used to relieve muscle spasms, cramping, and tightness caused by certain conditions including multiple sclerosis (MS, a disease in which the nerves do not function properly and patients may experience weakness, numbness, loss of muscle coordination and problems with vision, speech, and bladder control) and spinal injury. Tizanidine is in a class of medications called skeletal muscle relaxants. It works by slowing action in the brain and nervous system to allow the muscles to relax.

Are there other uses for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Tizanidine comes as a tablet, a capsule, and an oral solution to take by mouth. Take consistently either always with or always without food every 6 or 8 hours as needed, but no more than three times a day.

Take exactly as directed. Ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor.

The capsules and tablets may release the medicine differently in the body. Do not switch from one product to the other without talking to your doctor.

Your doctor will probably start you on a low dose of tizanidine and gradually increase your dose, depending on your response to this medication.

Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will probably decrease your dose gradually.

What special precautions should I follow?

Before taking tizanidine,

  • tell your doctor and pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
  • some medications should not be taken with tizanidine. Other medications may cause dosing changes or extra monitoring when taken with tizanidine. Make sure you have discussed any medications you are currently taking or plan to take before starting tizanidine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking tizanidine, please get the advice of your doctor or pharmacist.
  • the following nonprescription products may interact with tizanidine: cimetidine (Tagamet®); famotidine (Pepcid®, Pepcid® AC). Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking tizanidine. Do not start any of these medications while taking tizanidine without discussing with your healthcare provider.
  • tell your doctor if you have or have ever had kidney or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tizanidine, call your doctor.
  • you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • you should know that tizanidine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking tizanidine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
  • tizanidine can decrease muscle tone, so be careful when walking or doing other activities where you rely on your muscle tone to help with your posture or balance.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tizanidine.
  • remember that alcohol can add to the drowsiness caused by this medication.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget to take a dose?

If your doctor has told you to take tizanidine regularly, take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What should I do in case of overdose?

In case of overdose, call the poison control helpline at 1-800-222-1222

. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

  • drowsiness
  • extreme tiredness
  • confusion
  • slow heartbeat
  • fainting
  • dizziness
  • slow or shallow breathing
  • loss of consciousness

What side effects can this medicine cause?

Tizanidine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • dizziness
  • drowsiness
  • unusual tiredness or weakness
  • nervousness
  • vomiting
  • dry mouth
  • constipation

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

  • nausea, extreme tiredness, lack of energy, loss of appetite, unusual bleeding or bruising, pain in the upper right part of the stomach, yellowing of the skin or eyes, or flu-like symptoms
  • rash; hives; itching; swelling of the face, throat, tongue, lips, or eyes; shortness of breath; or difficulty breathing or swallowing
  • seeing things or hearing voices that do not exist
  • slow heartbeat
  • changes in vision

Tizanidine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone (

1-800-332-1088).

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to tizanidine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

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