Tizanidine for muscle spasm

  • When starting this treatment, your doctor will give you a small dose and then gradually increase it.
  • There are two strengths of tablet, 2 mg and 4 mg.
  • Tizanidine may cause drowsiness. If this happens to you, do not drive or use tools or machines.
Type of medicine Muscle relaxant
Used for Long-term muscle stiffness (spasticity)
Also called Zanaflex®
Available as Tablets

Long-term muscle stiffness can occur in multiple sclerosis and other conditions where there has been damage to nerves that supply muscles. In these cases, the muscles may contract (or shorten) tightly, and can then become stiff and harder to use. This is called muscle spasticity.

Tizanidine works by relaxing the muscles and preventing spasms which reduces any associated pain and discomfort.

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 or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have liver or kidney problems.
  • 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 this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the specific brand of tizanidine you have been given, and a full list of possible side-effects from taking it.
  • When starting this treatment, your doctor will give you a small dose (one tablet daily) and then gradually increase the dose so that you will be taking 1-2 tablets three or four times a day. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted symptoms. Take the tablets exactly as your doctor has told you. Your dose will also be on the label of the pack to remind you.
  • You can take tizanidine tablets before or after your meals.
  • Try to take your doses at the same times of day, each day. This will help you to remember to take them. If you do forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case leave out the missed dose). Do not take two doses together to make up for a forgotten 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 may cause drowsiness. If this happens to you, do not drive or use tools or machines, as this may put yourself and others at risk.
  • It is recommended that you do not drink alcohol while you are on tizanidine. Taking tizanidine and alcohol increases the chance that you may experience side-effects such as feeling sleepy or dizzy.
  • Treatment with tizanidine is usually long-term, so keep taking these tablets unless your doctor tells you otherwise. Suddenly stopping treatment may cause problems, so your doctor will want you to reduce your dose gradually if this is necessary.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common tizanidine side-effects What can I do if I experience this?
Feeling drowsy, dizzy, or tired If this happens, do not drive or use tools or machines
Dry mouth Try chewing sugar-free gum or sweets
Feeling sick, upset stomach Stick to simple foods - avoid rich or spicy meals
Feeling light-headed, especially when you stand up Getting up more slowly should help. If you begin to feel dizzy, sit down for a few minutes
Other less common side-effects include difficulty sleeping, hallucinations, a slower heart rate, and an itchy skin rash If any of these become troublesome, speak with your doctor

Important: if you develop jaundice (yellowing of your skin or the whites of your eyes) or dark urine, speak with your doctor starightaway. These are signs that there may be a problem with your liver.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

  • 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. Never give it to other people even if their condition appears to be the same as yours.
  • Never 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 December 2010.
  • British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Original Author: Helen Allen Current Version: Peer Reviewer: Dr Helen Huins
Last Checked: 26/09/2012 Document ID: 3755  Version: 24 © EMIS

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.

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