Zanaflex is a brand-name muscle relaxant currently unavailable in the U.S. and possibly discontinued by its manufacturer. Its active ingredient, tizanidine, is widely available as a generic to treat muscle spasms due to serious medical conditions such as multiple sclerosis or central nervous system injuries. Healthcare professionals are still likely to prescribe generic tizanidine as “Zanaflex,” but pharmacists know to substitute the generic version.
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Zanaflex
Tizanidine HCI
Treats muscle spasticity.
Centrally-acting skeletal muscle relaxant, alpha-2 adrenergic receptor agonist
Capsule, tablet
By mouth
Tizanidine treats muscle spasms in people with neurologic disorders such as multiple sclerosis, spinal cord injury, or brain injury. Because of side effects, doses are recommended to be taken when people wish to engage in important activities.
Capsule
2 mg
4 mg
6 mg
Tablet
4 mg
For muscle spasticity in adults: 2–4 mg taken as needed in doses spaced six to eight hours apart (maximum daily dose: three doses not exceeding 36 mg total).
Zanaflex
10 tablets bottle
Zanaflex
15 tablets bottle
Zanaflex
20 tablets bottle
Zanaflex
30 capsules bottle
Zanaflex
30 tablets bottle
Zanaflex
45 tablets bottle
Zanaflex
60 capsules bottle
Zanaflex
90 tablets bottle
Zanaflex
2mg capsule
Zanaflex
4mg capsule
Zanaflex
6mg capsule
Zanaflex
4mg tablet
Follow all the prescriber’s instructions. The dose may change during treatment.
Do not switch between tablets and capsules without a prescription.
Take a dose when needed unless directed otherwise by the prescriber. Because the effects last a short time, take the dose before activities that require relief from muscle spasms.
Doses should be separated by at least six to eight hours.
Do not take more than three doses in a day.
Zanaflex can be taken with food or on an empty stomach but always take it the same way.
Store Zanaflex in a closed, child-proofed container at room temperature (59°F to 86°F).
Keep Zanaflex out of the reach of children.
Take a missed dose when remembered.
If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose.
The prescribing information does not list any medical conditions as contraindications.
Do not use Zanaflex if you have had an allergic reaction to tizanidine.
Zanaflex is contraindicated in anyone taking a drug that powerfully inhibits the body’s ability to break down tizanidine, such as ciprofloxacin and fluvoxamine.
Tell any doctor or other healthcare provider who treats you that you are taking Zanaflex.
Zanaflex is a powerful medication, so the prescriber needs regular examinations and blood tests to monitor treatment and side effects. Keep all appointments.
Tell the prescriber if you are pregnant, breastfeeding, or have kidney or liver problems.
Tell the prescriber if you smoke.
Tizanidine can cause serious problems, including:
Liver damage
Very low blood pressure
Withdrawal symptoms include muscle rigidity, muscle spasms, racing heartbeats, and high blood pressure
Tizanidine can cause drowsiness and dizziness. Avoid driving or other potentially hazardous activities until you know how this medicine affects you.
Do not stop taking tizanidine until talking to the prescriber, especially if the doses are large or have been taken for a long time. The doctor may need to slowly decrease the dose to safely discontinue the drug.
Before taking Zanaflex, make sure the prescribing healthcare provider knows about all prescription drugs, over-the-counter medications, and supplements being taken.
Tell other healthcare professionals about tizanidine before they prescribe new medications.
Never take tizanidine along with ciprofloxacin (an antibiotic) or fluvoxamine (an antidepressant).
Tizanidine can cause serious side effects when combined with certain drugs, particularly:
Other muscle relaxants
Drugs that treat or affect heart rhythms
Stomach acid reducers such as cimetidine or famotidine
Certain types of blood pressure drugs, particularly alpha-2 adrenergic receptor agonists (find a complete list of these drugs here)
Birth control pills
Acyclovir, a herpes drug
Drugs that make you sleepy such as benzodiazepines, narcotic pain medications, barbiturates, and sleeping aids
Avoid alcohol when taking tizanidine.
Avoid smoking.
Find out more about tizanidine interactions to avoid here.
Serious side effects
Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:
Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
Slow heartbeat
Lightheadedness, dizziness, fainting, low blood pressure
Seeing or hearing things that aren’t there
Blistering, peeling, or red skin rash
Allergic reaction: Itching, hives, rash, swelling in your face or hands, swelling or tingling in your mouth or throat, throat tightness, chest tightness, trouble breathing,
Less serious side effects
Sleepiness
Dry mouth
Weakness
Dizziness
Low blood pressure
Slowed heart rate
Infection
Tizanidine, StatPearls
Zanaflex drug summary, Prescriber’s Digital Reference (PDR)
Tizanidine hydrochloride capsule prescribing information, NIH National Library of Medicine
Tizanidine hydrochloride tablet prescribing information, NIH National Library of Medicine
Zanaflex tizanidine hydrochloride capsule, tablet prescribing information, NIH National Library of Medicine
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