Zanaflex (Tizanidine-Oral)

Zanaflex comes as a tablet to take it orally. It usually is taken two or three times a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Zanaflex exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Drug Class and Mechanism

Tizanidine is an agonist at (alpha) 2 -adrenergic receptor sites and presumably reduces spasticity by increasing presynaptic inhibition of motor neurons. In animal models, tizanidine has no direct effect on skeletal muscle fibers or the neuromuscular junction, and no major effect on monosynaptic spinal reflexes. The effects of tizanidine are greatest on polysynaptic pathways. The overall effect of these actions is thought to reduce facilitation of spinal motor neurons.

The imidazoline chemical structure of tizanidine is related to that of the anti-hypertensive drug clonidine and other (alpha) 2 -adrenergic agonists. Pharmacological studies in animals show similarities between the two compounds, but tizanidine was found to have one-tenth to one-fiftieth (1/50) of the potency of clonidine in lowering blood pressure.

Missed Dose

If you take several doses per day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if you remember a missed dose when it is almost time for your next scheduled dose, skip the missed dose. Do not take a double dose to make up for a missed one.

Storage

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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Side effects from Zanaflex can occur. Tell your doctor if any of these symptoms are severe or do not go away: dizziness, upset stomach, vomiting, tingling sensation in the arms, legs, hands, and feet, dry mouth, increased muscle spasms. If you experience either of the following symptoms, call your doctor immediately: yellowing of the skin or eyes, unexplained flu-like symptoms.

More Information

• If you experience any of the following serious side effects, stop taking tizanidine and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
  • hallucinations or abnormal behavior; or
  • liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue).
• Other, less serious side effects may be more likely to occur. Continue to take tizanidine and talk to your doctor if you experience
  • drowsiness or dizziness;
  • weakness;
  • dry mouth;
  • increased muscle tone or spasms; or
  • sweating.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.