Tizanidine
Administration
- Type: Muscle relaxant
- Dosage Forms: Cap: 2mg, 4mg; Tab: 2mg, 4mg
- Routes of Administration: Oral
- Common Trade Names: Zanaflex
Adult Dosing
Spasticity
- Individualize dose PO q6-8h prn
- Start 2mg PO x1
- Max: 3 doses/24h up to 36mg/day
- Taper dose 2-4 mg/day to D/C if prolonged use
Pediatric Dosing
Safety/efficacy not established in pediatric patients
Special Populations
Pregnancy Rating
- Consider alternative during pregnancy
- Possible risk of fetal harm
Lactation risk
- Consider alternative while breastfeeding
- Possible risk of infant sedation and hypotension
Renal Dosing
- Adult: CrCl <25: Decrease dose
Hepatic Dosing
- Adult: Not defined
Contraindications
- Allergy to class/drug
- Avoid abrupt withdrawal
Adverse Reactions
Serious
- Hepatotoxicity
- Bradycardia, hypotension
- Syncope
- Hallucinations
- Anaphylaxis, Stevens-Johnson syndrome, exfoliative dermatitis
- Abrupt D/C: Rebound HTN, tachycardia, hypertonia
Common
- Xerostomia
- Somnolence, dizziness, nervousness
- UTI, urinary frequency
- Constipation, Vomiting
- Dyskinesia
Pharmacology
- Half-life: 2.5 hr
- Metabolism: Liver; CYP450: 1A2 substrate
- Excretion: Urine 60%, feces 20%
Mechanism of Action
- Binds to central alpha-2 adrenergic receptors, increasing presynaptic motor neuron inhibition and reducing spasticity
- Centrally acting
Comments
See Also
References
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