Tizanidine: Uses, How It Works, Medicines
Tizanidine is a prescription muscle relaxant used to relieve painful muscle spasm and muscle stiffness (spasticity). Spasticity can come from conditions such as multiple sclerosis or spinal injury. It commonly causes drowsiness, dizziness and a dry mouth, and it can lower blood pressure and affect the liver. It should not be stopped suddenly.
Also known as: Tizanidine tablet, Tizanidine 2 mg, Tizanidine 4 mg, Tizanidine hydrochloride, Tizanidine IP, Zanaflex, Tizan
Pharmacist review in progress. This page is based on the sources listed below and is being checked by our registered pharmacist.
How does Tizanidine work?
Tizanidine acts on the brain and spinal cord. It calms the nerve signals that keep muscles tense, so the muscles relax and spasm and stiffness ease. It does not act directly on the muscle itself.
How to take Tizanidine
Follow the label or your doctor's advice. The dose is usually built up slowly, and your doctor decides how many tablets and how often.
Side effects of Tizanidine
Most people take tizanidine without serious problems. Some side effects are common and mild, but a few need medical help.
Uncommon or mild
- Drowsiness or sleepiness
- Dizziness
- Dry mouth
- Tiredness or weakness
- Nausea or constipation
- Low blood pressure
Rare but serious: get medical help
- Yellow skin or eyes, dark urine, severe tiredness or pain in the upper right of the stomach (possible liver problems)
- Fainting or very low blood pressure
- Seeing or hearing things that are not there (hallucinations)
- A very slow heartbeat
- Swelling of the face, lips or throat, or difficulty breathing (severe allergic reaction). Call 112
Who should be careful
Some people need to check with a doctor before taking tizanidine, or need extra care while taking it.
When the label says not to use it
- Allergy to tizanidine or any ingredient
- Severe liver disease
- Taking fluvoxamine or ciprofloxacin
- Drowsiness and dizziness: do not drive or use machinery until you know how it affects you
- Low blood pressure: get up slowly from lying or sitting
- Liver: blood tests of liver function may be needed; tell your doctor about liver disease
- Kidney problems: smaller doses may be needed
- Stopping suddenly: it can cause a rebound rise in blood pressure and heart rate, so the dose is lowered slowly under a doctor's guidance
- Heart problems or heartbeat rhythm problems
- Pregnancy and breastfeeding: safety is not established; ask your doctor
- Alcohol and other sedating medicines add to the sleepiness
Medicines and things that interact with Tizanidine
Tizanidine can change how other medicines work, and some medicines raise its level in the blood. Tell your doctor or pharmacist about everything you take.
- Fluvoxamine and ciprofloxacin: must not be taken with tizanidine
- Other medicines that slow its breakdown, such as cimetidine, famotidine, amiodarone and some other antibiotics: avoid unless a doctor advises
- Blood pressure medicines: blood pressure may fall too low
- Sleeping tablets, anxiety medicines, opioid painkillers and some antidepressants: extra sleepiness
- Oral contraceptives: they can raise tizanidine levels
- Alcohol: adds to sleepiness and raises the amount of tizanidine in the body
- Smoking: can lower its level
If someone takes too much
An overdose can cause extreme drowsiness, confusion, a slow heartbeat, very low blood pressure, shallow breathing and loss of consciousness. Call 112 or go to the nearest hospital at once and take the medicine pack with you.
Regulatory status in India
Approved for sale in India as a prescription medicine; tizanidine is listed in Schedule H of the Drugs Rules 1945 (entry 502). Single-ingredient tizanidine is not on the CDSCO list of medicines banned under section 26A of the Drugs and Cosmetics Act. The combination nimesulide + tizanidine is on that banned list, so check the ingredient list on the pack.
Type of medicine
Tizanidine belongs to this type of medicine.
Medicines that contain Tizanidine
These medicines sold in India contain Tizanidine. They are listed A to Z, not ranked.
- Tizan 2 · 2 mg tablet
What is Tizanidine used for?
Medicines that contain Tizanidine are used for these conditions.
Common questions
What is tizanidine used for?
Tizanidine is a prescription muscle relaxant used to ease painful muscle spasm and the muscle stiffness (spasticity) seen in conditions such as multiple sclerosis and spinal injury. It does not treat the underlying cause. A doctor decides whether it suits you.
Does tizanidine make you sleepy?
Yes. Drowsiness and dizziness are very common, so avoid driving or using machinery until you know how it affects you. Alcohol and some other medicines make the sleepiness worse. Tell your doctor if it troubles you rather than changing the dose yourself.
Can I stop tizanidine suddenly?
No. Stopping suddenly after regular use can cause a rebound rise in blood pressure and heart rate. Do not stop on your own. Your doctor will lower the dose gradually if needed.
Can I take tizanidine with ciprofloxacin or fluvoxamine?
No. These medicines slow tizanidine's breakdown and can cause very low blood pressure and heavy drowsiness, so the combination is not allowed. Tell every doctor and pharmacist that you take tizanidine before any new medicine is prescribed.
Sources
- Tizanidine 2 mg tablets (Tizagelan): Summary of Product Characteristics. electronic medicines compendium (emc), UK
- Tizanidine. MedlinePlus, US National Library of Medicine
- ATC/DDD Index: M03BX02 Tizanidine. WHO Collaborating Centre for Drug Statistics Methodology
- List of drugs prohibited for manufacture and sale through gazette notifications under section 26A of the Drugs & Cosmetics Act 1940. Central Drugs Standard Control Organisation (CDSCO)
- The Drugs Rules, 1945 (consolidated, September 2024 edition), Schedule H: prescription drugs. Central Drugs Standard Control Organisation (CDSCO)