Medications that act as central nervous system depressants and have sedative and musculoskeletal relaxant properties are called muscle relaxants. Used in addition to rest, physical therapy, and other measures to relieve discomfort, muscle relaxants are beneficial for short-term use for acute, painful musculoskeletal conditions. The goal with these medications is a reduction of skeletal muscle spasms, relief of pain, and increased mobility of the affected muscles.
Zanaflex (tizanidine) is a short-acting muscle relaxer. It works by blocking nerve impulses or pain sensations that are sent to your brain. Zanaflex is used to treat spasticity by temporarily relaxing muscle tone. Zanaflex is a short-acting medication that should be taken only for daily activities that require relief from muscle spasticity.
Switching between Zanaflex tablets and capsules, or changing the way you take it with regard to eating, can cause an increase in side effects or a decrease in therapeutic effect. Do not take more than three doses (36 mg) of tizanidine in a 24-hour period. Too much of tizanidine can damage your liver. Cold or allergy medicine, narcotic pain medicine, sleeping pills, other muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tizanidine. Avoid drinking alcohol. It can increase some of the side effects of tizanidine.
Zanaflex Capsules are supplied as 2, 4, and 6 mg capsules for oral administration. Zanaflex Capsules contain the active ingredient, tizanidine hydrochloride, and the inactive ingredients, hypromellose, silicon dioxide, sugar spheres, titanium dioxide, gelatin, and colorants.
Zanaflex tablets are supplied as 4 mg tablets for oral administration. Zanaflex tablets contain the active ingredient, tizanidine hydrochloride, and the inactive ingredients, colloidal silicon dioxide, stearic acid, microcrystalline cellulose and anhydrous lactose.
To reduce the risk of experiencing side effects, the recommended initial adult dose of Zanaflex is 2 mg up to 3 times daily. The dose is then increased gradually in 2 mg to 4 mg steps until an effective dose is reached. The most common maintenance dose is 8 mg taken up to 3 times daily (every 6 to 8 hours). Do not take more than 36 mg of Zanaflex within a 24-hour period. Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without talking to your doctor. Always take tinazidine exactly as prescribed by your doctor. Zanaflex can be taken with or without meals, however taking Zanaflex with food may increase the side effects of this medication. Always take Zanaflex the same way, either with food or on an empty stomach. Stopping the medication suddenly may cause an increase in blood pressure, rapid heart rate and muscle spasms. Talk to your doctor to find a safe way to stop taking the medication.
It is important to take this medication exactly as prescribed by your doctor. If you miss a dose of this medicine take it as soon as possible, if you remember within an hour or so of the missed dose. If you do not remember until later, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Before you begin using Zanaflex, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Tizanidine.
Birth control: Women taking birth control pills may need a lower dose of Zanaflex to achieve a good effect. Birth control pills prevent tizanidine from leaving the body readily and may cause Zanaflex to build up in the body leading to side effects.
Drowsiness/reduced alertness: This medication may cause drowsiness and severe dizziness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.
Heart rhythm: Zanaflex can cause changes to the normal rhythm of the heart, including an irregular heartbeat called QT prolongation. QT prolongation is a serious life-threatening condition that can cause fainting, seizures, and sudden death. If you are at risk for heart rhythm problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Zanaflex is removed from the body by the liver and may cause liver problems. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Low blood pressure: Symptoms of severe lowering of blood pressure, such as weakness or dizziness, particularly when rising suddenly from a sitting or lying position, may occur. People who are prone to low blood pressure should be cautious when using this medication. This effect may happen before the dose of medication is enough to reduce the muscle spasticity. Starting this medication at a very low dose and gradually increasing the daily dose helps to reduce the effect of rapidly dropping blood pressure.
Mental health: Zanaflex can cause hallucinations. People with a history of mental health concerns, such as psychosis or schizophrenia are more likely to experience this effect. If you have a history of mental health issues, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Stopping the medication: Stopping this medication suddenly can cause increased muscle spasms, an increase in blood pressure, or a rapid heart rate. Talk to your doctor before stopping this medication.
Pregnancy: Zanaflex has not been studied for use by pregnant women. In some animal studies, Zanaflex caused birth defects and other pregnancy problems. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if Zanaflex passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Zanaflex has not been established for children less than 18 years of age.
Adults: Zanaflex is cleared from the body at a slower rate in older adults. This can result in an increase in the number and severity of side effects. The doctor will take this into consideration when determining the dose you should be taking.
Muscle relaxants are not really a class of drugs, but rather a group of different drugs that each has an overall sedative effect. Typically, muscle relaxants are prescribed early in a course of back pain, on a short-term basis, to relieve back pain associated with muscle spasms. Muscle relaxants are also sometimes prescribed for patients with back pain and other symptoms of fibromyalgia. It is thought that they may relieve the pain of tense muscles and muscle spasms common in fibromyalgia. There are several types of muscle relaxant medications commonly used to treat back pain or neck pain. Muscle relaxants are widely prescribed for acute back pain, often in conjunction with an over-the-counter or prescription pain medication. They are generally prescribed for a short time to relieve pain in the lower back or neck caused by muscle spasms, also called muscle cramps.
This dosage information is for Zanaflex oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:
Adult dosage (ages 18 years and older)
Child dosage (ages 0 - 17 years)
This medication has not been studied in children. It should not be used in people younger than 18 years.
Adult dosage (ages 65 years and older)
The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.
You can take tizanidine with or without food. But you should be consistent. Take it the same way each time. You can cut or crush the tablet. Not every pharmacy stocks this drug.
Zanaflex may be prescribed to you by your doctor for the muscle pain that comes along with fibromyalgia. Zanaflex is a muscle relaxant used to take care of muscle spasms.
Lesions of the spine
Reviewed by: Ramon 07/06/19
I use Zanaflex for painful muscle spasms associated with static and functional lesions of the spine (I have cervical and lumbar syndromes). I take tizanidine in pill form. To relieve muscle spasm of pain I take 2-4 mg 3 times a day, regardless of the time of meals. If the effect is insufficient, I take an additional 2–4 mg per night. I have more restful sleep which in turn helps me have a better day thank you Zanaflex.
Reviewed by: Edgar 06/05/19
I have been taking Zanaflex for 4 years. It really helps with the spasms I get all over and I also increase my dose at night for sleep. Works great.
Reviewed by: Mitchell 05/25/19
This med was prescribed to treat my insomnia. I take one 4mg and helps me sleep 2 hours. If I take 2 at a time it gives me hallucinations and I still sleep only 2 hours. I still take it because I prefer to sleep 2 hours than being awake for 36 hours. The drug has been very helpful. The downside is the expense which is more than most other therapies, but definately worth it.
Zanaflex after surgery
Reviewed by: Darren 04/17/19
I use Zanaflex after surgery for herniated disc. I started with a daily dose of 6 mg in 3 doses and gradually increased the daily dose with intervals of 4-7 days for 2-4 mg. The optimum daily dose was usually 12-14 mg in 3-4 doses. The daily dose did not exceed 36 mg. Cant believe how fast this works, i recommend this to anyone.
Pain went away
Reviewed by: Casey 03/16/19
Can't say a bad thing about the Zanaflex. This is the only thing that took the pain away worked better than narcotics! The only muscle relaxer that has ever worked for me. This drug has helped me fall asleep. Celexa and Elavil help me get deep sleep, but I was still having difficulty FALLING asleep. Zanaflex puts me down within an hour. No tossing and turning trying to find a comfortable position, waiting on the Elavil to kick in. It has also been great in PREVENTING my migraines. I found that since I began taking, my migraine frequency is down to almost none...if I go without zanaflex for a few days, within a week I have a migraine again. This one has been a life saver for me.
Reviewed by: Roberto 02/15/19
Tizanidine, the generic form of Zanaflex, is part of a medication program that has resulted in a complete reversal of Fibromyalgia Syndrome. Along with other sedation and Mirapex/Pramipexole, [which is the key ingredient,] I have, as my family physician said "lost 30 pounds of weight and 30 pounds of prescriptions." I got sick physically and emotionally at age 7 and well at age 62 by overcoming Hyper-Vigilance and getting Stage 4 Restorative Sleep, the lack of which made me ill in the first place.
Reviewed by: Tommy 01/07/19
4 mg Tizanadine, taken 3x daily, along with Tramadol, 100mg 4x daily, was the solution when 10 mg Percocet,4x daily was no longer effective. Having had a lifelong history of lower back pain along with trigger point pain in post-surgical areas of my body I was desperate. My primary physician, after a series of questions and tests, suggested fibromyalgia. I am now in my first week of treatment and while pain in certain areas of my body is not completely absent, it no longer is amplified. Additional measures may be required to include diet, exercise and neurological medications. Yet with the success of relief of my pain, I'm feeling hopeful and willing to do what it takes!
Reviewed by: Hector 06/08/18
Before I went on other medication that had bad interactions with it, Zanaflex did help relieve my fibromyalgia to a degree. While I never got back to where I would be capable to work even part time, the pain level decrease was a pleasant vacation.
Very good for Sleep
Reviewed by: Ricardo 05/26/18
Along with a half dose ambien, it knocks me out for 6 hours and I awake like a normal person. Have not tried it long enough for any long term effects or to see if it totally cures my daytime bedrest periods. I have horrid insomnia and this along with some other medication has made it some of the best sleep I have gotten in over 15 years.
Zanaflex is the best yet
Reviewed by: Gilbert 04/14/18
At least I've not yet had an adverse reaction to it as of yet. Don't plan to do anything after you have taken Zanaflex for about two hours but I do highly recommend it if you have back/neck/shoulder pain. It is 100% effective.
Great for migraine
Reviewed by: Herman 05/08/18
Zanaflex was prescribed to me, along with a calcium blocker, as a maintenence regimine for frequent & severe migraines. I take 2 of the zanaflex (generic form) & 2 of the calc. blocker at bed, and within 45 minutes I am out. Doesn't really help with the fibro, but would help with the migraines that accompany fibro. Don't take it & try to drive, or use a deli slicer, that kind of thing!
Reviewed by: Wesley 08/17/18
I've been using Zanaflex since 2002. I take one little pill at bedtime every day. I'll use it other times if needed, but not as a general rule. It does drop my blood pressure, which makes me sleepy, so its perfect for bedtime; 45 minutes in and I can't stay awake. it lasts in the bloodstream for six hours so its perfect for bedtime. i only have trouble sleeping when i'm in pain, and my pain is predominantly from muscle spasms. i also use it when i need to travel (not driving as the pill makes me sleepy), but flying; it prevents my trigger points from becoming irritated and kicking in the muscle spasms. i also use it when i overrotate my SI and have real pain-level 10 muscle spasms in my back. i do worry about the possible effects to the liver, so i have a full liver panel test once a year- when i started, the doctor had my liver function tested after 1 month, 3 months, 6 months, and then yearly. Zanaflex (or even the generic which i now take) might cost a little more, but one flexeril made me feel like marshmellow man in a cyber fog for several days. one other word of warning, when i first started taking zanaflex, i was also taking vioxx about every 3rd day; when i took the combination, it dropped my BP to 80/55, probably dangerously low; i checked my BP because it was knocking me out so i couldn't stay awake at all. it turns out that the same P450 in the liver that metabolizes Zanaflex is inhibited/activated by some drugs, like vioxx. the medical community didn't know it at the time, but i found the information when i was reading about P450s and drug interactions. there are some drugs that inhibit/activate the same P450 that metabolizes Zanaflex - so read about drug interactions on the internet before you take zanaflex. its not too common of an interaction, most drugs don't interact, but the wrong ones can drop the BP dangerously low.
Zanaflex, generic Tizanidine, is not a narcotic. While you need a prescription for it, it is not a controlled substance. It is an anti-spasmotic drug used to help control painful muscle spasms. It is prescribed for upper-body and neck spasms caused by cervical or vertebral injuries. The drug is short-acting, so it is often prescribed along with analgesics, benzodiazepines, or other muscle relaxants or narcotic painkillers. In some US pharmacies the purchase of Zanaflex requires a prescription. Zanaflex is not classified under the Controlled Substances. Though in some countries Tizanidine is available without prescription.