Zanaflex (Tizanidine Hydrochloride)

(℞) Prescription Required

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Zanaflex (Tizanidine Hydrochloride) Dosage and Side Effects

ZANAFLEX is used to treat muscle spasms caused by certain conditions such as multiple sclerosis, ALS, or spinal cord injury.

Warnings and Precautions

ZANAFLEX is a short-acting medication that you should only take for daily activities that require relief from muscle spasms.

Using too much ZANAFLEX can severely damage your liver, causing liver failure.

Tell your doctor if you have any type of previous injury to your liver. Your doctor will likely check blood levels after a month of use if you fall into this category.

It's also important to inform your doctor if you have experienced kidney failure.

Call your doctor immediately if you develop dry mouth, dizziness, a strong desire for sleep, or any sign of weakness while taking ZANAFLEX. Your dosage may have to be reduced or discontinued.

You should not drive, use heavy machinery, or do any activity that requires you to be alert while using ZANAFLEX.

If you are scheduled for surgery, let your doctor know you are taking ZANAFLEX.

Before having surgery, tell your doctor or dentist about all the products you use, including over-the-counter (OTC) drugs.

In older adults, the effects of ZANAFLEX may also last much longer.

Pregnancy and ZANAFLEX

ZANAFLEX may be harmful to an unborn baby.

Animal studies have shown an adverse effect, but there are no adequate studies in pregnant women. Tell your doctor if you are pregnant or might become pregnant during treatment.

Do not use this medication without telling your doctor if you are breastfeeding.

ZANAFLEX 'High' and Recreational Use

Because of ZANAFLEX's sedative effects, numerous online and anecdotal reports have suggested that some people abuse the drug for a narcotic-like "high."

However, ZANAFLEX is not a narcotic.

Side Effects

ZANAFLEX has some common side effects that should go away with continued use, including:

  • Dry mouth
  • Weakness
  • Fatigue
  • Dizziness
  • Nervousness
  • Depression
  • Vomiting
  • Tingling sensation in the arms, legs, hands, and feet
  • Constipation
  • Diarrhea
  • Stomach pain
  • Heartburn
  • Increased muscle spasms
  • Back pain
  • Rash
  • Sweating
  • Light-colored stools

Tell your doctor if any of these symptoms are severe or do not go away.

Serious Side Effects of ZANAFLEX

Some side effects of ZANAFLEX can be serious.

If you experience any of these symptoms, call your doctor immediately:

  • Nausea
  • Extreme tiredness
  • Unusual bleeding or bruising
  • Lack of energy
  • Loss of appetite
  • Pain in the upper right part of the stomach
  • Yellowing of the skin or eyes (jaundice)
  • Unexplained flu-like symptoms
  • Seeing things or hearing voices that do not exist
  • Slow heartbeat
  • Changes in vision

Let your doctor know if you have any other unusual problems while taking ZANAFLEX.

Interactions with this medication

Do not take ZANAFLEX if you are also taking the antidepressant fluvoxamine (Luvox) or the antibiotic ciprofloxacin (Cipro).

Let your doctor know about all other medicines and supplements you're taking before taking ZANAFLEX.

Using ZANAFLEX along with the following medicines is not recommended:

  • Acyclovir (Zovirax)
  • Ciprofloxacin (Cipro)
  • Dronedarone (Multaq)
  • Fluvoxamine (Luvox)
  • Pimozide (Orap)
  • Saquinavir (Invirase)
  • Thioridazine (Mellaril)

Food has a complex effect on how ZANAFLEX is absorbed and processed in the body.

Starting at a lower dose and gradually increasing the dose minimizes the risk for adverse effects.

Unless your doctor tells you otherwise, continue your normal diet and take your medicine when you eat.

Alcohol and ZANAFLEX

Alcohol increases the overall amount of drug in the bloodstream.

You should not drink alcohol while taking ZANAFLEX.

Proper Use of this medication

ZANAFLEX also reacts differently depending on whether you take it with food or on an empty stomach, or if you sprinkle the contents of the capsule on food.

The usual starting dose is 2 mg taken by mouth every six to eight hours. A maximum of three doses can be taken in a 24-hour period. Your doctor could increase the strength in 2- to 4-mg steps to help reach the optimum effect and tolerance for your condition.

In order to reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose.

Follow your doctor's instructions carefully.

ZANAFLEX Withdrawal

ZANAFLEX may cause you to have withdrawal reactions, especially if it has been used regularly for a long time or in high doses.

Withdrawal symptoms, such as anxiety, tremor, increased blood pressure, heart rate, and muscle tenseness, may occur if you suddenly stop using this medication.

To prevent this from happening, your doctor may reduce your dose gradually to discontinue your use of ZANAFLEX.


Get immediate help or go to an emergency room if you suspect you have taken too much ZANAFLEX.

Symptoms of an overdose include:

  • Blurred vision
  • Chest pain
  • Confusion
  • Difficult or troubled breathing
  • Dizziness, faintness, or lightheadedness when getting up from a lying position
  • Irregular, fast or slow, or shallow breathing
  • Loss of consciousness
  • Pale or blue lips, fingernails, or skin
  • Severe sleepiness
  • Sweating

Missed Dose of ZANAFLEX

If your doctor has told you to take ZANAFLEX regularly, take the missed dose as soon as you remember it.

If it's almost time for your next dose, however, skip the missed dose and continue your regular schedule.

Don't "double up" to make up for a missed one.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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