Zanaflex

Tizanidine is a muscle relaxer that is used to treat spasticity by temporarily relaxing muscle tone.

Tizanidine may also be used for purposes not listed in this medication guide.

You should not use tizanidine if you are allergic to it, or if:

• you also take the antidepressant fluvoxamine (Luvox); or
• you also take the antibiotic ciprofloxacin (Cipro).

Tell your doctor if you have ever had:

• liver disease;
• kidney disease; or
• low blood pressure.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Tizanidine is usually taken up to 3 times in one day. Allow 6 to 8 hours to pass between doses. Do not take more than three doses (36 mg) in a 24-hour period. Too much of this medicine can damage your liver.

You may take tizanidine with or without food, but take it the same way each time. Switching between taking tizanidine with food and taking it without food can make the medicine less effective or cause increased side effects.

Switching between tizanidine tablets and capsules may cause changes in side effects or how well the medicine works.

• Taking the tablets with food can increase your blood levels of tizanidine.
• Taking the capsules with food can decrease your blood levels of tizanidine.

If you make any changes in how you take tizanidine, tell your doctor if you notice any change in side effects or in how well the medicine works.

Tizanidine is a short-acting medication, and its effects will be most noticeable between 1 and 3 hours after you take it. You should take tizanidine only for daily activities that require relief from muscle spasms.

You will need frequent medical tests.

If you stop using tizanidine suddenly after long-term use, you may have withdrawal symptoms such as dizziness, fast heartbeats, tremors, and anxiety. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include weakness, drowsiness, confusion, slow heart rate, shallow breathing, feeling light-headed, or fainting.

Do not use tizanidine at a time when you need muscle tone for safe balance and movement during certain activities. In some situations, it may be dangerous for you to have reduced muscle tone.

Drinking alcohol with this medicine can cause side effects.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;
• weak or shallow breathing;
• confusion, hallucinations; or
• pain or burning when you urinate.

Common side effects may include:

• drowsiness, dizziness, weakness;
• feeling nervous;
• blurred vision;
• flu-like symptoms;
• dry mouth, trouble speaking;
• abnormal liver function tests;
• runny nose, sore throat;
• urination problems, painful urination;
• vomiting, constipation; or
• uncontrolled muscle movements.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Taking tizanidine with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your other medicines, especially:

• acyclovir;
• ticlopidine;
• zileuton;
• birth control pills;
• an antibiotic--ciprofloxacin, levofloxacin, moxifloxacin, or ofloxacin;
• blood pressure medicine--clonidine, guanfacine, methyldopa;
• heart rhythm medicine--amiodarone, mexiletine, propafenone, verapamil; or
• stomach acid medicine--cimetidine, famotidine.

This list is not complete. Other drugs may affect tizanidine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Your pharmacist can provide more information about tizanidine.