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Tizanidine: Side Effects, Uses, Dose, Interaction and Precautions


GENERIC NAME(s): Tizanidine
BRAND NAME(s): Zanaflex
DRUG CLASS: Skeletal Muscle Relaxants


Tizanidine is a medication used as muscle relaxant to help relax certain muscles in the body. It relieves cramps, spasms, and tightness of the muscles caused by some medical conditions, including multiple sclerosis or certain injuries to the spine.

It is available in the following dosage forms:

  • Tablet
  • Capsule

Tizanidine medication is available only with your doctor’s prescription.


Tizanidine Side Effects

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

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

Some side effects can be serious. Call your doctor immediately if you have any of these symptoms:

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


Symptoms of overdose may include:

  • Blurred vision
  • Confusion
  • Difficult or troubled breathing
  • Change in consciousness
  • Chest pain or discomfort
  • Lightheadedness, dizziness, or fainting
  • Loss of consciousness
  • Decreased responsiveness or awareness
  • Pale or blue lips, fingernails, or skin
  • Severe sleepiness
  • Sleepiness or unusual drowsiness
  • Slow or irregular heartbeat
  • Sweating
  • Unusual tiredness or weakness
  • Irregular, fast or slow, or shallow breathing
  • Dizziness, lightheadedness or faintness when getting up from a lying position


The dose of Tizanidine medication may be different for different patients. Follow all the directions on the prescription label or ask your doctor for more details. For muscle relaxation, oral dosage (capsule or tablet) of this medicine is as follows: (1)

  • Adults—At first, 2 mg every 6-8 hours. Your doctor or health care provider may adjust your dose as required. Do not consume more than 36 mg within a 24-hour period.
  • Children—Use and dose must be determined by your doctor.


Tizanidine (Zanaflex) may interact with other drugs and can cause serious side-effects. Before start or stop any medication, first take your doctor’s approval.

Using Tizanidine medication with any of the following medicines is not recommended. Your doctor or health care provider may decide not to prescribe this drug or may change some of the other medicines you take.

  • Fluvoxamine
  • Ciprofloxacin
  • Viloxazine
  • Dihydrocodeine
  • Bromazepam
  • Alprazolam
  • Benzhydrocodone
  • Deferasirox
  • Buprenorphine
  • Butorphanol
  • Alfentanil
  • Famotidine
  • Fentanyl
  • Cetirizine
  • Cimetidine
  • Ethynodiol Diacetate
  • Clozapine
  • Codeine
  • Desogestrel
  • Dienogest
  • Ethinyl Estradiol
  • Gabapentin Enacarbil
  • Doxylamine
  • Glycopyrrolate
  • Calcium Oxybate
  • Cannabidiol
  • Gestodene
  • Drospirenone
  • Esketamine
  • Lofexidine
  • Loxapine
  • Flibanserin
  • Gabapentin
  • Lemborexant
  • Levocetirizine
  • Mestranol
  • Givosiran
  • Glucagon
  • Glycopyrronium Tosylate
  • Hydrocodone
  • Estradiol Valerate
  • Hydromorphone
  • Ketamine
  • Magnesium Oxybate
  • Levonorgestrel
  • Levorphanol
  • Meperidine
  • Metoclopramide
  • Mexiletine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Norethindrone
  • Pixantrone
  • Norfloxacin
  • Norgestrel
  • Ofloxacin
  • Oxycodone
  • Methacholine
  • Norgestimate
  • Methadone
  • Oxymorphone
  • Peginterferon Alfa-2b
  • Periciazine
  • Midazolam
  • Morphine
  • Ponesimod
  • Potassium Oxybate
  • Pregabalin
  • Propafenone
  • Quetiapine
  • Remifentanil
  • Pentazocine
  • Revefenacin
  • Rofecoxib
  • Scopolamine
  • Zileuton
  • Trazodone
  • Secretin Human
  • Remimazolam
  • Sodium Oxybate
  • Sotalol
  • Sufentanil
  • Tapentadol
  • Voclosporin
  • Zolpidem
  • Tiotropium
  • Tramadol
  • Vemurafenib
  • Verapamil
  • Ticlopidine

Using Tizanidine with any of the following medicines is usually not recommended. If both medicines are prescribed by your doctor together, he may change the dose of the drug.


  • Alcohol
  • Tobacco


Tell your doctor if you are allergic to it or if you have a history of any other allergies. Tell your doctor or health care provider if:

  • If you have kidney disease.
  • If you have liver disease.
  • You are taking Ciprofloxacin (Cipro) or fluvoxamine. There are chances that your doctor will not recommend to take this medicine if you’re taking either of these medications.
  • If you are pregnant or planning to get pregnant.
  • If you are breast-feeding.
  • If you are having an operation or surgery, such as a dental surgery.
  • Do not consume alcohol, it can make you more dizzy.
  • This medication can make you drowsy. Do not perform any task that require alertness such as car driving, operating a machine, etc..

Tell your doctor or health care provider what other medications, nutritional supplements, herbal products and vitamins you are currently taking. Be sure to mention any of the following:

  • Acyclovir (Zovirax)
  • Baclofen
  • Cimetidine (Tagamet)
  • Amiodarone (Cordarone, Pacerone)
  • Clonidine (Catapres, Catapres-TTS)
  • Famotidine (Pepcid, Pepcid AC)
  • Medications for anxiety
  • Diazepam (Valium)
  • Oral contraceptives (birth control pills)
  • Sedatives and sleeping pills
  • Tranquilizers
  • Dantrolene (Dantrium)
  • Medications for seizures or high blood pressure
  • Mexiletine (Mexitil)
  • Propafenone (Rythmol)
  • Fluoroquinolones such as gemifloxacin (Factive)
  • Levofloxacin (Levaquin)
  • Moxifloxacin (Avelox)
  • Norfloxacin (Noroxin)
  • Ofloxacin (Floxin)
  • Zileuton (Zyflo)
  • Ticlopidine (Ticlid)
  • Verapamil (Calan, Covera, Isoptin, Verelan)


Q. Is Tizanidine a strong muscle relaxer?

A. No. Tizanidine is a short-acting muscle relaxer. (2)

Q. Is Tizanidine a narcotic?

A. No. Tizanidine (Zanaflex) is not a narcotic. (3)

Q. Does Tizanidine make you sleepy?

A. This medicine may cause drowsiness, lightheadedness or dizziness in some people. (4)

Q. What is Zanaflex 4 mg used for?

A. This medication is used to reduce and treat muscle spasms caused by certain conditions (such as multiple sclerosis, spinal cord injury). (5)

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