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Your doctor will tell you before prescribing you Zanaflex (tizanidine) exactly how to take this medication. Follow his or her directions, they can usually be found on the prescription label if you forget.

You should take Zanaflex only for daily activities that require relief from spasticity. Most patients who take Zanaflex take up to 3 doses a day if needed, with a 6-8 hour period in between doses. You may take Zanaflex with or without food, must it must be taken the same way each time. Taking it differently each time may cause ineffectiveness or increased side effects.

Do not take more than 3 doses (36ng) in a 24 hour period; liver damage can be a result of over-using this medication. You may also need frequent blood tests to monitor your liver function during treatment. Ask your doctor how to safely stop this medication before stopping suddenly.

Store at room temperature away from heat and moisture.


Do not use Zanaflex (tizanidine)

You should not use this product if you also use fluvoxamine (Luvox) or ciprofloxacin (Cipro).

Do not use this medication if you are allergic to tizanidine.

Dose adjustment or special precautions may be required

To ensure this medication is safe for you, tell your doctor if you have liver disease, kidney disease, or low blood pressure.

Risks and other information you need to know

This medication is a short-acting medication; only use this medication for daily activities which cause spasticity.

Switching from the tablet to capsule form can cause an increase in side effects or a decrease in effectiveness; this applies if you change how you take the dose (with or without food).

Do not use more than 36mg of tizanidine in a day (24 hour period); liver damage can be a result of using too much of this medication.

It is not known if this medication will harm an unborn baby therefore if you are pregnant, you should speak with your doctor before using this medication.

It has not been established whether this medication will pass into breast milk or if it will harm a nursing infant. Speak to your doctor if you are breast feeding.

Side Effects

Common side effects of Zanaflex (tizanidine) 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; vomiting, constipation; or uncontrolled muscle movements.

The above side effects should not alarm you.

Serious side effects of Zanaflex (tizanidine) may include:

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

If you have any of the above side effects, contact your doctor right away.

Please note this is not a complete list of side effects. Not everyone experiences side effects; they are not guaranteed. If you do have side effects and they become unmanageable, consult your doctor about alternate medications.


What is Tizanidine?

Tizanidine, sold by the brand-name Zanaflex, is a prescription medication that comes in the form of a tablet. Each tablet contains 2 or 4 mg of Tizanidine, which belongs to the drug class called alpha-2-adrenergic agonists. It is swallowed by mouth and metabolized by the liver with a half-life of about 2.5 hours. It is available as a generic alternative; both the brand-name product and the generic alternative can be purchased at My Drug Center with a valid prescription.


What is Tizanidine used for?

Tizanidine is used for patients with certain conditions that cause spasticity. This includes conditions like multiple sclerosis or spinal cord injuries. Spasticity is when muscles contract, become stiff, or spasms which can be uncomfortable and painful at times, and always involuntary and uncontrollable. It occurs when nerve impulses that control movement in the muscles are disturbed or damaged. Using Tizanidine can help manage these uncontrollable muscle spasms (spasticity).


How long does Tizanidine stay in your system?

Tizanidine doesn’t remain in the system for very long due to its short half-life of 2.5 hours. This means it will remain in the system for about 12.5 hours, about half a day. However, this medication creates inactive metabolites during metabolism; the metabolites will remain in the system for longer than Tizanidine will (for up to 8 days following your dose).


What does Tizanidine do?

Tizanidine has an effect on certain nerve impulses. These nerve impulses send pain sensations to your brain which causes the muscles to contract and stiffen. Tizanidine blocks these impulses from being sent which prevents spasticity and temporarily relaxes the muscle tone.


How long does Tizanidine last?

The exact amount of time this medication remains effective following your dose may vary between each individual. Generally, Tizanidine will have peak effects after 1-2 hours following your dose and should last for up to 6 hours. This medication is commonly taken three times per day, about every 6-8 hours as needed, to ensure a consistent level of the drug remains in the system so effects last.


What are the side effects of Tizanidine?

Some commonly reported side effects of Tizanidine include drowsiness, weakness, feeling nervous, blurred vision, flu-like symptoms, and dry mouth. However, there are other side effects which may also occur that are not listed here. Side effects should not alarm you as they are a normal response of the body when taking a new medication; if they do not go away over time or become unmanageable, you may want to consider consulting with your doctor.


What class of drug is Tizanidine?

Tizanidine belongs to the drug class known as alpha-2-adrenergic agonists. It can also be considered a muscle relaxant. These types of drugs bind to and activate the adrenergic alpha-2 receptors, which are receptors that neurotransmitters, such as norepinephrine (noradrenaline) and epinephrine (adrenaline), use in order to send signals though the central and peripheral nervous systems. These receptors can be found in many places throughout the central nervous system, such as the brainstem, midbrain, spinal cord, cerebral cortex, and septum, among others.


What does Zanaflex look like?

Zanaflex is a small round tablet which is commonly white in color. It can also sometimes come as a blue or blue and white capsule; it may vary depending on location. The generic form of this medication can have many different appearances, but commonly comes as a small white round or oval tablet.


How much does Zanaflex cost?

The cost of Zanaflex varies; internationally, the cost of 120 tablets can be found for as low as $68.00, about $0.57 per tablet. In the United States, the cost is much higher; a supply of 120 tablets is about 5 times as expensive. If you would like to save money on your medication, you may want to consider ordering internationally through My Drug Center. Keep in mind, a valid prescription will be required.


What is the difference between Zanaflex and Flexeril?

These two drugs (Zanaflex and Flexeril) are very similar and used for the same indication, muscle spasms (spasticity), so what makes them different? There are many differences between these two medications, and though there may be more than listed, here are 6 examples of how they differ;

Active Ingredient: Zanaflex is made up of Tizanidine; Flexeril is made up of Cyclobenzaprine. Tizanidine creates metabolites that are not known to be active and is metabolized by only one enzyme in the liver (CYP1A2); Cyclobenzaprine create metabolites that are active and is metabolized by a couple different liver enzymes (major CYP3A4 and CYP1A2; minor CYP2D6).

Available Dosages: Zanaflex is available in 2 and 4 mg tablets; Flexeril is available in 5, 7.5, and 10 mg tablets. Tizanidine is available in lower strengths which may be better for those with less severe muscle spasms; Flexeril is available in higher strengths which may be better for those with more severe muscle spasms.

Drug Class/Mechanism of Action: Both Zanaflex and Flexeril are muscle relaxants, but Zanaflex is also an alpha-2-adrenergic agonists. This means these two medications work to relax muscles in different ways. Zanaflex binds to and activates the adrenergic alpha-2 receptors while Flexeril has a mechanism of action that isn’t fully understood but is thought to affect the brain stem to reduce tonic somatic motor activity.

Half-Life: Zanaflex has a half-life of only 2.5 hours, compared to Flexeril’s long half-life of roughly 32 hours. Half-lives indicate how long it takes for a medication to clear by 50%. Zanaflex will clear the system long before Flexeril will. Generally, a longer half-life means fewer doses may be needed however a shorter half-life may allow a quicker onset of effects.

Pregnancy Warning: Zanaflex is category C; Flexeril is category B. All medications will fall into a pregnancy category of A, B, C, D, or X, which measures the risk of the drug on a fetus if taken by an expecting mother.  Zanaflex has been shown to have adverse effects on the fetus in animal studies, but has not yet been established in human studies, but the potential benefit may outweigh the risk. Flexeril has failed to demonstrate a risk to the fetus in animal studies, but has not yet been established in human studies.

Known Drug Interactions: Zanaflex has 193 more known drug interactions than Flexeril. Zanaflex has 564 known drug interactions compared to the 371 known to Flexeril. This difference indicates that Flexeril may be a better medication for those who already take other prescription medications.

Brand Discontinuation: Flexeril is no longer available as a brand. The manufacturers of Flexeril discontinued the brand medication, so Flexeril is only available as a generic alternative. Zanaflex is available as both the brand-name product and generic alternative. This is a minor difference, as generic medications are very much similar to the brand and only differ in a few ways (such as appearance and packaging), however, if you prefer brand-name medications, this difference may matter to you.

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