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Skeletal Muscle Relaxant, Spasms, Spasticity Control,
Tizanidine Hydrochloride (HCL), Zanaflex

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Tizanidine HCl, Cautions, Drugstore.com:"DO NOT STOP TAKING THIS MEDICINE without first checking with your doctor. Some conditions may become worse when this medicine is suddenly stopped. Your dose may need to be gradually decreased to avoid side effects. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, tell the doctor or dentist that you are using this medicine. THIS MEDICINE MAY CAUSE DROWSINESS. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. Ask your doctor or pharmacist if you have questions about which medicines cause drowsiness. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy." Drugstore.com
407 Heron Drive Swedesboro, NJ 08085-9810
1-800-378-4786
e-mail us: aboutrx@drugstore.com
http://www.drugstore.com/qxn49884078253_333181_sespider/tizanidine_hcl/zanaflex/tizanidine_hcl.htm

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Tizanidine hydrochloride, Special Concerns, Healthdigest.org:"Use with caution in renal impairment, in elderly and during laction. Use with extreme caution in hepatic insufficiency. Safety and efficacy have not been determined in children."
Healthdigest.org
210 Morgan Street - C Raleigh, NC 27603
800.782.9200
info@healthdigest.org
http://www.healthdigest.org/drugs/tizanidinehydrochloride.html

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Zanaflex, How does this medication work?, Medbroadcast.com:"Tizanidine belongs to a group of medicines called muscle relaxants. When muscles in your body spasm, cramp, or become tight due to medical problems such as multiple sclerosis or spine injury, the condition is known as spasticity. Muscle relaxants like tizanidine and baclofen are used to treat this condition. They work by blocking excess firing of the nerve cells that control muscle movement. Your doctor may choose to use this medication for other conditions not listed here. If you're unsure why you are taking this medication, please ask your doctor.The benefits of tizanidine are related to its effects on the nervous system. The beneficial effects of tizanidine are noticeable within about one hour of taking the first dose."
MediResource Inc.
18 Wynford Drive Suite 507 Toronto, ON M3C 3S2
Tel: (416) 383-0010
Fax: (416) 383-0005
http://medbroadcast.com/drug_info_details.asp?brand_name_id=1322&dowhat=accept_disclaimer

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Zanaflex, Proper Usage, Nationalmssociety.com:"Tizanidine is a short-acting drug for the management of spasticity. Its peak effectiveness occurs one to two hours after dosing, and is finished between three to six hours after dosing. Therefore, your physician will prescribe a dosing schedule that provides maximal relief during activities and periods of time of greatest importance to you.In order to minimize unwanted side effects with this medication, your physician will start you on a low dose and gradually raise it until a well-tolerated and effective level is reached.Studies of tizanidine have not been done in pregnant women. Animal studies, using doses significantly higher than those prescribed for humans, have resulted in damage to the offspring. If you are pregnant or planning to become pregnant, discuss this with your physician before starting this medication.It is not known whether tizanidine passes into the breast milk. Women should not take this medication while nursing unless told to do so by their physician."
The National Multiple Sclerosis Society
733 Third Avenue New York, NY 10017
http://www.nationalmssociety.com/Meds-Tizanidine_md.asp

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Zanaflex, Most important fact about this drug, PDRhealth.com:"Zanaflex causes drowsiness in almost half the people who use it. It also tends to reduce blood pressure in many people, frequently leading to dizziness and light-headedness. The likelihood of significant drowsiness increases when Zanaflex is combined with other spasticity drugs, such as Lioresal, Klonopin, and Valium. When taking Zanaflex, always be cautious about driving or operating dangerous machinery."
Thomson Healthcare
5 Paragon Drive Montvale, NJ 07645
hostmaster@MEDEC.COM
http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/zan1638.shtml

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Tizanidine, What other drugs will affect tizanidine?, Peacehealth.org:"Tizanidine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.Birth control pills can increase the effects of tizanidine. Tell your doctor if you are taking birth control pills before starting treatment with tizanidine.Tizanidine may lower blood pressure. Tell your doctor if you are taking another medicine to lower blood pressure or a medicine to treat another heart condition.Drugs other than those listed here may also interact with tizanidine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines."
PeaceHealth System Office
14432 SE Eastgate Way, Suite 300 Bellevue, WA 98007-6412
Telephone: (425) 747-1711
Fax: (425) 649-3825
webservices@peacehealth.org
http://www.peacehealth.org/kbase/multum/d04102a1.htm

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Zanaflex, Possible Side Effects, Pillstore.com:"Nausea, drowsiness, dizziness, constipation, unusual weakness or dry mouth might occur. If these continue or are bothersome, notify your doctor. To minimize dizziness, stand up slowly when arising from a sitting or lying position. Notify your doctor if you develop: yellowing skin or eyes, stomach pain, vomiting, hallucinations. Very unlikely but report: vision or hearing changes, urinary frequency or burning, slow or irregular heartbeat, black stool. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist."

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Zanaflex, Possible Side Effects, Quitsmokingpatch.com:"Side effects, that may go away during treatment, include drowsiness, dry mouth, flushing, or dizziness. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience increased muscle weakness; trouble urinating or lack of bladder control; or change in emotions, mood, or behavior. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist."
1-800-Patches
4505 Wasatch Blvd. Suite 130 Salt Lake City, Utah 84124
801-277-8600
561-760-0112 (fax)
info@1800patches.com
http://www.quit-smoking-patch.com/prescription-drugs/zanaflex-muscle-relaxers.htm

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Tizanidine HCl, Drug Interactions, Rxlist.com:"In vitro studies of cytochrome P450 isoenzymes using human liver microsomes indicate that neither tizanidine nor the major metabolites are likely to affect the metabolism of other drugs metabolized by cytochrome P450 isoenzymes.Acetaminophen: Tizanidine delayed the Tmax of acetaminophen by 16 minutes. Acetaminophen did not affect the pharmacokinetics of tizanidine.Alcohol: Alcohol increased the AUC of tizanidine by approximately 20% while also increasing its Cmax by approximately 15%. This was associated with an increase in side effects of tizanidine. The CNS depressant effects of tizanidine and alcohol are additive.Oral Contraceptives: No specific pharmacokinetic study was conducted to investigate interaction between oral contraceptives and tizanidine. Retrospective analysis of population pharmacokinetic data following single and multiple dose administration of 4 mg tizanidine, however, showed that women concurrently taking oral contraceptives had 50% lower clearance of tizanidine compared to women not on oral contraceptives (see PRECAUTIONS)."
RxList LLC
500 3rd Street Suite 530 San Francisco, CA 94107
Ph: (609) 882-8887
info@rxlist.com
http://www.rxlist.com/cgi/generic/tizanidine_ad.htm

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Tizanidine, What should I do if I forget a dose?, Safemedication.com:"If you take several doses per day, take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals. However, if you remember a missed dose when it is almost time for your next scheduled dose, skip the missed dose. Do not take a double dose to make up for a missed one."
American Society of Health-System Pharmacists
7272 Wisconsin Avenue
Bethesda, MD 20814
(301) 657-3000
http://www.safemedication.com/displaydrug.cfm?id=601121

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Tizanidine, What should I avoid while taking tizanidine?, WebMD.com:"Use caution when driving, operating machinery, or performing other hazardous activities. Tizanidine may cause drowsiness and dizziness. If you experience drowsiness or dizziness, avoid these activities. Dizziness is most likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. Use caution with alcohol, other muscle relaxants, sleep or anxiety medicines, and pain medicines. These drugs may increase drowsiness and dizziness while you are taking tizanidine. Do not take any other medicine during treatment with tizanidine without first talking to your doctor or pharmacist."
669 River Drive Center 2 Elmwood Park, NJ 07407
Phone: 201-703-3400
Fax: 201-703-3401
Email: service@webmd.net
http://my.webmd.com/hw/drug_data/d04102a1.asp?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}

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