What are the primary uses of Zanaflex 4mg. How should patients take this medication. What are the most common side effects of Zanaflex. Are there any serious precautions to consider when using tizanidine.

Understanding Zanaflex: A Powerful Muscle Relaxant

Zanaflex, also known by its generic name tizanidine, is a medication primarily used to treat muscle spasms. It’s particularly effective for conditions such as multiple sclerosis and spinal cord injuries. The drug works by helping to relax muscles, providing relief from painful and uncomfortable spasms.

Tizanidine belongs to a class of drugs called central alpha-2-adrenergic agonists. These medications work by affecting certain nerve receptors in the spinal cord, which helps reduce muscle tension and spasticity.

How does Zanaflex work in the body?

Zanaflex acts on the central nervous system to reduce muscle tone. It binds to alpha-2 receptors in the spinal cord and brain stem, which leads to a decrease in the release of excitatory neurotransmitters. This action results in muscle relaxation and a reduction in spasticity.

Proper Usage and Dosing Guidelines for Zanaflex

Administering Zanaflex correctly is crucial for its effectiveness and safety. The medication is typically taken orally, with dosing frequency depending on the individual’s condition and response to treatment.

• Usually prescribed every 6 to 8 hours
• Dosage based on medical condition and response to treatment
• Maximum daily dose: 36 milligrams
• No more than 3 doses in a 24-hour period

Doctors often start patients on a low dose and gradually increase it to minimize side effects. It’s essential to follow your healthcare provider’s instructions carefully and not exceed the recommended dosage.

Can the absorption of Zanaflex vary depending on how it’s taken?

Yes, the absorption of Zanaflex can vary significantly based on several factors:

1. Whether it’s taken as a tablet or capsule
2. If it’s consumed with food or on an empty stomach
3. Whether the contents of the capsule are sprinkled on food

These variations in absorption can affect the medication’s efficacy and potential side effects. It’s crucial to discuss with your doctor the best way to take Zanaflex, especially when considering dose changes or switching between different forms of the medication.

Potential Side Effects: What to Watch For

Like all medications, Zanaflex can cause side effects. While many people tolerate the drug well, it’s important to be aware of potential adverse reactions.

What are the most common side effects of Zanaflex?

The most frequently reported side effects include:

• Dry mouth
• Drowsiness
• Dizziness
• Lightheadedness
• Constipation
• Weakness
• Fatigue

If these effects persist or worsen, it’s important to consult your healthcare provider. They may adjust your dosage or recommend strategies to manage these side effects.

Are there any serious side effects associated with Zanaflex use?

While less common, some serious side effects can occur with Zanaflex use. These include:

• Fainting
• Mental/mood changes (including hallucinations)
• Slow or irregular heartbeat
• Vision changes (such as blurred vision)
• Liver disease (rare but potentially fatal)

Symptoms of liver disease may include persistent nausea/vomiting, severe abdominal pain, dark urine, or yellowing of the eyes/skin. If you experience any of these serious side effects, seek medical attention immediately.

Drug Interactions and Precautions

Zanaflex can interact with various substances and medical conditions, potentially altering its effectiveness or increasing the risk of side effects.

Which substances should be avoided while taking Zanaflex?

Certain substances can intensify the side effects of Zanaflex or interact negatively with the medication:

• Alcohol: Can increase drowsiness and dizziness
• Marijuana (cannabis): May enhance sedative effects
• Other central nervous system depressants
• Certain antibiotics and antidepressants

Always inform your healthcare provider about all medications, supplements, and recreational substances you use to avoid potential interactions.

Are there specific medical conditions that require caution when using Zanaflex?

Certain medical conditions may increase the risk of adverse effects or require dosage adjustments:

• Low blood pressure
• Kidney disease
• Liver disease
• History of fainting or dizziness

Patients with these conditions should be closely monitored when starting Zanaflex or adjusting their dosage.

Special Considerations for Older Adults

Older adults may be more sensitive to the effects of Zanaflex, particularly its sedative properties. This increased sensitivity can lead to a higher risk of side effects, especially dizziness and drowsiness.

Why might older adults be at higher risk when taking Zanaflex?

Several factors contribute to the increased risk in older adults:

• Age-related changes in metabolism and drug clearance
• Potential interactions with other medications commonly used by older adults
• Increased susceptibility to falls due to dizziness and drowsiness

Healthcare providers may start older patients on lower doses and monitor them more closely for side effects. It’s crucial for older adults to communicate any concerns or unusual symptoms to their doctor promptly.

Pregnancy and Breastfeeding Considerations

The use of Zanaflex during pregnancy and breastfeeding requires careful consideration and should be discussed thoroughly with a healthcare provider.

Is Zanaflex safe to use during pregnancy?

The safety of Zanaflex during pregnancy has not been definitively established. Current guidelines suggest that it should only be used during pregnancy when clearly necessary. The potential benefits must be weighed against the possible risks to the developing fetus.

Pregnant women or those planning to become pregnant should discuss their treatment options with their healthcare provider. In some cases, alternative medications or therapies may be recommended.

Can Zanaflex be used while breastfeeding?

It is currently unknown whether Zanaflex passes into breast milk. Due to this uncertainty, breastfeeding mothers should consult their doctor before using this medication. The potential risks to the nursing infant must be carefully evaluated against the benefits of the treatment for the mother.

In some cases, healthcare providers may recommend temporarily discontinuing breastfeeding or choosing an alternative medication that is known to be safer during lactation.

Managing Withdrawal and Long-term Use

Long-term use of Zanaflex can lead to physical dependence, making it important to understand how to manage potential withdrawal symptoms and the implications of extended use.

What are the symptoms of Zanaflex withdrawal?

Abrupt discontinuation of Zanaflex, especially after long-term or high-dose use, can lead to withdrawal symptoms such as:

• Anxiety
• Tremor
• Increased blood pressure
• Elevated heart rate
• Muscle tenseness

To minimize the risk of withdrawal, doctors typically recommend a gradual reduction in dosage rather than sudden cessation. This tapering process allows the body to adjust to decreasing levels of the medication over time.

How should patients approach long-term use of Zanaflex?

Long-term use of Zanaflex requires ongoing monitoring and communication with healthcare providers. Patients should:

1. Attend regular check-ups to assess the medication’s effectiveness
2. Report any changes in symptoms or new side effects
3. Discuss any concerns about dependence or tolerance
4. Be aware of potential interactions with other medications or substances
5. Follow prescribed dosing schedules carefully

It’s important to note that the effectiveness of Zanaflex may change over time, and dosage adjustments may be necessary. Patients should never adjust their dosage without consulting their healthcare provider first.

Monitoring and Follow-up Care

Regular monitoring is crucial for patients taking Zanaflex to ensure its continued effectiveness and to catch any potential complications early.

What types of monitoring might be necessary for patients on Zanaflex?

Depending on the individual’s health status and response to the medication, monitoring may include:

• Regular blood pressure checks
• Liver function tests
• Assessment of muscle spasticity and overall symptom control
• Evaluation of side effects and their impact on daily life
• Monitoring for signs of dependence or tolerance

The frequency of these check-ups will be determined by the healthcare provider based on the patient’s individual needs and risk factors.

How can patients effectively communicate with their healthcare providers about Zanaflex use?

Open and honest communication with healthcare providers is essential for optimal management of Zanaflex therapy. Patients should:

1. Keep a log of symptoms and side effects
2. Report any changes in their condition, whether improvements or worsening
3. Discuss any difficulties in adhering to the prescribed regimen
4. Ask questions about alternative treatments or dosing strategies
5. Inform their provider about any new medications or supplements they start taking

By maintaining clear communication, patients and healthcare providers can work together to optimize the benefits of Zanaflex while minimizing potential risks and side effects.

Zanaflex Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

This medication is used to treat muscle spasms caused by certain conditions (such as multiple sclerosis, spinal cord injury). It works by helping to relax the muscles.

How to use Zanaflex

Take this medication by mouth as directed by your doctor, usually every 6 to 8 hours.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). 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. Do not take more than 36 milligrams a day or more than 3 doses in a 24-hour period.

Your body will absorb this medication differently depending on whether you take it as a tablet or capsule, whether you take it with food or on an empty stomach, or if you sprinkle the contents of the capsule on food. Be sure to discuss with your doctor how to take this medication to determine the best way to take your dose, especially when changes to your dose are being considered or if your doctor prescribes a different form of tizanidine (such as tablet or capsule).

If you suddenly stop using this medication, you may have withdrawal symptoms (such as anxiety, tremor, increased blood pressure/heart rate/muscle tenseness). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used tizanidine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Dry mouth, drowsiness, dizziness, lightheadedness, constipation, weakness, and tiredness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting, mental/mood changes (such as hallucinations), slow/irregular heartbeat, vision changes (such as blurred vision).

Tizanidine has rarely caused very serious (rarely fatal) liver disease. Tell your doctor right away if you develop symptoms of liver disease, including: nausea/vomiting that doesn’t stop, severe stomach/abdominal pain, dark urine, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking tizanidine, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood pressure, kidney disease, liver disease.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness and drowsiness. These effects can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: certain drugs to treat high blood pressure (alpha agonists such as clonidine, methyldopa).

Other medications can affect the removal of tizanidine from your body, which may affect how tizanidine works. Examples include birth control pills, ciprofloxacin, fluvoxamine, viloxazine, among others.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), other muscle relaxants, and opioid pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Does Zanaflex interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness/drowsiness, confusion, slow/shallow breathing, fainting.

Do not share this medication with others.

Lab and/or medical tests (such as blood pressure, liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

Zanaflex 6 mg capsule

Color: blueShape: oblongImprint: 6 MG

This medicine is a blue, oblong, capsule imprinted with “6 MG”.

Zanaflex 4 mg capsule

Color: white,blueShape: oblongImprint: 4 MG

This medicine is a blue, oblong, capsule imprinted with “6 MG”.

Zanaflex 2 mg capsule

Color: light blueShape: oblongImprint: 2 MG

This medicine is a blue, oblong, capsule imprinted with “6 MG”.

Zanaflex 4 mg tablet

Color: whiteShape: roundImprint: logo and 594

This medicine is a blue, oblong, capsule imprinted with “6 MG”.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Zanaflex: Uses, Dosage & Side Effects

Generic name: tizanidine [ tye-ZAN-i-deen ]
Drug class: Skeletal muscle relaxants

Medically reviewed by Kaci Durbin, MD. Last updated on Mar 29, 2023.

What is Zanaflex?

Zanaflex is a short-acting muscle relaxer. It works by blocking nerve impulses (pain sensations) that are sent to your brain.

Zanaflex is used to treat spasticity associated with diseases like multiple sclerosis and spinal cord injuries by temporarily relaxing muscle tone.

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

Warnings

Zanaflex is a short-acting medication that should be taken only for daily activities that require relief from muscle spasticity.

You should not take tizanidine if you are also taking fluvoxamine (Luvox) or ciprofloxacin (Cipro).

Do not use Zanaflex at a time when you need muscle tone for safe balance and movement during certain activities. In some situations, it may endanger your physical safety to be in a state of reduced muscle tone.

Switching between Zanaflex tablets and capsules, or changing the way you take it with regard to eating, can cause an increase in side effects or a decrease in therapeutic effect. Follow your doctor’s instructions carefully. After making any changes in how you take Zanaflex, contact your doctor if you notice any change in how well the medicine works or if it causes increased side effects.

Do not take more than three doses (36 mg) of tizanidine in a 24-hour period. Too much of tizanidine can damage your liver. Cold or allergy medicine, narcotic pain medicine, sleeping pills, other muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by tizanidine. Tell your doctor if you need to use any of these other medicines together with Zanaflex.

Avoid drinking alcohol. It can increase some of the side effects of tizanidine.

Before taking this medicine

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

To make sure Zanaflex is safe for you, tell your doctor if you have ever had:

It is not known whether Zanaflex 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 tizanidine. Ask your doctor about any risk.

How should I take Zanaflex?

Take Zanaflex exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

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

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

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

You will need frequent blood tests to check your liver function.

If you stop using Zanaflex 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.

What happens if I miss a dose?

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.

What happens if I overdose?

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.

What to avoid

Do not use Zanaflex 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 Zanaflex will affect you. Your reactions could be impaired. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Zanaflex side effects

Get emergency medical help if you have signs of an allergic reaction to Zanaflex: 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

• yellowing of the eyes or skin.

• pain or burning when you urinate.

Common Zanaflex side effects may include:

• drowsiness, dizziness, weakness;

• dry mouth;

• feeling nervous;

• blurred vision;

• flu-like symptoms;

• 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.

Dosing information

Usual Adult Dose for Muscle Spasm:

-Initial dose: 2 mg orally every 6 to 8 hours as needed
-The dose of Zanaflex can be increased by your doctor if needed
-The medication effects peak in about 1 to 2 hours and last for 3 to 6 hours
-Do not take more than 16mg of Zanaflex at one time. Do not take more than 36mg in 24 hours.

Comments:
-The capsules and tablets are absorbed differently by the body. Do not switch from one to the other without talking to your doctor.
-Zanaflex should be taken with food every time or without food every time. Do not switch back and forth.

What other drugs will affect Zanaflex?

Taking Zanaflex 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, including ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin, or others;

• blood pressure medicine such as clonidine, guanfacine, methyldopa;

• heart rhythm medicine including amiodarone, mexiletine, propafenone, verapamil; or

• stomach acid medicine such as cimetidine, famotidine.

This list is not complete. Other drugs may interact with tizanidine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Popular FAQ

The maximum effect of tizanidine occurs about 1 hour to 2 hours after taking a dose. It wears off in about 3 to 6 hours after taking it. Tizanidine is typically given no more than 3 times a day.

Tizanidine is not listed as a controlled substance by the U.S. Drug Enforcement Administration (DEA). Abuse potential has not been evaluated in human studies.

Tizanidine can cause sleepiness, but it has not been approved by the U.S. Food and Drug Administration (FDA) to treat sleep disorders. Tizanidine is a skeletal muscle relaxant. It is approved by the FDA to help relieve muscle spasms.

Tizanidine is known to cause low blood pressure. In some cases, it may cause low blood pressure that is so low that you could faint or pass out. The chances of fainting can be lowered if your doctor raises the dose of tizanidine very slowly. You may also have to be careful when you move from a sitting position to a standing position. In clinical trials, the most common side effects of tizanidine were dry mouth, sleepiness, dizziness and asthenia (defined as weakness, fatigue and/or tiredness).

Tizanidine normally starts working 1 to 2 hours after taking it. It wears off about 3 hours to 6 hours after taking it. Tizanidine can be taken up to 3 times a day to help relieve muscle spasms.

Tizanidine may be addictive, but it has not been evaluated in human studies. Withdrawal symptoms have been reported after abruptly stopping tizanidine, but abuse of other medications concomitantly was suspected in these cases. Dosing should be tapered off to avoid possible withdrawal symptoms.

Tizanidine is not known to cause weight gain. In clinical trials, the most common side effects of tizanidine were dry mouth, sleepiness, dizziness and asthenia (defined as weakness, fatigue and/or tiredness).

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Zanaflex vs Flexeril: Differences, Similarities & What’s Best for You – Drug Vs. Friend

Home >> Drug Vs. Friend >> Zanaflex vs Flexeril: Differences, Similarities and Which is Best for You

Drug Vs. Friend

Drug Overview and Key Differences | Conditions of treatment | Efficiency | Insurance coverage and cost comparison | Side effects | Drug Interactions | Warnings | FAQ

Flexeril brand no longer available; however, it is still available in generic form – cyclobenzaprine – and under the brand names Amrix and Fexmid.

Zanaflex (tizanidine) and Flexeril (cyclobenzaprine) are muscle relaxants used to treat painful conditions of the musculoskeletal system. If you are experiencing neck or back strain, a muscle relaxant such as Zanaflex or Flexeril may be recommended. These drugs can also help relieve muscle spasms and stiffness associated with other physical conditions and injuries.

Like other muscle relaxants, Zanaflex and Flexeril act on the central nervous system (CNS). They also have similar side effects and cost. However, they are used and formulated differently.

What are the main differences between Zanaflex and Flexeril?

Zanaflex

Zanaflex (what is Zanaflex?) is a brand name for tizanidine that acts as an alpha-2 adrenoceptor agonist. It was originally approved at 1996 for the treatment of muscle spasticity. Although its exact mechanism of action is unknown, it is thought to help muscle spasticity by suppressing motor nerve signals.

Zanaflex is available in 2 mg and 4 mg oral tablets. It is also available as an oral capsule in dosages of 2mg, 4mg, and 6mg. Zanaflex is usually taken up to three times a day.

Flexeril

Flexeril (What is Flexeril?) is a brand name drug originally approved by the Food and Drug Administration at 1977 year. The generic version of Flexeril, cyclobenzaprine, is widely available. Flexeril is structurally similar to tricyclic antidepressants and primarily acts on the central nervous system (CNS). It helps reduce muscle hyperactivity by acting on the gamma and alpha motor systems.

Cyclobenzaprine is no longer available as Flexeril. Instead, cyclobenzaprine can be found under different brand names: Amrix (extended release) and Fexmid (immediate release). The immediate release cyclobenzaprine can be taken up to three times a day, and the extended release form can be taken once a day.

Main differences between Zanaflex and Flexeril
	Zanaflex ril
Drug class	Relaxes muscles	Relaxes muscles
Brand/generic status	Branded and generic versions available	Branded and Generic Versions Available The Flexeril brand name is no longer available in the US. Other brand names include Amrix and Fexmid.
What is the common name?	Tizanidine	Cyclobenzaprine
What form(s) does the drug come in?	Oral tablet Oral capsules	Oral tablet Extended release oral capsule
What is the standard dosage?	Initial dose of 2 mg, followed by subsequent doses every 6 to 8 hours. Maximum 3 doses in 24 hours. The dosage can be increased every 1-4 days by 2-4 mg. The maximum daily dose is 36 mg.	Immediate-release tablets: 5 mg to 10 mg three times a day. Extended-release capsules: 15 to 30 mg once daily.
How long does a typical treatment take?	Short or long term depending on the condition	Not more than 2-3 weeks
Who usually takes this medicine?	Adults aged 18 and over	Adults and young people aged 15 and over

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Diseases treated by Zanaflex and Flexeril

Both Zanaflex and Flexeril are medicines used for muscle cramps and pain relief from the musculoskeletal system. Zanaflex is commonly prescribed to treat spasticity caused by multiple sclerosis, cerebral palsy, and spinal cord injury. Flexeril is often prescribed to relieve muscle pain and spasms caused by sprains in the back and neck.

Zanaflex and Flexeril are sometimes prescribed off-label for the treatment of fibromyalgia and migraine. Zanaflex or Flexeril, which are often combined with other medications, can also help manage muscle stiffness and tremors associated with tetanus.

90 049 Muscle spasms 9004 9 Fibromyalgia

Condition	Zanaflex	Flexeril
yes	yes
Musculoskeletal disorders	yes	yes
Tetanus	yes	yes
Off label	Off label
Migraines	Off label	Off label

9 0024 Are Zanaflex or Flexeril more effective?

Zanaflex and Flexeril are effective drugs for muscle cramps and muscle pain. Their use depends on which one is more suitable in each case. There are currently no clinical data showing a direct comparison of the two drugs.

According to a meta-analysis, cyclobenzaprine has been studied in most clinical trials with evidence to support its use. Tizanidine has been shown to be effective in spasticity caused by multiple sclerosis. Both cyclobenzaprine and tizanidine have been shown to be effective in musculoskeletal disorders such as acute neck or back pain.

A meta-analysis evaluated over 100 different studies comparing several muscle relaxants, including Lioresal (baclofen), Soma (carisoprodol), Robaxin (methocarbamol), Skelaxin (metaxalone), and Valium (diazepam). Overall, the study showed that these drugs are comparable in terms of efficacy and safety. Other recommendations suggest that muscle relaxants cause: increased drowsiness and should only be used for short periods.

Drugs such as Zanaflex and Flexeril are often recommended along with physiotherapy for pain relief. Consult with your doctor to determine the best treatment option for you.

Zanaflex vs Flexeril coverage and cost comparison

Generic Zanaflex is usually covered by most Medicare programs and insurance plans. The amount prescribed will vary depending on the strength of the drug and the doctor’s instructions. The average retail price of Zanaflex is about $56. With a Zanaflex discount coupon, retail value can be less than $10 for a 30.4mg tablet.

Flexeril is also covered by most Medicare and health plans when prescribed as a generic drug. Immediate-release tablets are usually recommended to be taken several times a day. The average retail price for a prescription for cyclobenzaprine can be around $42. You can also use a Flexeril Coupon to get a discount of around $7 at a participating pharmacy.

9004 9 Typical Medicare copay

	Zanaflex	Flexeril
Usually covered by insurance?	yes	yes
Usually covered by Medicare?	yes	yes
Standard dosage	4 mg tablet every 6-8 hours	10 mg tablet three times a day
$0-41	$1-35
SingleCare Cost	$9 +	$7 +

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Common Side Effects Zanaflex versus Flexeril

The most common side effects of Zanaflex include dry mouth, drowsiness, dizziness, muscle weakness or fatigue, and constipation. Other reported side effects include urinary tract infections (UTIs) and involuntary movements (dyskinesia).

The most common side effects of Flexeril include drowsiness, dry mouth, headache, fatigue and dizziness. Flexeril is also known to cause other side effects such as constipation and nausea. Zanaflex Flexeril Side effect Applicable? Frequency Applicable? Frequency Drowsiness yes 48% yes 29% Dry mouth

9 0049 yes 49% yes 21% Headache No

5% Fatigue yes 41% yes 6% 052

yes 16% yes 1% -3% Nausea No – yes 3% Constipation yes 4% yes 1% -3% DWS

900 49 yes 10% No – 0049 –

This may not be a complete list of side effects you may experience. Please contact your doctor or health care provider for more information.
Source: DailyMed (Zanaflex), DailyMed (Flexeril)

Drug Interactions between Zanaflex and Flexeril

Zanaflex is primarily metabolized by the CYP1A2 enzyme in the liver. Medicines that block or inhibit this enzyme may increase the levels of Zanaflex in the body. Elevated levels of the drug can lead to increased side effects such as drowsiness and dizziness. Zanaflex should be avoided with CYP1A2 inhibitors such as ciprofloxacin and cimetidine, as well as with birth control pills containing ethinyl estradiol.

Flexeril may interact with serotonergic drugs such as antidepressants and MAO inhibitors. Taking these drugs with Flexeril may increase your risk of serotonin syndrome, a condition that requires immediate medical attention.

Both Zanaflex and Flexeril may interact with drugs that have CNS depressant effects. These types of drugs include barbiturates, opioids, and benzodiazepines. Zanaflex and Flexeril can enhance their effect and lead to increased dizziness and sedation.

9No

Drug	Drug class	Zanaflex	Flexeril 9 No 0052
Ethinylestradiol Norethindrone Levonorgestrel	Oral contraceptives
Amitriptyline Nortriptyline Clomipramine	Tricyclic antidepressants	No nobarbital Pentobarbital Secobarbital	Barbiturates	yes	yes
Oxycodone Hydrocodone Tramadol	Opioids	yes	yes
Alprazolam Lorazepam 90 016 Diazepam	Benzodiazepines	yes	yes

*Consult your doctor about interactions with other medicines.

Zanaflex and Flexeril Warnings

Zanaflex may cause hypotension or abnormally low blood pressure. This effect usually manifests itself as orthostatic hypotension which occurs when a person shifts to an upright position after lying down. In excessive doses, Flexeril is also known to cause changes in blood pressure.

Zanaflex may cause liver damage in some people, especially those with a history of liver dysfunction. Flexeril should also be used with caution in people with liver problems.

Flexeril is known to cause serotonin syndrome, especially when taken with certain antidepressants, MAO inhibitors and opioids. When starting treatment with Flexeril, signs and symptoms of serotonin syndrome should be monitored.

Frequently asked questions about Zanaflex and Flexeril

What is Zanaflex?

Zanaflex or tizanidine is a muscle relaxant used to treat muscle spasticity caused by multiple sclerosis and spinal cord injury. It works by blocking signals between motor nerves to relax muscle tone. It is usually taken in 2mg or 4mg tablets every six to eight hours.

What is flexeril?

Flexeril is the brand name for cyclobenzaprine. It is a muscle relaxant indicated for acute painful conditions of the musculoskeletal system such as neck or back pain. It works in the central nervous system (CNS), relieving muscle pain and spasms. Cyclobenzaprine is available in both immediate and extended release forms.

Are Zanaflex and Flexeril the same thing?

Zanaflex and Flexeril are not the same thing. The half-life of Zanaflex is about 2.5 hours, while Flexeril has an average of 18 hours. Zanaflex is only available as immediate-release tablets and oral capsules, while Flexeril is available as extended-release capsules.

Zanaflex or Flexeril is better?

Zanaflex is a new drug approved by the FDA for the treatment of muscle spasticity due to multiple sclerosis and spinal cord injury. Flexeril is an older drug that has been more extensively studied for musculoskeletal pain and spasms. The best medicine is the one that works best for your particular condition. Check with your doctor to find the best option for you.

Can I use Zanaflex or Flexeril during pregnancy?

Zanaflex may be harmful to an unborn baby according to animal studies. There have been no adequate animal or human studies to show that Flexeril is harmful during pregnancy. Muscle relaxants should only be used if there are clear benefits that outweigh the potential risks. Talk to your doctor about treatment options during pregnancy.

Can I use Zanaflex or Flexeril with alcohol?

Drinking alcohol while taking Zanaflex or Flexeril may increase the sedative effect of these drugs. It is generally not recommended to drink alcohol with muscle relaxants.

Is tizanidine better than cyclobenzaprine?

Tizanidine may be preferred for muscle spasms caused by multiple sclerosis, cerebral palsy and spinal cord injury. Cyclobenzaprine is used along with physical therapy and rest to relieve pain and muscle spasms.

Is Zanaflex addictive?

Zanaflex is not a DEA controlled substance. However, like other muscle relaxants, it can be abused by some people. Zanaflex is considered a short-term treatment option. Abuse and dependence can occur with prolonged use and lead to addiction.

Does Flexeril help with pain?

Flexeril may indirectly relieve pain associated with muscle spasms. Depending on what is causing the pain, your doctor may first recommend an over-the-counter drug such as acetaminophen or ibuprofen.

Zanaflex instructions, description and reviews

Pronunciation

Generic name: tizanidine (tye ZAN i deen)
Names brands : Zanaflex

Zanaflex (tizanidine) is short-acting muscle relaxer. It works by blocking nerve impulses (pain sensations) that are sent to your brain.

Zanaflex is used to treat spasticity by temporarily relaxing muscle tone.

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

Zanaflex is a short acting drug that should only be taken for daily activities that require relief from muscle spasticity.

You should not take tizanidine if you are taking fluvoxamine (Luvox) or ciprofloxacin (Cipro).

Do not use Zanaflex at a time when you need muscle tone for safe balance and movement during certain activities. In some situations, this can compromise your physical safety in a state of reduced muscle tone.

Slideshow Muscle cramps: is there anything to worry about?

Switching between Zanaflex tablets and capsules or changing the way it is taken with regards to food may cause an increase in side effects or a decrease in therapeutic effect. Follow your doctor’s instructions carefully. After making any changes to how you take Zanaflex, contact your doctor if you notice any changes in how well the medicine works or if it causes increased side effects.

Do not take more than three doses (36 mg) of tizanidine in a 24 hour period. Too much tizanidine can damage your liver. Cold or allergy medicine, narcotic pain medicine, sleeping pills, other muscle relaxers, and medicine for seizures, depression, or anxiety can add to tizanidine-induced drowsiness. Tell your doctor if you need to use any of these other medicines along with Zanaflex.

Avoid alcohol. This may increase some of the side effects of tizanidine.

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

To make sure Zanaflex is safe for you, tell your doctor if you have:

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

It is not known whether tizanidine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

Take Zanaflex exactly as it was prescribed for you. Follow all directions on the prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts, or for longer than recommended.

In most cases, you can take Zanaflex up to 3 times in one day if needed. Allow 6 to 8 hours to pass between doses.

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

Switching between Zanaflex tablets and capsules may also cause changes in side effects or drug efficacy.

Follow your doctor’s instructions carefully. After making any changes to how you take Zanaflex, contact your doctor if you notice any changes in side effects or how well the medication works.

Zanaflex is a short acting drug and its effects will be most noticeable between 1 and 3 hours after taking it. You should only take this medicine for daily activities that require relief from muscle spasms.

Do not exceed three doses (36 mg) in 24 hours. Too much of this medicine can damage your liver.

You will need frequent blood tests to check your liver function.

If you stop using Zanaflex suddenly after prolonged use, you may experience withdrawal symptoms such as dizziness, fast heartbeat, tremors and restlessness. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

See also: Dosing Information (more details)

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up for a missed dose.

Read also about Renova.

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 of light driving or fainting.

Do not use Zanaflex at a time when you need muscle tone for safe balance and movement during certain activities. In some situations, a decrease in muscle tone can be dangerous for you.

Drinking alcohol with this medicine may cause side effects.

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires your attention. Avoid getting up too quickly from a sitting or lying position, or you may feel dizzy. Stand up slowly and steadily to prevent falling.

Read also about Orencia.

Get emergency medical help if you have signs of an allergic reaction to Zanaflex : hives; Labored breathing; Swelling of the face, lips, tongue, or throat.

Call your doctor right away if you have:

• Feeling light-headed like you might disappear;

• Weak or shallow breathing;

• Confusion, hallucinations; or

• Pain or burning when urinating.

Common side effects of Zanaflex may include:

• Drowsiness, dizziness, weakness;

• nervous;

• Blurred vision;

• Flu-like symptoms;

• Dry mouth, anxiety;

• Abnormal liver function tests;

• Runny nose, sore throat;

• Urination problems;

• Vomiting, constipation; or

• Uncontrolled muscle movements.

This is not a complete list of side effects and others may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

See also: Side Effects (more details)

Usual Adult Dose for Muscle Cramps:

Initial Dose: 2 mg orally every 6 to 8 hours as needed
– Printing effects occur after about 1-2 hours and last from 3 to 6 hours; Treatment may be repeated as needed up to three doses within 24 hours; Gradually increase the dose by 2-4 mg at intervals of 1 to 4 days until a satisfactory reduction in muscle tone is achieved.
Maximum single dose: 16 mg
Maximum daily dose: 36 mg in 24 hours

Comments:
-Clinically significant differences in absorption are expected between capsules and tablets when taken with or without food; These differences may lead to changes in efficacy and tolerability.
– When a decision is formulated and a decision is made to take with or without food, this regimen should not be changed.

Use: Management of spasticity.

Taking Zanaflex with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Tell your doctor about all your current medicines and if you start or stop using, especially:

• aciclovir;

• ticlopidine;

• Zileuton;

• Birth control pills;

• Antibiotic – ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin or ofloxacin;

• Blood pressure drug – clonidine, guanfacine, methyldopa;

• Heart rhythm medicine – amiodarone, mexiletine, propafenone, verapamil; or

• Stomach acid – cimetidine, famotidine.

This list is not exhaustive. Other drugs may interact with tizanidine, including prescription and over-the-counter medicines, vitamins, and herbal products.