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Zanaflex
Zanaflex (tizanidine) is a muscle relaxant commonly prescribed to treat muscle spasticity. It works by temporarily relaxing muscle tone and relieving muscle spasms associated with conditions such as multiple sclerosis, spinal cord injuries, or other neurological disorders. Zanaflex belongs to a class of drugs known as alpha-2 adrenergic agonists, and it helps manage muscle stiffness and discomfort by acting on the central nervous system.
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Frequently Asked Questions
How long does it take for Zanaflex to work?
Zanaflex typically starts working within 1-2 hours of taking it, providing relief from muscle spasms for up to 6 hours.
Can I take Zanaflex daily?
Yes, Zanaflex can be taken daily, but it should not be used more than three times in 24 hours. Your doctor may adjust your dose based on how well you tolerate the medication.
Can Zanaflex cause weight gain?
Weight gain is not a common side effect of Zanaflex. However, if you experience any unexpected changes in weight, you should inform your healthcare provider.
Can Zanaflex be used for back pain?
Zanaflex is primarily prescribed for muscle spasticity related to neurological conditions, but it may also be prescribed off-label for back pain or muscle spasms caused by injury or strain.
Is Zanaflex addictive?
Zanaflex does not have a high potential for addiction compared to some other muscle relaxants, but it can cause dependence if taken for a prolonged period. Always follow your doctor’s instructions and avoid abruptly stopping the medication without medical guidance.
Comprehensive Drug Guide
How Does Zanaflex Work?
Zanaflex works by stimulating alpha-2 adrenergic receptors in the central nervous system, which reduces the release of certain neurotransmitters involved in muscle tone regulation. This results in a decrease in nerve impulses to muscles, leading to relaxation of overactive muscles and reduction in spasms. Zanaflex is fast-acting but short-lived, making it useful for episodic relief of muscle stiffness.
Common Dosages
- Tablets: 2 mg, 4 mg
- Capsules: 2 mg, 4 mg, 6 mg
Typical Dosing
- For muscle spasticity: The usual starting dose is 2 mg up to three times a day, and it may be increased in increments based on the patient's response. The maximum recommended daily dose is 36 mg, but the individual doses should be spaced out to minimize side effects.
Typical Dosing
FDA Approved Indications
- Muscle spasticity caused by neurological disorders, such as multiple sclerosis or spinal cord injuries
Who Shouldn't Take Zanaflex?
- Known hypersensitivity to tizanidine or any component of the formulation
- Severe liver impairment
- Concomitant use with CYP1A2 inhibitors (such as ciprofloxacin or fluvoxamine), which can significantly increase the levels of Zanaflex in the body and lead to severe side effects
Advice From The Pharmacist
- Zanaflex is typically taken on an as-needed basis for muscle spasms, but it should not be taken more than three times in 24 hours. Make sure doses are spaced at least 6-8 hours apart to avoid excessive drowsiness or low blood pressure.
- Take Zanaflex consistently either with or without food, as switching between the two may cause variations in how much of the drug is absorbed.
- Zanaflex may cause drowsiness or dizziness, so avoid driving or operating heavy machinery until you know how the medication affects you.
- Regular liver function tests may be needed, especially if you are taking Zanaflex for an extended period.
- Avoid drinking alcohol while taking Zanaflex, as it can increase the risk of sedation and other side effects.
Side Effects of Zanaflex
Common Side Effects
- Drowsiness
- Dizziness
- Dry mouth
- Weakness
- Fatigue
Uncommon/Severe Side Effects
- Low blood pressure (hypotension)
- Liver damage (signs include yellowing of the skin or eyes, dark urine)
- Bradycardia (slow heart rate)
- Severe allergic reactions (rash, itching, difficulty breathing)
Risks and Warnings of Zanaflex
- Sedation and Dizziness: Zanaflex may cause significant drowsiness or dizziness, especially at higher doses or when combined with other CNS depressants like alcohol or benzodiazepines.
- Hypotension: Zanaflex can cause a significant drop in blood pressure, particularly when standing up. Patients should be cautious when changing positions to avoid dizziness or fainting.
- Liver Toxicity: Zanaflex may cause liver damage, especially in patients with pre-existing liver conditions or those taking the drug for extended periods. Liver function should be monitored during treatment.
Interactions with Zanaflex
Common Drug Interactions
- CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine): These drugs can increase the levels of Zanaflex in the body, raising the risk of serious side effects such as extreme drowsiness and low blood pressure.
- CNS depressants: Combining Zanaflex with alcohol, opioids, or sedative medications can increase the risk of sedation and breathing difficulties.
- Antihypertensive medications: Zanaflex may enhance the effects of blood pressure-lowering drugs, leading to an increased risk of hypotension.
Alternatives to Zanaflex
- Baclofen: Another muscle relaxant used for treating muscle spasticity in conditions like multiple sclerosis and spinal cord injury.
- Cyclobenzaprine: A muscle relaxant commonly prescribed for acute muscle spasms, although it works through a different mechanism.
- Diazepam (Valium): A benzodiazepine used as a muscle relaxant for both muscle spasms and anxiety, though it has higher potential for sedation and dependence.
