Zanaflex: Targeted Muscle Spasm Relief with Tizanidine
| Product dosage: 2mg | |||
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Synonyms | |||
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Zanaflex (tizanidine hydrochloride) is a short-acting muscle relaxant indicated for the management of spasticity. It is a centrally acting alpha-2 adrenergic agonist that works by inhibiting motor neurons in the brain and spinal cord, effectively reducing excessive muscle tone and frequency of painful spasms. This prescription medication is commonly used in conditions such as multiple sclerosis, spinal cord injury, and certain neurological disorders where spasticity impairs daily function or causes discomfort. Proper dosing and medical supervision are essential due to its potent effects and potential for side effects, including sedation and hypotension.
Features
- Active ingredient: Tizanidine hydrochloride
- Available in 2 mg and 4 mg oral tablets
- Also supplied as capsule form for altered absorption profiles
- Short half-life (approximately 2.5 hours)
- Metabolized primarily in the liver via cytochrome P450 1A2
- Excreted renally (approximately 60%) and fecally
Benefits
- Reduces muscle spasticity and rigidity, improving range of motion
- Decreases frequency and intensity of painful muscle spasms
- May enhance comfort during physical therapy and rehabilitation
- Can improve sleep quality by alleviating nighttime spasticity
- Supports functional gains in activities of daily living
- Offers flexible dosing for individualized treatment plans
Common use
Zanaflex is primarily prescribed for the management of spasticity resulting from multiple sclerosis, spinal cord injuries, and other neurological conditions. It is used both as scheduled therapy and as needed for breakthrough spasticity episodes. Some clinicians may prescribe it off-label for tension headaches, certain types of back pain, or as an adjunct in fibromyalgia management, though these uses are not FDA-approved.
Dosage and direction
The recommended initial dose is 2 mg orally every 6-8 hours as needed, not to exceed three doses in 24 hours. Dosage may be gradually increased in 2-4 mg increments, with intervals of 1/2 to 1 week between increases. The maximum recommended total daily dose is 36 mg. Tablets should be taken with water, with or without food, though consistency in administration relative to meals is advised due to food’s effect on absorption. Capsule formulation should be taken consistently either with or without food.
Precautions
Patients should be cautioned about the sedative effects of Zanaflex and advised against operating machinery or driving until they know how the medication affects them. Blood pressure should be monitored regularly, especially during dose titration. Liver function tests are recommended at baseline and periodically during treatment. Abrupt discontinuation should be avoided due to potential rebound hypertension, tachycardia, and hypertonia. Use with caution in patients with renal impairment (creatinine clearance < 25 mL/min).
Contraindications
Zanaflex is contraindicated in patients with known hypersensitivity to tizanidine or any component of the formulation. Concurrent use with potent CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin is contraindicated. Should not be used with other alpha-2 adrenergic agonists. Not recommended in patients with significant hepatic impairment.
Possible side effect
Common side effects (≥10%): dry mouth, somnolence, asthenia, dizziness Less common (1-10%): hypotension, bradycardia, gastrointestinal discomfort, elevated liver enzymes Rare (<1%): hallucinations, syncope, hepatitis, anaphylaxis Most side effects are dose-dependent and often diminish with continued use or dose adjustment
Drug interaction
Potent CYP1A2 inhibitors (fluvoxamine, ciprofloxacin) significantly increase tizanidine exposure. Concurrent use with other CNS depressants (alcohol, benzodiazepines, opioids) may produce additive sedative effects. Oral contraceptives may decrease tizanidine clearance. Caution with antihypertensives due to additive hypotensive effects. Acetaminophen may delay tizanidine absorption.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed one. Patients should maintain their regular dosing schedule and consult their physician if multiple doses are missed.
Overdose
Symptoms may include severe dizziness, somnolence, vomiting, hypotension, bradycardia, and respiratory depression. Management is supportive and symptomatic. Activated charcoal may be beneficial if administered soon after ingestion. Hemodialysis is not effective due to high protein binding. In cases of significant hypotension, intravenous fluids and vasopressors may be required.
Storage
Store at controlled room temperature (20-25°C or 68-77°F). Keep in original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Zanaflex is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual response to medication may vary. Patients should consult their physician for diagnosis and treatment recommendations tailored to their specific medical condition.
Reviews
Clinical studies demonstrate Zanaflex’s efficacy in reducing muscle tone and spasms in spasticity patients. In randomized controlled trials, approximately 60-70% of patients experienced clinically significant improvement in muscle tone compared to placebo. Many patients report improved comfort and function, though sedation is a commonly noted limitation. Long-term studies suggest maintained efficacy with proper dose management. Patient satisfaction varies based on individual tolerance to side effects and the specific nature of their spasticity.