Because of potential hepatotoxicity, therapy with tizanidine should be administered cautiously in patients with impaired hepatic function. Therapy with tizanidine should be administered cautiously in patients with a history of psychiatric disorders. Tizanidine Cmax was increased approximately 12-fold (range 5-fold to 32-fold), elimination half-life was increased by almost 3-fold, and AUC increased 33-fold (range 14-fold to 103-fold). The proposed mechanism is inhibition of tizanidine metabolism via CYP450 1A2. Retrospective evaluation of population pharmacokinetic data following single- and multiple-dose administration of tizanidine revealed an approximately 50% decrease in the clearance of tizanidine in women receiving oral contraceptives compared to women not receiving oral contraceptives. MANAGEMENT: The use of tizanidine in combination with oral contraceptives or other CYP450 1A2 inhibitors should generally be avoided. Therapy with tizanidine should be administered cautiously in patients with or predisposed to hypotension. The effect of immediate–release fluvoxamine maleate tablets (100 mg daily for four days) on the pharmacokinetics and pharmacodynamics of a single dose of tizanidine has been studied in 10 healthy male subjects. Zanaflex (tizanidine) drug InteractionsThere are 801 drug interactions with Zanaflex (tizanidine)Zanaflex (tizanidine) food/lifestyle InteractionsThere are 2 food/lifestyle interactions with Zanaflex (tizanidine)See also. In one contraceptive user, the tizanidine AUC exceeded the mean AUC of the control subjects by nearly 20 times. Luvox CR Capsules and tizanidine should not be used together (see CONTRAINDICATIONS and PRECAUTIONS). If you are or will be ***-feeding while you use Tizanidine , check with your doctor. theophylline, methylxanthines, tizanidine) results in increased plasma concentrations of the coadministered drug and could lead to clinically significant pharmacodynamic side effects of the coadministered drug. Tizanidine should only be given during pregnancy when benefit outweighs risk. MANAGEMENT: Use of tizanidine with other substances that commonly cause sedation should be approached with caution, particularly in elderly or debilitated patients. In a study of 30 healthy volunteers administered a single 4 mg dose of tizanidine, mean peak plasma concentration (Cmax) of tizanidine was 3. Patients should not use ciprofloxacin if they are already taking tizanidine. In addition, both the systolic and diastolic blood pressures were lowered by tizanidine more in the contraceptive users (29 mmHg and 21 mm Hg, respectively) than in the control subjects (17 mmHg and 13 mmHg, respectively). You will need to discuss the benefits and risks of using Tizanidine while you are pregnant. It is not known if Tizanidine is found in *** milk. Prolonged pharmacologic effects of tizanidine may occur due to drug accumulation. According to the manufacturer, approximately 5% of patients treated with tizanidine in clinical studies had elevations in serum transaminases greater than 3 times the upper limit of normal (or 2 times if baseline levels were elevated), compared to 0. Therapy with tizanidine should be administered cautiously and initiated at reduced dosages in patients with impaired renal function. All patients treated with tizanidine should have liver function tests performed at baseline, 1, 3 and 6 months, and periodically thereafter. There were no significant differences in the elimination half-life or time to peak concentration in plasma (Tmax) of tizanidine between the groups. According to the manufacturer, two-thirds of patients in a study given single 8 mg doses of tizanidine had a 20% reduction in either the diastolic or systolic blood pressure. You should not take ciprofloxacin if you are already taking tizanidine. In three cases cited by the package labeling, two involved concomitant use of hepatotoxic agents in addition to tizanidine, while the third had no other known risk factors. The hypotensive and sedative effects of tizanidine were also potentiated.
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