Tizanidine is a muscle relaxer that has shown promise in the preventative treatment of chronic daily headaches and migraines.It works by slowing action in the brain and nervous system to allow the muscles to relax.

Tizanidine is an alpha2-adrenergic agonist, which means it inhibits the release of norepinephrine to the spinal cord and brain.

In one double-blind study, the muscle relaxant tizanidine reduced overall headache intensity, duration, and frequency in participants. After the four-week trial, 54% of tizanidine recipients reported improvement in the headache index and 30% reported improvement in total headache days.¹

Tizanidine comes as a tablet and a capsule to take by mouth. It is usually taken consistently either always with or always without food two or three times a day. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take tizanidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Tizanidine is usually prescribed in 2 mg and 4 mg doses every six to eight hours. Your doctor will probably start you on a low dose of tizanidine and gradually increase your dose, depending on your response to this medication.

The maximum effect of tizanidine occurs about 1-2 hours after taking a dose.²

Tizanidine wears off in about 3-6 hours after taking it.³

Do not stop taking tizanidine without talking to your doctor. If you suddenly stop taking tizanidine, your heart may beat faster and you may have increased blood pressure or tightness in your muscles. Your doctor will probably decrease your dose gradually.

Tizanidine is available at RedBox Rx for $20 per month, no insurance required. Start a low-cost $25 online consult for headaches and migraines to see if tizanidine could be right for you.

Tizanidine is only available by prescription and can be purchased online. Start a low-cost $20 online consult with RedBox Rx for headaches and migraines to see if tizanidine could be right for you.

Before taking tizanidine:

• Tell your doctor and pharmacist if you are allergic to tizanidine or any other medications.

• Tell your doctor if you are taking ciprofloxacin (Cipro) or fluvoxamine. Your doctor will probably tell you not to take tizanidine if you are taking either of these medications.

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acyclovir (Zovirax); amiodarone (Cordarone, Pacerone); baclofen; cimetidine (Tagamet); clonidine (Catapres, Catapres-TTS); dantrolene (Dantrium); diazepam (Valium); famotidine (Pepcid, Pepcid AC); medications for anxiety, seizures, or high blood pressure; mexiletine (Mexitil); oral contraceptives (birth control pills); propafenone (Rythmol); fluoroquinolones such as gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin); ticlopidine (Ticlid); sedatives; sleeping pills; tranquilizers; verapamil (Calan, Covera, Isoptin, Verelan); and zileuton (Zyflo). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Other medications may also interact with tizanidine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.

• Tell your doctor if you have or have ever had kidney or liver disease.

• Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tizanidine, call your doctor.

• If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tizanidine.

• You should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

• Remember that alcohol can add to the drowsiness caused by this medication.

• You should know that tizanidine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking tizanidine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up. Tizanidine can decrease muscle tone, so be careful when walking or doing other activities where you rely on your muscle tone to help with your posture or balance.

If your doctor has told you to take tizanidine regularly, take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Tizanidine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• Dizziness.

• Drowsiness.

• Weakness.

• Nervousness.

• Depression.

• Vomiting.

• Tingling sensation in the arms, legs, hands and feet.

• Dry mouth.

• Constipation.

• Diarrhea.

• Stomach pain.

• Heartburn.

• Increased muscle spasms.

• Back pain.

• Rash.

• Sweating.

Tizanidine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Keep this medication in the container it comes in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily.

In case of overdose, call the poison control helpline. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to tizanidine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

The brand name for tizanidine is Zanaflex®

RedBox Rx offers several FDA-approved treatment options for migraines and headaches including:

• Amitriptyline(Generic Elavil®)

• Divalproex Sodium ER(Generic Depakote ER®)

• Ibuprofen.

• Naproxen Sodium Tablet(Generic Naprosyn®)

• Propranolol(Generic Inderal®)

• Rizatriptan(Generic Maxalt®)

• Sumatriptan Tablet(Generic Imitrex®)

• Topiramate(Generic Topamax®)

• Zolmitriptan(Generic Zomig®)

1. National Library of Medicine

2. Drugs.com

3. Drugs.com