A to Z of MS Tizanidine
Product name
Zanaflex
Tizanidine is a drug used to treat spasticity and spasms in MS. There have been several studies of the drug that showed it beneficial as a treatment for spasticity when compared to placebo. Other studies have shown tizanidine to be as effective as other spasticity drugs. The NICE Guideline states that tizanidine should only be given if treatment with baclofen or gabapentin is unsuccessful or side effects are unmanageable.
How tizanidine works
It is thought that tizanidine blocks impulses through the nerves that cause muscles to tighten, thus reducing the level of spasticity.
How is tizanidine given?
Tizanidine is taken orally as a tablet. Medication can be increased in steps until the desired effect is achieved or side effects become a problem.
Side effects and contraindications
The most frequent side effects are tiredness, drowsiness, and dry mouth. Liver function tests should be checked during the first months of treatment. Whilst tizanidine can cause muscle weakness, this seems to be significantly less than that caused by other spasticity drugs.
References
UK Tizanidine Trial Group.
A double-blind, placebo-controlled trial of tizanidine in treatment of spasticity caused by multiple sclerosis.
Neurology 1994;44(11 Suppl 9):S70-78.
abstract
Hoogstraten MC, et al.
Tizanidine versus baclofen in the treatment of spasticity in multiple sclerosis patients.
Acta Neurologica Scandinavica 1988;77(3):224-230.
abstract
Wagstaff AJ, Bryson HM.
Tizanidine. A review of its pharmacology, clinical efficacy and tolerability in the management of spasticity associated with cerebral and spinal disorders.
Drugs 1997;53(3):435-452.
abstract