Tizanidine (Zanaflex)

Other names: Zanaflex

Tizanidine is a drug used to treat spasticity and spasms in multiple sclerosis. 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 MS Guideline states that tizanadine can be used if treatment with baclofen or gabapentin has not been successful.

How does tizanidine work?

It is thought that tizanidine blocks impulses through the nerves that cause muscles to tighten, thus reducing the level of spasticity.

How do I take tizanidine?

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
dry mouth
changes in heart rate
decrease in blood pressure

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.

You may be advised to avoid driving or operating heavy machinery if you are taking tizanidine.

Find out more

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.
Summary (link is external)

Hoogstraten MC, et al.
Tizanidine versus baclofen in the treatment of spasticity in multiple sclerosis patients.
Acta Neurologica Scandinavica 1988;77(3):224-230.
Summary (link is external)

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.
Summary (link is external)

National Institute for Health and Care Excellence
Management of multiple sclerosis in primary and secondary care
London: NICE; 2014
Full Guideline (link is external)

On this page

Managing spasticity and spasms

Managing spasticity and spasms can include a combination of self-management, physiotherapy, occupational therapy and medication. Learn about the different options for managing these symptoms.

Find treatments for MS symptoms

The symptoms of multiple sclerosis can be managed by medication, input from therapists or rehabilitation specialists and/or the development of self-management strategies.

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