Tizalud 2 mg (Tablet)

Indications

• Treatment of painful muscle spasms associated with static and functional disorders of the spine
• Treatment of painful muscle spasms following surgery for herniated intervertebral disc or osteoarthritis of the hip
• Treatment of spasticity due to neurological disorders like multiple sclerosis, chronic myelopathy, and cerebral palsy

Pharmacology

• Tizanidine is a centrally acting skeletal muscle relaxant
• Inhibition of excitatory amino acid release
• Reduction of resistance to passive movements
• Alleviation of spasms and clonus
• Moderate central analgesic effect

Dosage & Administration

• Individualized dose adjustment
• Low starting dose of 2 mg three times daily
• Usual dose of 2 to 4 mg three times daily for relief of painful muscle spasms
• Initial daily dose for spasticity due to neurological disorders should not exceed 6 mg
• Pediatrics patients: limited experience, not recommended
• Geriatric patients: start at lowest dose, increase carefully
• Renal impairment: start at 2 mg once daily, increase cautiously
• Hepatic impairment: contraindicated in severe cases, start with lowest dose
• Discontinuation: slow down titration to avoid rebound hypertension and tachycardia

Interaction

• Concomitant administration with CYP1A2 inhibitors may affect plasma levels
• Contraindicated with fluvoxamine or ciprofloxacin
• Caution with drugs known to prolong QT interval
• Potential interactions with antihypertensives, rifampicin, cigarette smoke, alcohol, sedatives, and hypnotics

Contraindications

• Known hypersensitivity to tizanidine or excipients
• Severely impaired hepatic function
• Concomitant use with strong CYP1A2 inhibitors like fluvoxamine or ciprofloxacin

Side Effects

• Somnolence, fatigue, dizziness, dry mouth, nausea, and gastrointestinal disorder with low doses
• Hypotension, bradycardia, muscular weakness, insomnia, sleep disorder, and hepatitis with higher doses

Pregnancy & Lactation

• Limited experience in pregnant women, use only if benefit outweighs risk
• Animal studies: increased gestation duration, prenatal and postnatal pup loss
• Small amounts excreted in rat milk, not recommended for breastfeeding women
• Females and males of reproductive potential: recommended pregnancy testing, effective contraception, and monitoring

Precautions & Warnings

• Caution with moderate CYP1A2 inhibitors and drugs known to increase QT interval
• Risk of hypotension, withdrawal syndrome, hepatic dysfunction, and hypersensitivity reactions
• Recommendation to refrain from activities requiring a high degree of alertness

Use in Special Populations

• Maximal mean plasma levels may increase in renal impairment
• No specific studies in hepatic impairment, contraindicated in severe cases
• Limited pharmacokinetic data in geriatrics, no clinically significant effect of gender

Overdose Effects

• Recovery generally uneventful in reported cases
• Symptoms include nausea, vomiting, hypotension, and respiratory distress
• Recommendation for activated charcoal administration and symptomatic treatment

Therapeutic Class

• Centrally acting Skeletal Muscle Relaxants

Storage Conditions

• Store in a dry place below 30°C
• Keep out of the reach and sight of children

Related Brands

• Tizadin 2 mg (Tablet) - aci-limited
• Sirdalud 2 mg (Tablet) - sandoz-a-novartis-division
• Relentus 2 mg (Tablet) - beximco-pharmaceuticals-ltd