INDICATIONS & USAGE
• Monitoring of aminotransferase levels is recommended at baseline and 1 month after maximum dose is achieved.
• Recommended starting dose: 2 mg by mouth every 6 to 8 hours, as needed, up to a maximum of 3 doses in 24 hours.
• Dosage can be increased by 2 mg to 4 mg per dose every 1 to 4 days; maximum total daily dosage is 36 mg
• Tizanidine pharmacokinetics differs between tablets and capsules, and when taken with or without food.
These differences could result in a change in tolerability and control of symptoms. Consistent administration with respect to food is recommended. If substitution between dosage forms is necessary, take into consideration these pharmacokinetic differences.
• Patients with renal impairment (creatinine clearance <25 mL/min) or hepatic impairment: use lower individual doses during titration. If higher doses are required, individual doses rather than dosing frequency should be increased.
• To discontinue tizanidine hydrochloride capsules, decrease dose slowly to minimize the risk of withdrawal adverse reactions
WARNINGS AND PRECAUTIONS
• Hypotension: monitor for signs and symptoms of hypotension, in particular in patients receiving concurrent antihypertensives; tizanidine should not be used with other α2-adrenergic agonists
• Risk of liver injury: monitor ALTs; discontinue tizanidine if liver injury occurs
• Sedation: tizanidine may interfere with everyday activities; sedative effects of tizanidine, alcohol, and other central nervous system (CNS) depressants are additive
• Hallucinations: consider discontinuation of tizanidine
Full Prescribing Information: Daily Med
