Tizanidine

What is tizanidine?

Tizanidine is a medicine that is used to treat muscle spasms, muscle cramps, and rigid muscles. It may help children with multiple sclerosis or other conditions, which cause muscle spasms or rigidity. Tizanidine does not cure these problems, but it may allow other treatment, such as physical therapy, to be more helpful in improving your child's condition.

You may hear tizanidine called by its brand names, Zanaflex or Apo-Tizanidine. Tizanidine comes in a tablet form.

Before giving tizanidine to your child?

Tell your doctor if your child has a severe allergy to tizanidine, other medicines, lactose, preservatives, dyes, or food.

Your child should not take tizanidine if they are taking ciprofloxacin or fluvoxamine.

Talk with your doctor or pharmacist if your child has any of the following conditions. Precautions may need to be taken if your child has:

• kidney disease
• liver disease
• low blood pressure
• heart disease

How should you give your child tizanidine?

Follow these instructions when giving your child tizanidine:

• Give your child tizanidine for as long as your doctor or pharmacist tells you, even if your child seems better.
• Talk to your child's doctor before you change the dose or stop giving this medicine for any reason. Your child may become ill if they stop taking this medicine suddenly.
• If your child needs to stop taking tizanidine, follow your doctor's instructions on how to slowly reduce the dose.
• Your child may take tizanidine with or without food, but be consistent. Food affects how much tizanidine is absorbed. Tizanidine should be taken the same way every day. For example, always take with food every day or always take tizanidine on an empty stomach every day.
• If your child is taking part of a tizanidine tablet, use a tablet splitter to get the correct dose. You can buy a tablet splitter at your pharmacy.
• If your child gets more than one dose of tizanidine every day, give the biggest dose at bedtime (if the doses are not equal).

What should you do if your child misses a dose of tizanidine?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

What are the possible side effects of tizanidine?

Your child may have some of these side effects while they take tizanidine. Check with your child's doctor if your child continues to have any of these side effects and they do not go away or they bother your child:

• drowsiness or feeling tired
• dry mouth
• feeling dizzy or lightheaded, especially after quickly standing up or sitting up

Call your child's doctor during office hours if your child has any of these side effects:

• yellow eyes or skin
• severe upset stomach or throwing up
• dark, red, or brown urine
• muscle tenderness, weakness, stiffness
• blurred vision
• hallucinations (seeing, hearing, or feeling things that are not really there)

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's doctor right away or take your child to the Emergency Department if your child has any of these side effects:

Signs of an allergic reaction such as:

• trouble breathing
• severe skin rash
• hives (raise red lumps on skin)
• swelling of the face, lips, mouth, or throat
• slow or irregular heartbeat

What safety measures should you take when your child is using tizanidine?

Keep all appointments at the clinic or doctor's office so that the doctor can check your child's reaction to tizanidine. The doctor may need to change the dose so that your child is getting the right amount.

Your child needs to continue to do the other things your doctor suggests to help with tight muscles, such as stretching exercises.

If your child has a dry mouth from taking tizanidine, give them lots of small sips of water, ice chips, or sugarless hard candy.

Tizanidine may make your child dizzy, drowsy, and less alert than normal. Watch carefully when your child is doing something that they need to be alert for, such as climbing stairs. If these side effects happen, tell your child's teacher that your child is taking a medicine that can cause these side effects.

This medicine may cause dizziness when getting up from a sitting or lying position. To help avoid this, your child should get out of bed or get up from a sitting position slowly. Your child should sit down or lie down if they feel dizzy.

There are some medicines that should not be taken together with tizanidine or in some cases, the dose of tizanidine or the other medicine may need to be adjusted. It is important that you tell your doctor and pharmacist if your child takes any other medications (prescription, over the counter, or herbal) including:

• ciprofloxacin or fluvoxamine
• anti-arrhythmics (amiodarone, propafenone)
• cimetidine
• certain antibiotics
• some medicines for cough and cold, hay fever, allergies, and sleeping problems: they can increase the risk of side effects of tizanidine
• some herbal products may increase the risk of side effects of tizanidine: valerian or St. John's Wort, for example, may make your child more drowsy

What other important information should you know about tizanidine?

• Keep a list of all medications your child is on and show the list to the doctor or pharmacist.
• Do not share your child's medicine with others. Do not give anyone else's medicine to your child.
• Make sure you always have enough tizanidine to last through weekends, holidays, and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
• Keep tizanidine at room temperature in a cool, dry place away from sunlight. Do not store it in the bathroom or kitchen.
• Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
  

Keep tizanidine out of your child’s sight and reach and locked up in a safe place. If your child takes too much tizanidine, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.