What is Zanaflex?
Zanaflex (tizanidine) is a “short-acting muscle relaxer”. It blocks the pain from the nerves. Otherwise, what is tizanidine used for? Besides just muscle relaxing, it can also “treat spasticity by temporarily relaxing muscle tone”. A Zanaflex dosage of over 36 mg (three doses) within 24-hours should be avoided, or else liver damage could occur. Regular liver testing is necessary when taking this medication. There are also certain medications that could interfere with tizanidine, such as Pepcid, Tagamet, Zovirax, Ticlid, Zyflo, birth control pills, certain antibiotics, and some blood pressure and heart rhythm medications. Some vitamins, herbs, and minerals may also have to be avoided when taking Zanaflex. Patients with liver and kidney disease, low or high blood pressure, or “Long QT syndrome” should talk to their doctors before taking the medication. Additionally, patients who are taking Cipro (the antibiotic) or Luvox (the antidepressant) should not take tizanidine. It is unknown whether or not the medication is harmful during pregnancy, as it is considered category C. It is also unknown whether or not it passes into breastmilk. The medication should be taken with water and it will have noticeable effects within 1-6 hours. Up to 3 doses per day are allowed, but there should be 6-8 hours between doses.1 Tizanidine treats muscle spasms, so it may also be used in patients with spinal cord injury or multiple sclerosis, as well.2 For people who use benzodiazepines regularly, Zanaflex might be prescribed as an alternative because it “calms the muscle activity without the risk of depression, anxiety, tolerance, dependency and addiction”.3
Zanaflex Side Effects
One of the side effects of tizanidine is excessive sleepiness. This could be compounded if patients also take sleeping pills, narcotics, allergy or cold medicines, other muscle relaxers, alcohol, or medications for depression, anxiety, or seizures. The prescription should also be avoided if “muscle tone is needed to assure safe balance and movement for certain activities” because it can lead to “reduced muscle tone”. If Zanaflex is taken long-term, there might be withdrawal symptoms when the medication is stopped, such as “dizziness, fast heart rate, tremors, anxiety, and increased spasticity”. The prescription may have to be stepped down gradually. Overdose is possible. Symptoms include confusion, shallow breathing, slow heart rate, drowsiness, fainting or feeling light-headed, or even coma. The patient’s thinking might become impaired as a result of tizanidine, so care should be taken when driving, and dizziness is most likely to happen when rising from lying down or sitting. Some other serious side effects include allergic reactions, trouble breathing, hives, face swelling, hallucinations, nausea or appetite loss, jaundice, or burning during urination. Less serious side effects include diarrhea or constipation, anxiety, fever, dry mouth, back pain or muscle weakness, increased muscle spasms, rash, sweating, or tingling or numbness.4 Older adults may be more prone to the side effects, especially drowsiness and dizziness.5
Alternatives to Muscle Relaxants
Muscle spasms can be treated with natural methods such chamomile, cherry juice, blueberry smoothies, cayenne pepper, vitamin D, magnesium, and rest. Chamomile and cherry juice act as anti-inflammatory agents. Cherry juice and blueberry smoothies have “antioxidant powers”. Cayenne pepper is “a natural muscle relaxant” for patients with “fibromyalgia and rheumatoid arthritis”. Vitamin D can help fight muscle spasms and pain; while it is found in some foods, it is also obtained from “regular exposure to sunlight”. Magnesium is an essential nutrient, and patients deficient in this could develop muscle pain. Finally, rest (and fluids) can relieve overworked muscles.6 Lavender is an essential oil that could be useful in relaxing muscles. It can be used by rubbing it on the temples or in a warm bath. With the latter, the bath can increase blood flow by heating the muscles, allowing the lavender to release tension. Vitamin C (an antioxidant) and potassium (for muscle development) may be helpful additions to the diet. Water is crucial for flushing out toxins. Besides chamomile, there are other potentially helpful herbs to try. Valerian is a muscle relaxant, is anti-inflammatory, and it assists with sleep. Horsetail, kava root, and white willow could provide pain relief.7 There are other alternatives to prescription medications, such as using arnica, peppermint, or lemongrass oils and getting chiropractic adjustments.8 Patients may also want to consider exercise and physiotherapy.9 Chiropractic care can be useful in treating muscle spasms, such as ones triggered by an electrolyte imbalance, fatigue, dehydration, or nerve irritation. Chiropractors can help patients who have muscle imbalances and they could provide advice on exercise as well. They can help treat the underlying cause of the spasm, without the risks and side effects of medications. In addition, the chiropractor may teach patients about nutrition and stretches that they can do to prevent and alleviate pain. It is important to hydrate, avoid diuretics (tea, coffee), and to take in enough carbohydrates, especially for patients who exercise regularly.10
Learn more about treating muscle spasms.