This dosage information may not include all the information needed to use Tizanidine safely and effectively. See additional information for Tizanidine.
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Usual Adult Dose for:
Usual Geriatric Dose for:
Additional dosage information:
Usual Adult Dose for Muscle Spasm
The initial dosage of tizanidine recommended for this patient with increased muscle tone associated with spasticity related to multiple sclerosis or spinal cord injury is 4 mg orally once a day.
The dose of tizanidine may be repeated as needed at 6 to 8 hour intervals to a maximum dose 3 doses per 24 hours. The dose may be gradually increased (every 4 to 7 days) in increments of 1 to 2 mg until desired response is attained. The manufacturer recommends that total daily dose should not exceed 36 mg. Additionally , the use of single doses greater than 12 mg is not recommended.
Starting at a lower dose and titrating upward minimizes the risk for adverse effects. Experience with single doses greater than 8 mg and total daily dose greater than 24 mg is limited.
Effects appear to be dose related and gradually diminish within 3 to 6 hours after a dose. Use must be individualized and directed at times and activities where benefit is most important.
Usual Geriatric Dose for Muscle Spasm
In geriatric patients, a starting dose of 2 mg orally once a day may be appropriate.
Renal Dose Adjustments
In patients with renal dysfunction, a starting dose of 2 mg orally once a day may be appropriate.
Liver Dose Adjustments
The use of tizanidine should be approached cautiously, if it is used at all, in patients with hepatic dysfunction due to its potential to cause hepatic toxicity.
If tizanidine is to be used in a patient with liver dysfunction, a starting dose of 2 mg orally once a day may be appropriate.
The dosage of tizanidine must be individualized due to wide interpatient variability in pharmacokinetics, response, and susceptibility to adverse effects.
Safety and effectiveness have not been established in pediatric patients (less than 18 years old).
Data not available
Food has complex and different effects on the pharmacokinetics of different tizanidine formulations. These pharmacokinetic differences may result in clinically significant differences when switching administration of the tablet between the fed or fasted state, switching administration of the capsule between the fed or fasted state, switching between the tablet and capsule in the fed state, or switching between the intact capsule and sprinkling the contents of the capsule on applesauce. These changes may result in an increase in adverse events, or delayed or more rapid onset of activity, depending on the nature of the switch. The prescriber should familiarize themselves with the changes in kinetics associated with the use of the different formulations under fasting or fed conditions.
If therapy is to be discontinued, particularly in patients who have been receiving high doses for long periods, the dose should be decreased gradually to minimize the risk of withdrawal and rebound hypertension, tachycardia, and hypertonia.