Ontralfy Dosage

Recommended Evaluation and Testing Before and After Initiating Ontralfy

Monitoring of aminotransferase levels is recommended at baseline and 1 month after maximum dose is achieved.

Recommended Dosage

The recommended starting dose is 2 mg (5 mL) by mouth every 6 to 8 hours, as needed, to a maximum of three doses in 24 hours.

Dosage can be gradually increased every 1 to 4 days by 2 mg (5 mL) to 4 mg (10 mL) at each dose based on clinical response and tolerability. The maximum total daily dosage is 36 mg (90 mL). Single doses greater than 16 mg (40 mL) have not been studied.

The pharmacokinetics of Ontralfy differ when taken with or without food. Ontralfy may be taken with or without food; however, consistent administration with respect to food is recommended to reduce variability in tizanidine plasma exposure. If administration with respect to food is changed, monitor patients for therapeutic effect or adverse reactions.

Because of the short duration of therapeutic effect, treatment with Ontralfy should be reserved for those daily activities and times when relief of spasticity is most important.

Recommended Dosage in Patients with Renal Impairment

In patients with creatinine clearance < 25 mL/min, use lower individual doses during titration. If higher doses are required, the individual doses rather than dosing frequency should be increased.

Recommended Dosage in Patients with Hepatic Impairment

In patients with hepatic impairment, use lower individual doses during titration. If higher doses are required, individual doses rather than dosing frequency should be increased.

Discontinuation of Ontralfy

When discontinuing Ontralfy, particularly in patients who have been receiving high doses for long periods or who may be on concomitant treatment with narcotics, decrease the dosage by 2 mg (5 mL) to 4 mg (10 mL) per day to minimize the risk of withdrawal adverse reactions.