Tizanidine is a centrally acting alpha adrenergic agonist with therapeutic action at spinal cord level.
This drug has consequences that impact on other aspects of brain injury.
Side Effects
- Sedation.
- Dose dependant hypotension.
- Dizziness.
- Dry mouth.
- Bradycardia or tachycardia (which can prolong the QT interval).
- Rarely hepatitis and hepatic failure.
Dose
- Start at 2mg daily.
- Increase in increments of 2mg every three days in 2 to 4 divided doses as dose increases.
- Max dose is 36mg/24hrs in 3 to 4 divided doses.
- Check ECG before commencing and at one month.
- Monitor liver function tests monthly for first four months if the dose increases to greater than 12mg per day or if the patient develops unexplained nausea, anorexia or fatigue.
- Avoid abrupt withdrawal (risk of rebound hypertension and tachycardia).