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).