Back Pain Home > Zanaflex Warnings and Precautions

Your healthcare provider should monitor your liver function periodically while you are taking Zanaflex. The drug may not be suitable for everyone, so talk to your healthcare provider about any safety issues before starting treatment. Warnings and precautions for Zanaflex also apply to people who take ciprofloxacin or fluvoxamine -- combining either of these drugs with Zanaflex could lead to a dangerous interaction.

What Should I Tell My Healthcare Provider Before Taking Zanaflex?

Prior to taking Zanaflex® (tizanidine hydrochloride), talk to your healthcare provider if you have:
  • Low blood pressure (hypotension)
  • A slow heart rate (bradycardia)
  • Liver disease, such as liver failure, hepatitis, or cirrhosis
  • Kidney disease, such as kidney failure (renal failure)
  • Any allergies, including to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and nonprescription medications, vitamins, and herbal supplements.

Specific Precautions and Warnings With Zanaflex

Some warnings and precautions to be aware of prior to taking Zanaflex include the following:
  • Because of the way Zanaflex works, it can lower blood pressure and heart rate. This can be a problem for some people, especially those who already have low blood pressure or a slow heart rate.
  • Be sure to arise slowly from a sitting or lying-down position, as this minimizes the chance of dizziness, lightheadedness, or fainting due to low blood pressure.
  • Occasionally, Zanaflex can cause liver damage. Your healthcare provider should monitor your liver function periodically (using a simple blood test) while you are taking this medication.
  • Because Zanaflex can cause liver damage and because the medication is broken down by the liver, this medication should generally be avoided by people who have liver disease.
  • Because the kidneys clear this medicine from the body, it may not be a good choice for people with kidney disease.
  • If you have been taking Zanaflex for a while -- especially at high doses -- you should not stop taking it suddenly, as this may cause high blood pressure, a fast heart rate, and worsened spasticity.
  • This drug can cause hallucinations or other psychotic problems, such as delusions or paranoia. Make sure to tell your healthcare provider right away if you think you might be experiencing such problems.
  • Zanaflex commonly causes drowsiness and dizziness, which may interfere with your ability to drive, operate heavy machinery, or focus mentally.
  • Zanaflex can potentially interact with other medications (see Zanaflex Drug Interactions).
  • This is a pregnancy Category C medication, which means it may not be safe for use during pregnancy, although the full risks are currently unknown. Talk with your healthcare provider before taking this medication if you are pregnant (see Tizanidine and Pregnancy).
  • It is unknown if Zanaflex passes through breast milk in humans. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Tizanidine and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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