Tizanidine hydrochloride 2 mg Tablets What Tizanidine hydrochloride is used for: Tizanidine hydrochloride is used to relax stiff muscles caused by: Painful muscle spasms related with static and functional disorders of the spine (cervical and lumbar syndromes) or following surgery (e.g. osteoarthritis of the hip which is a joint disease affecting the hip or herniated intervertebral disc). Spasticity (muscle stiffness and tightness) caused by neurological problems such as multiple sclerosis (disabling disease of the brain and spinal cord), chronic myelopathy (injury to the spinal cord), degenerative spinal cord diseases, cerebrovascular accidents (e.g. stroke), and cerebral palsy (group of permanent movement disorders that start in early childhood). Do not use Tizanidine hydrochloride: If you are allergic to Tizanidine hydrochloride, or any of the ingredients in this medicine. Tell your doctor about the allergy and what signs you had. If you have severe liver impairment. If you are taking medicines known as strong CYP1A2 inhibitors (e.g. fluvoxamine or ciprofloxacin). Ask your doctor or pharmacist if you are not sure. Warnings and Precautions: Stop the medication right away and talk to your doctor or pharmacist if you develop allergic reactions such as shortness of breath, skin rash, swelling of the face or neck, decreased blood pressure and dizziness. Intake of other medicines known as inhibitors of CYP1A2 (e.g. amiodarone, propafenone, mexiletine, rofecoxib, cimetidine, some fluoroquinolones, oral contraceptives and ticlopidine) with this medicine is not recommended. Talk to your doctor before starting this medicine if you are taking other medicines. Some medicines may interact with Tizanidine and may cause QT prolongation (type of abnormal heart rhythm). This medicine may cause decreased blood pressure which may lead to severe symptoms like loss of consciousness and circulatory collapse. It is recommended that you do not abruptly stop taking this medicine, your doctor will advise you how to decrease the dose gradually to avoid withdrawal syndrome. Your doctor may recommend liver function tests if you are taking doses of 12 mg or above or if you have clinical symptoms that indicate liver problems. Your doctor may stop your medicine completely in case of severe liver damage. Talk to your doctor before starting this medicine if you have kidney problems as caution must be exerted when giving this medicine in case of kidney problems. Your doctor may decrease the dose more slowly or adjust the dose when needed. Use of this medicine is not recommended in children and caution must be exerted when giving this medicine to an elderly patient. Talk to your doctor before taking this medicine if you are an alcohol consumer. Alcohol consumption may increase drowsiness caused by tizanidine. Talk to your doctor before taking this medicine if you are a smoker. Your doctor may recommend a different dose if you are a smoker. Possible side effects: Possible side effects include allergic reactions and signs of withdrawal syndrome that may happen if you stop taking the medicine abruptly, like rebound hypertension and tachycardia (reflex increase in blood pressure and heart rate), that may lead to cerebrovascular accident (stroke). Side effects that may occur with low doses (such as those recommended for the relief of painful muscle spasms) include drowsiness, fatigue, gastrointestinal problems, dry mouth, increase in liver enzymes, dizziness, nausea and blood pressure decrease. Side effects that may occur with higher doses (such as those recommended for the treatment of spasticity) include muscular weakness, low blood pressure or heart rate, difficulty sleeping and other sleeping problems, hallucinations and liver inflammation or failure. Other side effects include confusion, vertigo, loss of consciousness and blurred vision. Other medicines and Tizanidine hydrochloride: Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medications including prescription medicines, over the counter medicines, herbals, vitamins and supplements. If you are taking medicines known as CYP1A2 strong inhibitors (e.g. antiarrhythmics, ticlopidine, cimetidine, some fluoroquinolones, oral contraceptives, rofecoxib). If you are taking medicines that may cause QT prolongation (type of abnormal heart rhythm). If you are taking medicines used to treat high blood pressure including diuretics. If you are taking sedatives or hypnotics (used to induce sleep). If you are taking antihistamine medicines (used for allergies). If you are taking rifampicin (antibiotic). If you are a cigarette smoker or alcohol consumer. If you are taking other alpha-2 adrenergic agonists (medicines that are similar to tizanidine). How to take Tizanidine hydrochloride: Painful muscle spasms Recommended usual dose is 2 to 4 mg orally three times daily in tablet form. Your doctor may recommend an additional dose of 2 or 4 mg if your case is severe. The daily dose should not exceed 36 mg. Spasticity due to neurological disorders The maximum recommended initial dose 6 mg per day in 3 divided doses, then your doctor may increase the dose gradually to reach an ideal response (usually between 12 to 24 mg/day). The daily dose should not exceed 36 mg. How To Use: Take this medicine exactly as prescribed by your doctor. Your doctor may recommend a different dose than the usual recommended dose mentioned on this leaflet and may adjust the dose depending on your case. Talk to your doctor or pharmacist if you are not sure. Take tablet with or without food but make sure that you take it the same way every time. Take tablet with a full glass of water. Swallow the tablets whole. Take your doses at the same time every day. How to store Tizanidine hydrochloride: Keep out of the reach of children and pets Do not use beyond the expiry date mentioned on the box Keep medication in its original pack to protect it from moisture and light Do not use damaged tablets Do not dispose medication in the wastewater or household waste. Ask your pharmacist how you can dispose medicines you no longer need. A valid prescription should be available upon delivery

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