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This safety and warning guide provides crucial information regarding the use of Tizanidine (Zanaflex). Ensure you discuss any concerns with your healthcare provider.

• Low Blood Pressure and Dizziness: Tizanidine can cause a drop in blood pressure, leading to dizziness, particularly when beginning the medication or when the dose is increased. To reduce fall risk, rise slowly from lying down and use support if needed. If dizziness persists or blood pressure remains low, consult your doctor. Increased risk factors include being over 65, taking blood pressure medications, or using fluvoxamine or ciprofloxacin.

• Drowsiness and Impaired Focus: Tizanidine may induce extreme sleepiness and affect concentration. This is more prevalent among those over 65 or those taking other sedative medications. Avoid alcohol and activities requiring alertness, such as driving, until you understand how the drug affects you. Enhanced risk occurs when combined with alcohol, illicit drugs, or other drowsiness-inducing medications.

• Medication Interactions: Certain drugs, like clonidine or guanfacine, can interact with Tizanidine, exacerbating low blood pressure and dizziness. Avoid using Tizanidine with fluvoxamine or ciprofloxacin due to potential interactions.

• Kidney Function Concerns: Individuals with kidney issues should use Tizanidine cautiously, as inadequate kidney function may lead to drug accumulation and intensified side effects. Lower doses are generally recommended for these patients.

• Liver Health Monitoring: Tizanidine can impact liver function. If you have existing liver problems, you may require regular blood tests to monitor liver health before and during treatment.

• Hallucinations: A few individuals may experience hallucinations, which typically subside after discontinuation of Tizanidine. Discuss alternative treatments with your provider if this occurs.

• Withdrawal Symptoms: Abruptly stopping Tizanidine, especially after long-term use or in conjunction with narcotic pain medications, can lead to withdrawal symptoms such as high blood pressure and muscle stiffness. A gradual dose reduction under medical supervision is advised.

• Allergic Reactions: Severe allergic reactions, including anaphylaxis, are possible. Seek emergency medical help if symptoms like hives, difficulty breathing, or swelling occur after taking Tizanidine.

Contraindications: Avoid using Tizanidine with strong CYP1A2 inhibitors, such as fluvoxamine or ciprofloxacin, as they can significantly increase Tizanidine levels in your body, posing serious health risks. Always consult your healthcare provider if you have these conditions before starting Tizanidine.

When taking this medication, some individuals might experience common side effects such as dry mouth, drowsiness, dizziness, lightheadedness, constipation, weakness, and tiredness. These effects are generally mild and manageable. To alleviate dry mouth, consider using sugarless candy or gum, drinking water, or using a saliva substitute. To reduce dizziness and lightheadedness, rise slowly from sitting or lying positions. It's reassuring to know that many people using this medication do not encounter serious side effects.

However, be aware of more serious side effects that require immediate medical attention. These include fainting, mental or mood changes like hallucinations, slow or irregular heartbeat, and vision changes such as blurred vision. Rarely, this medication can lead to severe liver disease, characterized by persistent nausea or vomiting, severe abdominal pain, dark urine, or yellowing of the skin or eyes. Allergic reactions, though rare, can be serious and may present as trouble breathing, rash, itching, swelling of the face, tongue, or throat. If any of these occur, seek urgent medical care.

Additionally, some users have reported urinary tract infections, other types of infections, vomiting, and blurry vision. If you experience any of these or other unlisted effects, especially if severe, it is important to contact your healthcare provider for advice.

When using Tizanidine, it is important to be aware of potential interactions with other medications. Inform your doctor and pharmacist about all the medications and supplements you are taking, including prescription, over-the-counter, vitamins, and herbal products. Some medications should not be used in combination with Tizanidine, such as ciprofloxacin, fluvoxamine, and viloxazine, as they can significantly alter how Tizanidine functions in your body.

Other medications, like certain blood pressure drugs (e.g., alpha agonists such as clonidine and methyldopa), may also interact with Tizanidine. Additionally, birth control pills and other medications like enasidenib can affect the removal of Tizanidine from your system, impacting its efficacy.

Be cautious when combining Tizanidine with substances that cause drowsiness, such as alcohol, marijuana, antihistamines (e.g., cetirizine, diphenhydramine), sleep or anxiety medications (e.g., alprazolam, diazepam, zolpidem), other muscle relaxants, and opioid pain relievers (e.g., codeine), as these can enhance sedative effects.

If you are prescribed Tizanidine alongside any of the above medications, your doctor may need to adjust dosages or monitor you closely for side effects to ensure safe use. Always check with your pharmacist before using any new medication, including those for allergies or cold remedies, to prevent unwanted drowsiness or interactions.