Tiz
Generic Name
Tizanidine
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| tiz 10 mg tablet | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Tiz 10 mg Tablet contains Tizanidine, a centrally acting skeletal muscle relaxant used to treat muscle spasticity associated with various neurological conditions.
Uses & Indications
Dosage
Adults
Initial dose is 2 mg once daily, gradually increased in 2-4 mg increments at 3-7 day intervals. Usual maintenance dose is 2-4 mg three times daily. Max 36 mg/day. The 10 mg tablet is typically used for maintenance or higher doses as prescribed by a physician.
Elderly
Start with a lower dose (e.g., 2 mg once daily) and titrate slowly with careful monitoring due to increased sensitivity and potential for adverse effects.
Renal_impairment
Reduce initial dose to 2 mg once daily. Dosage should be adjusted based on response and tolerability, with careful monitoring of renal function and adverse effects.
How to Take
Take orally, with or without food, but consistency of administration (always with food or always without food) is recommended to avoid fluctuations in absorption. Do not crush or chew the tablet.
Mechanism of Action
Tizanidine is an alpha-2 adrenergic agonist that acts centrally at the spinal and supraspinal levels to reduce muscle tone. It is thought to exert its effect by increasing presynaptic inhibition of motor neurons.
Pharmacokinetics
Onset
Within 1 hour of administration.
Excretion
Mainly excreted by the kidneys (approximately 60% of the dose) with a small amount excreted in feces.
Half life
Approximately 2.5 hours.
Absorption
Rapidly and almost completely absorbed after oral administration, with peak plasma concentrations occurring within 1 to 2 hours. Bioavailability is about 40%.
Metabolism
Extensively metabolized in the liver, primarily by the cytochrome P450 1A2 (CYP1A2) enzyme.
Side Effects
Contraindications
- Concomitant use with strong CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin due to increased tizanidine levels and risk of severe hypotension.
- Hypersensitivity to tizanidine or any component of the formulation.
Drug Interactions
Antihypertensives
May enhance the hypotensive effect of tizanidine, increasing the risk of severe hypotension and bradycardia.
Fluvoxamine, Ciprofloxacin
Significantly increases tizanidine plasma concentrations, leading to severe hypotension, bradycardia, and somnolence. Concomitant use is contraindicated.
Alcohol and other CNS depressants (e.g., Benzodiazepines, Opioids)
Increased risk of sedation, dizziness, and hypotension.
Other CYP1A2 Inhibitors (e.g., Amiodarone, Propafenone, Cimetidine, Oral Contraceptives)
May increase tizanidine exposure; use with caution and monitor for adverse effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, dizziness, lightheadedness, bradycardia, hypotension, and possibly coma. Management is supportive, including gastric lavage, activated charcoal, and monitoring of vital signs. In cases of severe hypotension, intravenous fluids and vasopressors may be necessary.
Pregnancy & Lactation
Pregnancy Category C. Tizanidine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk, so breastfeeding is not recommended during treatment with Tizanidine.
Side Effects
Contraindications
- Concomitant use with strong CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin due to increased tizanidine levels and risk of severe hypotension.
- Hypersensitivity to tizanidine or any component of the formulation.
Drug Interactions
Antihypertensives
May enhance the hypotensive effect of tizanidine, increasing the risk of severe hypotension and bradycardia.
Fluvoxamine, Ciprofloxacin
Significantly increases tizanidine plasma concentrations, leading to severe hypotension, bradycardia, and somnolence. Concomitant use is contraindicated.
Alcohol and other CNS depressants (e.g., Benzodiazepines, Opioids)
Increased risk of sedation, dizziness, and hypotension.
Other CYP1A2 Inhibitors (e.g., Amiodarone, Propafenone, Cimetidine, Oral Contraceptives)
May increase tizanidine exposure; use with caution and monitor for adverse effects.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include drowsiness, dizziness, lightheadedness, bradycardia, hypotension, and possibly coma. Management is supportive, including gastric lavage, activated charcoal, and monitoring of vital signs. In cases of severe hypotension, intravenous fluids and vasopressors may be necessary.
Pregnancy & Lactation
Pregnancy Category C. Tizanidine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk, so breastfeeding is not recommended during treatment with Tizanidine.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture.
Availability
Available in pharmacies and hospitals
Approval Status
Approved (Generic)
Patent Status
Generic
Clinical Trials
Tizanidine has undergone extensive clinical trials to establish its efficacy and safety for the treatment of spasticity. Post-marketing surveillance continues to monitor for rare adverse effects.
Lab Monitoring
- Liver function tests (ALT, AST) should be monitored at baseline and periodically (e.g., monthly for the first 6 months, then periodically) during treatment, especially in patients with hepatic impairment or those receiving higher doses.
- Blood pressure monitoring, especially during dose titration, due to the risk of hypotension.
Doctor Notes
- Counsel patients on the significant potential for sedation and dizziness, especially at treatment initiation and with dose increases.
- Emphasize the importance of not abruptly discontinuing the medication to avoid withdrawal symptoms.
- Monitor liver function tests and blood pressure regularly, particularly in patients with pre-existing hepatic or cardiovascular conditions, or those on higher doses.
- Avoid concomitant use with strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin) due to increased adverse effects.
Patient Guidelines
- Do not abruptly discontinue Tiz, as it may lead to withdrawal symptoms such as rebound spasticity, tachycardia, and hypertension. Taper the dose gradually.
- Avoid alcohol and other CNS depressants while taking Tiz, as they can increase drowsiness and dizziness.
- Report any signs of liver problems (e.g., unexplained nausea, anorexia, dark urine, jaundice) to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double dose to make up for a missed one.
Driving Precautions
Tizanidine can cause drowsiness, dizziness, and sedation, which may impair your ability to drive or operate machinery. Patients should be advised to avoid such activities until they know how Tiz affects them.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating heavy machinery, until you know how Tiz affects you.
- Stay hydrated and avoid sudden changes in posture to minimize dizziness.
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