A centrally acting alpha-2 adrenergic agonist used for the management of spasticity associated with multiple sclerosis and spinal cord injury. Tizanidine provides muscle relaxation with shorter duration of action than baclofen, which may be advantageous for treating intermittent spasticity.
Concurrent use with fluvoxamine or ciprofloxacin (potent CYP1A2 inhibitors, significant drug interaction)
The bottom line
Evidence rating strong. Most-documented uses: reduction of spasticity from ms and spinal cord injury, short duration of action useful for intermittent spasticity, relief of increased muscle tone. 10 sources indexed (2023–2025), with 1 interaction record on file.
The science
How it works, mechanistically.
Core mechanism
Acts as an agonist at alpha-2 adrenergic receptors in the spinal cord and brainstem, increasing presynaptic inhibition of motor neurons. By reducing the release of excitatory amino acids from spinal interneurons, tizanidine decreases polysynaptic reflex activity, thereby reducing muscle tone. It also has some activity at imidazoline receptors.
Class
Skeletal Muscle Relaxant (Antispastic)
Dosing
Dosing & protocol.
Common range
2–8 mg every 6–8 hours as needed; maximum 36 mg/day in 3 divided doses (as prescribed by your physician)
Recommended form
Tablet or capsule
Food increases peak concentration and extent of absorption; should be taken consistently either with or without food (not interchangeably)
Alcohol can add to tizanidine's sedation, dizziness, low blood pressure, and fainting risk. A published case report describes syncope after concomitant tizanidine and alcohol use. This is especially concerning when standing up, driving, or combining with other blood-pressure-lowering or sedating substances.
Recommendation: Avoid alcohol while taking tizanidine. If alcohol was used, do not drive and be careful standing or walking until the effects are clearly gone. Seek help for fainting, severe weakness, confusion, or trouble breathing.
Killam-Worrall L, Brand R, Castro JR et al.. Baclofen and Tizanidine Adverse Effects Observed Among Community-Dwelling Adults Above the Age of 50 Years: A Systematic Review. The Annals of pharmacotherapy. 2024
Nair A, Rangaiah M, Borkar N. Efficacy and safety of oral tizanidine premedication as pre-emptive analgesia in adult patients undergoing elective surgeries- A systematic review. Saudi journal of anaesthesia. 2023
Hung KKC, Lam RPK, Lee HKH et al.. Comparison of diclofenac with tramadol, tizanidine or placebo in the treatment of acute low back pain and sciatica: multi-center randomized controlled trial. Postgraduate medical journal. 2024
Su Zhang VR, Niu F, Lee EA et al.. Safety of baclofen versus tizanidine for older adults with musculoskeletal pain. Journal of the American Geriatrics Society. 2023
George MM, Deamer RL, Lee-Rodriguez S et al.. Safety of Baclofen and Tizanidine in Older Adults: A Retrospective Cohort Study in a Large Integrated Health Care System. Journal of the American Geriatrics Society. 2025
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Tizanidine in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.
NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.
NutriStack