Homechevron_rightDrugschevron_rightTizanidine (Zanaflex) Prices
Generic Zanaflex
Used for Spasticity
Used for Spasticity
Tizanidine (Zanaflex) is a muscle relaxer used to treat stiff, rigid muscles. It's taken by mouth, typically 3 times a day. Tizanidine (Zanaflex) isn't a controlled substance, so it isn't known to cause an addiction. But it does have several risks and warnings for side effects such as low blood pressure, dry mouth, and sleepiness. Tizanidine (Zanaflex) comes as both brand and generic name tablets and capsules.
Reviewed by:
Allison Gourley, PharmD
Connie Zheng, PharmD
Last reviewed on August 3, 2023
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What is Tizanidine (Zanaflex)?
02:26
Featuring Alyssa Billingsley, PharmD | Reviewed by Connie Zheng, PharmD, Mera Goodman, MD, FAAP
What is Tizanidine (Zanaflex) used for?
Muscle stiffness and rigidity
How Tizanidine (Zanaflex) works
Tizanidine (Zanaflex) is a type of muscle relaxer called an alpha-2 adrenergic receptor agonist. It works by slowing down nerves in your spinal column that control muscle tone. When those nerves slow down, your muscles relax.
When does Tizanidine (Zanaflex) start working?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Full effect
Drug Facts
Common BrandsZanaflex
Drug ClassAlpha-2 adrenergic receptor agonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
Get your GoodRx coupon
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Avg retail price
$27.76
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What are the side effects of Tizanidine (Zanaflex)?
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Other Side Effects
Serious Side Effects
Contact your healthcare provider immediately if you experience any of the following.
When do Tizanidine (Zanaflex) possible side effects begin and end?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Sleepiness
Dizziness
Urinary tract infection
Allergic reaction
Seek immediate medical care if you experience this side effect.
Source:DailyMed
More on Tizanidine (Zanaflex) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Chest pain or discomfort
fever or chills
nausea or vomiting
nervousness
pain or burning while urinating
unusual tiredness
Less common
Blurred vision
flu-like symptoms
irregular heartbeat
itching skin
kidney stones
right upper stomach tenderness
seeing things that are not there
shortness of breath
weight gain
Incidence not known
Continuing vomiting
general feeling of tiredness or weakness
headache
light-colored stools
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred vision
change in consciousness
chest pain or discomfort
confusion
decreased awareness or responsiveness
difficult or troubled breathing
dizziness, faintness or lightheadedness when getting up from a lying position
irregular, fast or slow, or shallow breathing
lightheadedness, dizziness, or fainting
loss of consciousness
pale or blue lips, fingernails, or skin
severe sleepiness
sleepiness or unusual drowsiness
slow or irregular heartbeat
sweating
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Dizziness or lightheadedness, especially when getting up from a lying or sitting position
drowsiness
dry mouth
fatigue
sleepiness
weakness
Less common
Constipation
nervousness
sore throat
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Tizanidine (Zanaflex)
Pros
Works very quickly
Available as a lower-cost generic
Capsules can be opened and sprinkled on applesauce
Can be taken only as needed
Multiple strengths available, so you can customize your dose easier
Cons
Taken multiple times a day
Stopping it suddenly can cause withdrawal symptoms, such as muscle rigidity and high blood pressure
Food can affect how well your body absorbs tizanidine (Zanaflex)
Not a good option for people with liver and kidney problems
Can cause dizziness, sleepiness, and low blood pressure as side effects
Pharmacist tips for Tizanidine (Zanaflex)
You can take tizanidine (Zanaflex) with or without food. But you should try to be consistent each time. This is because food causes your body to absorb the medication differently, which can affect how well this medication works and its side effects.
If you choose to take tizanidine (Zanaflex) with food, always take it within 30 minutes of a meal. If you choose to take tizanidine (Zanaflex) without food, always wait at least 3 hours after a meal to take your medication.
If your provider switched you from tizanidine (Zanaflex) tablets to capsules, be aware that you might notice some differences between how fast or how well the tablets and capsules work. If you take tizanidine (Zanaflex) tablets with food, you might feel their effects more quickly. But if you take tizanidine (Zanaflex) capsules, it can take longer before you experience their effects.
If you're having a hard time swallowing your tizanidine (Zanaflex) capsule, you can open it up and sprinkle the contents on applesauce. You will have to be consistent and always take the medication this way because the amount of tizanidine (Zanaflex) your body absorbs is different if it's sprinkled on applesauce than if you swallow the capsule whole.
If you have been on tizanidine (Zanaflex) for a long period of time, you shouldn't stop this medication suddenly. This can cause withdrawal symptoms, including high blood pressure, muscle spasticity, and a fast heartbeat. Talk to your provider if you want to stop taking tizanidine (Zanaflex). They will work with you to lower your dose safely.
Tizanidine (Zanaflex) can cause low blood pressure, especially if you change positions too quickly. This can cause you to get dizzy and fall. Whenever possible, try to stand up from sitting or lying down slowly and place your hands on a sturdy object while getting up.
Tell your healthcare provider about all the medications you're taking, including over-the-counter products. Tizanidine (Zanaflex) can interact with certain medications, including the antibiotic ciprofloxacin, and lead to very low blood pressure and a slow heartbeat.
Side effects like dizziness and sleepiness are common. Don't drink alcohol while taking tizanidine (Zanaflex), as it can make these side effects worse.
Tizanidine (Zanaflex) can affect your ability to focus and concentrate. Avoid driving or performing any activity that requires a lot of attention until you know how this medication affects you.
A common side effect of tizanidine (Zanaflex) is dry mouth. Chewing gum or sucking on ice can help with this. There are also special mouthwashes and lozenges available at your local pharmacy that can help.
More on Tizanidine (Zanaflex) tips
Frequently asked questions about Tizanidine (Zanaflex)
How many tizanidine (Zanaflex) tablets can I take at once?
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Take tizanidine (Zanaflex) as instructed by your provider. Tizanidine (Zanaflex) tablets come in a few different strengths. How many tablets you can take per dose depend on the total milligrams you've been prescribed and what strength of tizanidine (Zanaflex) tablets you've been dispensed. If you're starting tizanidine (Zanaflex) for the first time, your provider will typically prescribe tizanidine (Zanaflex) 2 mg every 6 to 8 hours as needed, for a maximum of 3 doses per day. Never take more tizanidine (Zanaflex) than what's been prescribed without being told to do so by your provider. Doing so can lead to serious side effects, such as dangerously low blood pressure and extreme sleepiness.
Is tizanidine (Zanaflex) a narcotic?
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No, tizanidine (Zanaflex) isn't a narcotic. A narcotic is an opioid pain reliever. Tizanidine (Zanaflex) is a muscle relaxer and doesn't treat pain the same way a narcotic medication does.
How long does it take for tizanidine (Zanaflex) to kick in?
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In general, you'll start to feel the effects of tizanidine (Zanaflex) about 1 to 2 hours after you take your dose. But this can differ depending on whether you're taking tizanidine (Zanaflex) capsules or tablets, and whether you have food in your stomach. If you take tizanidine (Zanaflex) tablets with food, you might feel their effects more quickly. But if you take tizanidine (Zanaflex) capsules, it can take longer before you experience their effects.
How long does tizanidine (Zanaflex) last?
expand_more
After the effect of tizanidine (Zanaflex) kicks in (which might take 1 to 2 hours), you can expect it to last up to 6 hours after that. Because of this, your provider will probably prescribe one dose of tizanidine (Zanaflex) every 6 to 8 hours.
Can I take tizanidine (Zanaflex) for sleep?
expand_more
Tizanidine (Zanaflex) isn't FDA-approved to help with sleep. But some researchers have studied how tizanidine (Zanaflex) might help certain people with muscle stiffness and rigidity fall asleep and stay asleep. Because tizanidine (Zanaflex) can cause extreme sleepiness as a side effect, some providers might consider this medication for people with insomnia that's caused by muscle spasticity problems. If you have questions about tizanidine (Zanaflex) and sleep, talk with your provider.
Is tizanidine (Zanaflex) addictive?
expand_more
Tizanidine (Zanaflex) doesn't cause physical and mental dependence like controlled substances do. But it can cause withdrawal symptoms (e.g., high blood pressure, tremors, muscle rigidity, anxiety) if you stop taking it all of a sudden. These symptoms are more likely to happen if you've been taking higher doses of tizanidine (Zanaflex) for a long period of time. If you want to stop taking tizanidine (Zanaflex), talk with your provider so they can help you lower your dose slowly and avoid withdrawal symptoms.
Does tizanidine (Zanaflex) cause weight gain?
expand_more
People who took tizanidine (Zanaflex) in clinical trials didn't report weight gain as a side effect. If you find yourself gaining weight, speak with your provider because it could be caused by something else.
Is tizanidine (Zanaflex) safe to use while pregnant?
expand_more
More research is needed to understand if tizanidine (Zanaflex) is safe to take during pregnancy. Animal studies suggest that birth defects aren't likely, but still possible. Talk with your provider if you're pregnant or thinking of becoming pregnant. They can recommend a muscle relaxant that's safer to take during pregnancy.
Is tizanidine (Zanaflex) the same as Flexeril?
expand_more
While both tizanidine (Zanaflex) and cyclobenzaprine (Flexeril) are muscle relaxers, they're not the same medication. Tizanidine (Zanaflex) is used for muscle spasticity, which can be thought of as stiff or rigid muscles that won't relax. It's helpful for certain conditions, like multiple sclerosis (MS). On the other hand, cyclobenzaprine (Flexeril) is typically only taken for a short period of time to treat muscle spasms that result from an injury, such as through sports or a car accident.
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What are the risks and warnings for Tizanidine (Zanaflex)?
Tizanidine (Zanaflex) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood pressure
Risk factors: Age 65 years or older | Taking blood pressure medications | Taking fluvoxamine or ciprofloxacin | Standing up from lying down quickly
Tizanidine (Zanaflex) can cause low blood pressure and dizziness, especially when you first start the medication and any time your provider raises your dose. Your provider will try to minimize these side effects by raising your dose slowly over time. To lower your risk of falls, make sure you stand up slowly from a lying position and use a sturdy object to help yourself up. If you continue to feel dizzy or unsteady, or if your blood pressure is too low, talk to your provider.
Extreme sleepiness
Risk factors: Taking with alcohol or illicit drugs | Taking other medications that cause drowsiness | People over 65
Taking tizanidine (Zanaflex) can make you feel sleepy and affect your concentration and focus. This is more likely to happen if you're over 65 or take other medications that cause drowsiness. Don't drink alcohol while taking this medication. Avoid activities that require you to be alert, like driving or operating machinery, until you know how the medication affects you.
Worsening drowsiness (from medication interactions)
There are certain mediations that can interact with tizanidine (Zanaflex) and worsen low blood pressure and dizziness. For examples, you're not recommended to take tizanidine (Zanaflex) along with clonidine (Catapress) or guanfacine. And you need to avoid taking tizanidine (Zanaflex) if you take either fluvoxamine (Luvox) or ciprofloxacin (Cipro).
Make sure to tell both your healthcare provider and your pharmacist about all medications and over-the-counter products you are taking before you start tizanidine (Zanaflex), even if you only take them once in a while or as needed.
Higher risk of tizanidine side effects (in people with kidney problems)
Risk factors: History of kidney problems
People who have kidney problems should be careful using tizanidine (Zanaflex). Tizanidine (Zanaflex) is processed by the kidneys, and if the kidneys aren't working properly, you could have a buildup of tizanidine (Zanaflex) in your body. This buildup can raise your risk of side effects like drowsiness and dizziness or make them more intense. If you have kidney problems, you will most likely be given lower doses of tizanidine (Zanaflex) to prevent these issues.
Liver damage
Risk factors: History of liver problems
Tizanidine (Zanaflex) can cause liver injury. If you have liver problems, you might not be able to take this medication. Or, your provider might ask you get blood tests done regularly to check your liver health.
Hallucinations
A very small number of people have experienced hallucinations after starting tizanidine (Zanaflex). For most people, the hallucinations went away once they stopped taking the medication. Talk to your healthcare provider if this happens to you. There might be alternative muscle relaxers that are better options for you.
Withdrawal symptoms
Risk factors: Taking tizanidine (Zanaflex) for more than 9 weeks | Taking high doses of tizanidine (Zanaflex) | Also taking narcotic pain medications | Stopping tizanidine (Zanaflex) suddenly
If you stop taking tizanidine (Zanaflex) suddenly, you might experience withdrawal symptoms, including high blood pressure, a fast heartbeat, and muscle stiffness. This is more common if you've been taking a total of 20 mg to 36 mg per day for more than 9 weeks and then suddenly stop. It's also more likely to happen if you are taking both tizanidine (Zanaflex) and certain pain medications, such as oxycodone or morphine. Talk to your healthcare provider if you would like to stop taking tizanidine (Zanaflex). They can help you lower your dose safely.
Allergic reactions
Severe allergic reactions to tizanidine (Zanaflex) are possible, including life-threatening problems like anaphylaxis (closing of the throat). Call 911 if this happens. If you notice hives, a rash, swelling of the lips or tongue, or difficulty breathing after using tizanidine (Zanaflex), call your healthcare provider right away.
Tizanidine (Zanaflex) dosage forms
The average cost for 30 tablets of 4mg of Tizanidine (Zanaflex) is $9.00 with a free GoodRx coupon. This is 67.57% off the average retail price of $27.76.
Capsule
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2mg | 30 capsules | $11.20 | $0.37 |
| 4mg | 30 capsules | $12.00 | $0.40 |
| 6mg | 90 capsules | $23.50 | $0.26 |
Tablet
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2mg | 30 tablets | $9.00 | $0.30 |
| 4mg | 30 tablets | $9.00 | $0.30 |
Typical dosing for Tizanidine (Zanaflex)
Adults: The typical starting dose is 2 mg by mouth every 6 to 8 hours, as needed (up to 3 doses a day). If needed, your provider might raise your dose every few days, up to a total of 36 mg per day.
Your dose might be different if you have liver or kidney problems.
Interactions between Tizanidine (Zanaflex) and other drugs
Tizanidine (Zanaflex) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Tizanidine (Zanaflex). Please note that only the generic name of each medication is listed below.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Ciprofloxacin
- Fluvoxamine
- Viloxazine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Alprazolam
- Benzhydrocodone
- Bromazepam
- Buprenorphine
- Butorphanol
- Calcium Oxybate
- Cannabidiol
- Capmatinib
- Cetirizine
- Cimetidine
- Clozapine
- Codeine
- Deferasirox
- Desogestrel
- Dienogest
- Dihydrocodeine
- Doxylamine
- Drospirenone
- Esketamine
- Estradiol Valerate
- Ethinyl Estradiol
- Ethynodiol Diacetate
- Famotidine
- Fentanyl
- Flibanserin
- Gabapentin
- Gabapentin Enacarbil
- Gestodene
- Givosiran
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Hydrocodone
- Hydromorphone
- Ketamine
- Lemborexant
- Levocetirizine
- Levonorgestrel
- Levorphanol
- Lofexidine
- Loxapine
- Magnesium Oxybate
- Meperidine
- Mestranol
- Methacholine
- Methadone
- Metoclopramide
- Mexiletine
- Midazolam
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Norethindrone
- Norfloxacin
- Norgestimate
- Norgestrel
- Ofloxacin
- Oxycodone
- Oxymorphone
- Peginterferon Alfa-2b
- Pentazocine
- Periciazine
- Pixantrone
- Ponesimod
- Potassium Oxybate
- Pregabalin
- Propafenone
- Quetiapine
- Remifentanil
- Remimazolam
- Revefenacin
- Rofecoxib
- Scopolamine
- Secretin Human
- Sodium Oxybate
- Sufentanil
- Tapentadol
- Ticlopidine
- Tiotropium
- Tramadol
- Trazodone
- Vemurafenib
- Verapamil
- Voclosporin
- Zileuton
- Zolpidem
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Fosphenytoin
- Lisinopril
- Phenytoin
How much does Tizanidine (Zanaflex) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Zanaflex (brand)
Tizanidine (Zanaflex) (generic)
Tizanidine (Zanaflex) contraindications
Contraindications are specific health conditions or situations in which a person shouldnot take a medication due to safety concerns. If you have any of the following conditionsor if any of the following apply to you, let your healthcare provider know because Tizanidine (Zanaflex) will not be safe for you to take.
Taking with medications that raise the level of tizanidine (Zanaflex) in your body (strong CYP1A2 inhibitors), such as fluvoxamine (Luvox) or ciprofloxacin (Cipro)
What are alternatives to Tizanidine (Zanaflex)?
There are a number of medications that your doctor can prescribe in place of Tizanidine (Zanaflex). Compare a few possible alternatives below.
Tizanidine (Zanaflex)
Used for:
Muscle stiffness and rigidity
$9.00 Lowest GoodRx priceView Prices
Cyclobenzaprine
Used for:
Muscle discomfort caused by acute (not long-term) conditions
$8.51 Lowest GoodRx priceView Prices
Baclofen
Used for:
Muscle spasms from multiple sclerosis or spinal cord injuries in people ages 12 years and older
$11.80 Lowest GoodRx priceView Prices
What is the latest news about Tizanidine (Zanaflex)?
Tizanidine (Zanaflex) images
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "E 44".White Round E 44 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "M 724".White Round M 724 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Oval, Multi-Segmented Tablet Imprinted With "R180".White Oval R180 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "U 169".White Round U 169 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "503".White Round 503 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "Apo Ti-4".White Round Apo Ti-4 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "1105".White Round 1105 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "1105".White Round 1105 - Tizanidine Hydrochloride 4mg Tablet
This medicine is White, Round, Multi-Segmented Tablet Imprinted With "1105".White Round 1105 - Tizanidine Hydrochloride 4mg Tablet
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References
starsBest studies we found
Alembic Pharmaceuticals Limited. (2023). Tizanidine hydrochloride capsule [package insert]. DailyMed.
American Heart Association. (2023). Low blood pressure - When blood pressure is too low.
Ascend Laboratories, LLC. (2023). Tizanidine tablet [package insert]. DailyMed.
View All References (4)
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Chaugai, S., et al. (2019). Co-prescription of strong CYP1A2 inhibitors and the risk of tizanidine-associated hypotension: A retrospective cohort study. Clinical Pharmacology and Therapeutics.
National Institute of Neurological Disorders and Stroke. (n.d.). Spasticity.
See, S., et al. (2008). Choosing a skeletal muscle relaxant. American Family Physician.
Tanaka, H., et al. (2004). Effects of tizanidine for refractory sleep disturbance in disabled children with spastic quadriplegia. No to Hattatsu [Brain and Development].
GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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