zanaflex drug interactions
Searches for appropriate studies were made using the following: Cochrane Neuromuscular Disease Group Register, Medline, Embase and LILACS (Latin American and Caribbean Literature on the Health Sciences) together the Chinese Biomedical Retrieval System, the database of the Chinese Cochrane Centre, conference paper databases and checked bibliographies. 10 Chinese journals were searched by hand.
zanaflex 8 mg
To define the current understanding of these entities and to review various treatment options.
zanaflex 10 mg
Retrospective review of all ingestions involving tizanidine reported to a poison control center from January 2000 through February 2003. Exclusion criteria were polydrug ingestion, no follow-up or lost to follow-up.
The effects of tizanidine were studied in patients with spastic paresis. The study consisted of 4 parts: I, double-blind cross-over trial at maximal dosage 10 mg/day in 13 patients; II, open trial at maximal dosage 32 mg/day in 10 patients; III, long-term medication at dosage 32 mg/day for 6-15 months in 4 patients; IV, single dose (12 mg) administration in 3 patients. The effects were evaluated from clinical examinations, subjective assessments, EMG, gait analysis and quantitative determinations of passive resistance and voluntary strength in isokinetic extensions and flexions of the knee and plantar and dorsal flexions of the ankle at different speeds of motion. At 3-10 mg/day, no effects were observed except for increased prime mover EMG activity in voluntary knee flexions. At 12-32 mg/day, passive resistance decreased significantly in 3 of the movements tested. The maximal voluntary strength increased significantly in 3 movements, frequently associated with enlarged activation of prime mover muscles, less frequently with reduced antagonist co-activation. Functional disability was subjectively reduced and verified by improved gait capacity in 4 patients. Sustained effects on motor performance during long-term medication were verified by withdrawal in 3 patients. Single dose administration resulted in reduced passive resistance and increased voluntary strength, associated with an increased activation of the prime mover muscles. The results indicate that tizanidine exerts its effects in part by reducing spastic restraint, in part by enhancing the capacity to activate paretic muscles.
zanaflex generic 6mg
The antagonist profile from the current study is most consistent with the theory that the alpha2B-adrenergic receptor subtype mediates the analgesic effect of intrathecally administered tizanidine on CCI-associated neuropathic pain.
zanaflex tizanidine reviews
This study was to quantify the effects of Lokomat training on ambulation capacity of patients with incomplete spinal cord injury (SCI), and to examine the potential assistance of anti-spasticity medication on training. Twenty-nine SCI subjects with spastic hypertonia at their ankle participated in a 12-session Lokomat training regimen, with half receiving Lokomat only (LOKO) and half receiving Lokomat combined with tizanidine (LOKO+TIZ). Walking capacity was evaluated in terms of the 10-meter walking (10MW) speed-a major clinical evaluation of SCI rehabilitation-four times (at the baseline, 1-, 2- and 4-weeks after training). Growth Mixture Model (GMM) was used to classify the walking speed into recovery patterns. Two latent classes were found for each treatment group, corresponding to low speed and high speed. Walking speed increased with training for high-walking-capacity subjects in the LOKO group, and for both high- and low-capacity subjects in the LOKO+TIZ group. Improvement magnitude between pre- and post-test varied among latent classes. Within each class, the baseline measure had a significant effect on walking speed improvement. This study shows that the Lokomat training improves walking speed for patients with SCI, and anti-spasticity medication, such as tizanidine, can improve the efficacy of Lokomat training, particularly for patients with low walking capacity.
zanaflex maximum dosage
We searched the Cochrane Neuromuscular Disease Group Register, MEDLINE, EMBASE, and LILACS (all to August 2005) and the Chinese Biomedical Retrieval System, the database of the Chinese Cochrane Center (The Cochrane Library, Issue 1 2005), conference paper databases and checked bibliographies. We handsearched ten Chinese journals.
zanaflex 2mg reviews
Tizanidine (Zanaflex) is a centrally acting imidazoline muscle relaxant that is structurally similar to clonidine (α(2)-adrenergic agonist) but not to other myorelaxants such as baclofen or benzodiazepines. Interestingly, cardiac arrhythmias and QT interval prolongation have been reported with tizanidine.
zanaflex pill high
Adherence to oral spasticity medication was poor irrespective of index spasticity medication or condition. Results from this study indicated that physicians cannot assume that patients are adherent to prescribed oral spasticity medications. A more complete understanding of the reasons behind nonadherence is required.
We included seven RCTs with a total 403 participants. We found a high risk of bias in all but one RCT. Two of the seven RCTs assessed a systemic drug versus placebo. We pooled data on an indirect measure of spasticity (160 participants) from these two studies but found no significant effect (odds ratio (OR) 1.66, 95% confidence interval (CI) 0.21 to 13.07; I(2) = 85%). We identified a significant risk of adverse events per participant occurring in the treatment group versus placebo group (risk ratio (RR) 1.65, 95% CI 1.12 to 2.42; 160 participants; I(2) = 0%). Only one of these studies used a functional outcome measure, and we found no significant difference between groups.Of the other five studies, two assessed a systemic drug versus another systemic drug, one assessed a systemic drug versus local drug, and the final two assessed a local drug versus another local drug.
zanaflex 2mg tab
The effects of intrathecal (i.th.) injections of antispastic drugs were studied on spontaneous activity in the electromyogram (EMG) in genetically spastic rats and on spinal reflex transmission in anaesthetized normal rats. Baclofen, 0.2-2 nmol, and midazolam, 10-80 nmol, suppressed tonic activity in the EMG recorded from the gastrocnemius muscle in mutant rats, whereas tizanidine, 1-100 nmol, enhanced it. The action of baclofen was antagonized by i.th. co-administration of delta-aminovalerate but not by bicuculline, that of midazolam by systemic pretreatment with Ro 15-1788. The effect of i.th. tizanidine was antagonized by co-administration of prazosin but not by yohimbine. Baclofen, 2 nmol, exerted suppressant effects on Hoffman (H)-reflexes and spinal flexor reflexes in normal animals, midazolam, 80 nmol, only on flexor reflexes. Tizanidine, 100 nmol, failed to suppress H-reflexes and flexor reflexes. The present results demonstrate a myorelaxant effect of i.th. injections of baclofen and midazolam but not of i.th. tizanidine.
zanaflex 4mg tablets
The effect of tizanidine given as a premedication on perioperative hemodynamics (mean blood pressure, heart rate), sedation, hypnosis and midazolam requirements for induction were assessed in 68 patients scheduled for elective surgery under general anesthesia. Patients were assigned to three groups. Group 1 was premedicated 90 min prior to induction with tizanidine 4 mg po (n = 28); group 2 was premedicated with tizanidine 2 mg po (n = 12); group 3 received no premedication (n = 28). In group 1, increase of mean blood pressure on anesthesia induction was attenuated significantly and sedative and hypnotic effects were stronger significantly compared with other groups. We also found that the amounts of midazolam necessary for loss of consciousness were significantly less in patients who had received tizanidine 4 mg. In conclusion, tizanidine is a useful drug as preanesthetic medication for general anesthesia.
Trial patients were treated with a subcutaneously implanted programmable continuous infusion pump (SynchroMed, Medtronic), filled with baclofen (a muscle relaxant) to treat patients with chronic disabling spasticity who did not respond to a maximum dose of oral baclofen, dantrolene and tizanidine.
zanaflex scheduled drug
Two hundred patients completed a 4-week, single-blind, placebo baseline period, with 134 fulfilling selection criteria and then randomized to tizanidine or placebo. Ninety-two patients completed at least 8 weeks of treatment (tizanidine, n = 45; placebo, n = 47), and 85 patients completed 12 weeks of treatment (tizanidine, n = 44; placebo, n = 41). Most patients (77%) met the diagnostic criteria for migraine of the International Headache Society; 23% had either chronic migrainous headache or chronic tension-type headache. Tizanidine was slowly titrated over 4 weeks to 24 mg or the maximum dose tolerated (mean, 18 mg; SD, 6.4; median, 20.0; range, 2 to 24), divided equally over three dose intervals per day. Overall headache index ([headache days x average intensity x duration in hours]/28 days) was the primary end point.
Outcomes were adherence, measured as continuous medication possession ratio (MPR) and as a binary indicator (MPR ≥0.80, adherent; MPR <0.80, nonadherent), change in oral spasticity medication, and use of nonoral spasticity therapy.
zanaflex 6mg tablets
Unlike rofecoxib, celecoxib does not clinically to significantly inhibit CYP1A2. The lack of significant in vivo inhibition of CYP1A2 can be correctly predicted on the basis of in vitro K(i) data and the free peripheral or portal plasma concentration of celecoxib.
zanaflex drug class
1. Effects of noradrenaline (NA) and the alpha2 agonists tizanidine and clonidine were tested on extracellularly recorded responses of gamma-motoneurones in deeply anaesthetized cats. Two types of responses were used; firstly, short latency phasic responses evoked by electrical stimulation of group II afferents in a muscle nerve and, secondly, tonic background discharges. 2. Responses evoked by group II muscle afferents were depressed when NA and tizanidine were applied ionophoretically close to a gamma-motoneurone and when clonidine was applied systemically. The number of spike potentials evoked by stimulation of these afferents decreased and their latencies increased. Responses evoked by flexor or extensor afferents in gamma-motoneurones innervating flexors or extensors were similarly depressed. 3. Tonic discharges were inconsistently and/or insignificantly affected by locally applied NA and tizanidine but were depressed by systemically applied clonidine. 4. Control tests indicate specific effects of NA and tizanidine application since similarly ionophoresed H+ ions did not change responses of gamma-motoneurones to stimulation of group II afferents, or only weakly enhanced their background discharges. Furthermore, serotonin ejected from a solution with a similar pH facilitated rather than depressed responses of gamma-motoneurones. 5. The results indicate that some antispastic effects of clonidine and tizanidine may be due to the depression of group II-evoked responses of gamma-motoneurones, resulting in weaker responses of muscle spindles to muscle stretches.
zanaflex generic availability
Tizanidine is a centrally acting muscle relaxant with a novel mechanism of action and structurally related to clonidine. There are no large case series of tizanidine exposure.
generic zanaflex pictures
Spasticity is a common and disabling symptom for many patients with upper motor neuron dysfunction. It results from interruption of inhibitory descending spinal motor pathways, and although the pathophysiology of spasticity is poorly understood, the final common pathway is overactivity of the alpha motor neuron. Therapy for spasticity is symptomatic with the aim of increasing functional capacity and relieving discomfort. Any approach to treatment should be multidisciplinary, including physical therapy, and possibly surgery, as well as pharmacotherapy. It is important that treatment be tailored to the individual patient, and that both patient and care giver have realistic expectations. Pharmacotherapy is generally initiated at low dosages and then gradually increased in an attempt to avoid adverse effects. Optimal therapy is the lowest effective dosage. Baclofen, diazepam, tizanidine and dantrolene are currently approved for use in patients with spasticity. In addition, clonidine (usually as combination therapy), gabapentin and botulinum toxin have shown efficacy, however, more studies are required to confirm their place in therapy. Intrathecal baclofen, via a surgically implanted pump and reservoir, may provide relief in patients with refractory severe spasticity.
zanaflex generic name
The anticonvulsant actions of DS 103-282 [5-chloro-4-(2-imidazolin-2-yl-amino)-2,1,3- benzothiadazole , tizanidine], have been evaluated after intraperitoneal administration in DBA/2 mice (seizures induced by sound), in Swiss S mice (seizures induced by N-methyl-D,L-aspartate; NMDLA ) and following intravenous or oral administration in Papio papio (seizure responses to intermittent photic stimulation). Protection against sound-induced seizures occurred after intraperitoneal administration of DS 103-282 (0.66-3.33 mg/kg). The ED50 doses for suppression of the tonic, clonic and wild-running phases of sound-induced seizures were 0.53, 0.79 and 1.3 mg/kg respectively. This protective effect of DS 103-282 (1.5 mg/kg, i.p.) was maximal after 30 min and was maintained for 60-120 min. Seizures induced by NMDLA were not suppressed by DS 103-282 (3.3-10 mg/kg, i.p.). In the baboons, a transient protection against photomyoclonic responses was observed 1 hr after intravenous administration of DS 103-282 (2-4 mg/kg). A similar profile of action was seen after oral administration of larger doses of DS 103-282 (16-32 mg/kg). Unwanted effects of DS 103-282 included transient piloerection, slight disturbance of gait and a fall in rectal temperature in mice, and muscular hypotonia and signs of sedation in baboons. These studies demonstrate an anticonvulsant action of DS 103-282, in both rodent and primate models of epilepsy, but do not support a postsynaptic blockade in excitatory neurotransmission as the mechanism of this action.