Side Effects of tizanidine: A Synthesis of Findings from 30 Studies
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This analysis is based on research papers included in PubMed, but medical research is constantly evolving and may not fully reflect the latest findings. There may also be biases towards certain research areas.
This information is not medical advice and is not a substitute for diagnosis or treatment by a physician. If you have concerns about "Side Effects of tizanidine: A Synthesis of Findings from 30 Studies", please consult your doctor.
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Major research findings
Tizanidine is an imidazoline with central alpha(2)-adrenoceptor agonist activity at both spinal and supraspinal levels, which is indicated as a short-acting drug for the management of spasticity. 13 Despite being used in pediatric populations, there is no adequate information or well controlled studies to document the safety and efficacy of tizanidine in this group. 13
A study in patients with spinal cord injuries determined that oral administration of tizanidine resulted in a reduction in spasticity that lasted for 3 to 4 hours. 11 There was no rebound increase in blood pressure, and resting heart rate was reduced. 11 Side effects included sedation and dry mouth. 11
Oral medications are often used to treat spasticity, but they often have limited efficacy and are prone to side effects. 14 For example, oral baclofen, diazepam, and tizanidine often have poor effects on spasticity and frequently lead to the appearance of undesirable side effects caused by the concentration of these molecules at the brain level. 14
In the treatment of tension headaches, tizanidine has been shown to be significantly more effective than placebo. 30 Tizanidine helped reduce the frequency and intensity of headaches in patients with tension headaches and reduced the use of analgesics. 30 However, side effects such as drowsiness and dry mouth were reported. 30
In children with cerebral palsy, combined treatment with botulinum toxin A and low-dose tizanidine was more effective and had fewer side effects than combined treatment with botulinum toxin A and baclofen, particularly with regard to improvements in motor function and a reduction in caregiver burden. 20
Reasons for Side Effects
Tizanidine is thought to reduce spasticity by activating alpha2 adrenergic receptors. 18 This action occurs in both the spinal cord and the brain, inhibiting the release of neurotransmitters and reducing neuronal excitability, thereby relieving muscle tension. 18 However, alpha2 adrenergic receptors are also present in other tissues such as the brain and heart, so tizanidine can also act on these tissues and cause side effects.
Common side effects
Drowsiness
Drowsiness is one of the most common side effects of tizanidine. 11 30 This is thought to be due to tizanidine inhibiting the activity of neurotransmitters in the brain, causing sedation. 18
Dry mouth
Tizanidine can cause dry mouth. 11 30 This is thought to be due to tizanidine inhibiting the activity of the salivary glands. 18
Low blood pressure
Tizanidine can cause low blood pressure. 7 This is thought to be due to tizanidine dilating blood vessels, lowering blood pressure. 18
Muscle weakness
Tizanidine can cause muscle weakness. 17 This is thought to be due to tizanidine inhibiting muscle activity. 18
Liver dysfunction
Tizanidine can cause liver dysfunction. 2 This is thought to be due to tizanidine being metabolized in the liver. 18
Decreased heart rate
Tizanidine can cause a decrease in heart rate. 11 This is thought to be due to tizanidine suppressing heart nerves. 18
Respiratory depression
Tizanidine can cause respiratory depression. 18 This is thought to be due to tizanidine suppressing the respiratory center. 18
Measures to counter side effects
Drowsiness
To reduce drowsiness caused by tizanidine, it is effective to reduce the dosage or take it before bedtime. 17 27
Dry mouth
To reduce dry mouth, it is important to drink plenty of fluids. 18
Low blood pressure
If you are concerned about low blood pressure, please consult a doctor. 18
Muscle weakness
If you are concerned about muscle weakness, please consult a doctor. 18
Liver dysfunction
If you suspect liver dysfunction, please consult a doctor. 18
Decreased heart rate
If you are concerned about a decrease in heart rate, please consult a doctor. 18
Respiratory depression
If you suspect respiratory depression, please consult a doctor. 18
Comparison between studies
Common points of studies
Many studies have shown that tizanidine is effective in treating spasticity. 11 18 Also, some studies have reported that tizanidine has fewer side effects compared to other spasticity treatments, such as baclofen. 18 4 However, tizanidine can cause side effects such as drowsiness and dry mouth. 11 30
Differences between studies
Studies have also reported that tizanidine is effective in treating tension headaches. 30 Also, in children with cerebral palsy, there have been reports that combined treatment with botulinum toxin A and tizanidine is more effective and has fewer side effects than baclofen. 20
Points to note about application to real life
While tizanidine is an effective medication for the treatment of spasticity and tension headaches, it is important to be aware of potential side effects such as drowsiness and dry mouth. 18 When taking tizanidine, follow your doctor's instructions and adhere to the appropriate dosage. 18 Also, exercise caution when performing tasks that require concentration, such as driving or operating machinery. 18
Limitations of current research
Research on tizanidine is still insufficient, especially in terms of safety and efficacy data for pediatric patients. 13 Additionally, research on the interactions between tizanidine and other medications is also lacking. 18
Directions for future research
To further investigate the safety and efficacy of tizanidine, clinical trials involving pediatric patients are needed. 13 Also, research on the interactions between tizanidine and other medications is required. 18
Conclusion
Tizanidine is an effective drug for the treatment of spasticity and tension headaches, but it is important to be aware of potential side effects such as drowsiness and dry mouth. 18 When taking tizanidine, follow your doctor's instructions and adhere to the appropriate dosage. 18 Also, further research on tizanidine is needed. 18
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