Update on tizanidine for muscle spasticity and emerging indications

Clinical Professor, Physical Medicine and Rehabilitation, Director Overlook Pain Center, Associates in Rehabilitation Medicine, 11 Overlook Road, MAC II, Suite B110, Summit, NJ 07091, USA.
Expert Opinion on Pharmacotherapy (Impact Factor: 3.53). 09/2008; 9(12):2209-15. DOI: 10.1517/14656566.9.12.2209
Source: PubMed


Tizanidine hydrochloride, an alpha(2)-adrenergic receptor agonist, is a widely used medication for the treatment of muscle spasticity. Clinical studies have supported its use in the management of spasticity caused by multiple sclerosis (MS), acquired brain injury or spinal cord injury. It has also been shown to be clinically effective in the management of pain syndromes, such as: myofascial pain, lower back pain and trigeminal neuralgia. This review summarizes the recent findings on the clinical application of tizanidine.
Our objective was to review and summarize the medical literature regarding the evidence for the usefulness of tizanidine in the management of spasticity and in pain syndromes such as myofascial pain.
We reviewed the current medical and pharmacology literature through various internet literature searches. This information was then synthesized and presented in paragraph and table form.
Tizanidine hydrochloride is a very useful medication in patients suffering from spasticity caused by MS, acquired brain injury or spinal cord injury. It can also be helpful in patients suffering from chronic neck and/or lower back pain who have a myofascial component to their pain. Doses should be started at low dose and gradually titrated to effect.

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    • "Physiological treatment has involved stretch exercises and foot splints worn at night (Man-Son-Hing et al. 1998; Blyton et al. 2012; Hallegraeff et al. 2012). Pharmacological treatments have included quinine, magnesium citrate, vitamin D3, tizanidine hydrochloride, eperisone hydrochloride, vitamin B, vitamin C, vitamin E, taurine, epalrestat, gabapentin, verapamil , carisoprodol, orphenadrine, and Shakuyakukanzo-to (a Chinese herbal medicine) (Fowler 1973; Daniel 1979; Pitkin 1983; Warburton et al. 1987; Sontag and Wanner 1988; Yamamoto 1994; Chan et al. 1998; Abdulla et al. 1999; Serrao et al. 2000; Khajehdehi et al. 2001; Roffe et al. 2002; Hinoshita et al. 2003; Miller and Layzer 2005; Guay 2008; Malanga et al. 2008; Ziegler 2008; El-Tawil et al. 2010; Chandanwale et al. 2011; Chandok et al. 2011; Blyton et al. 2012; Hallegraeff et al. 2012). In Japan, peripheral nerve block has been used as a treatment for nocturnal leg cramps. "
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