Active Ingredient: Tizanidine
Treatment of spasticity associated with multiple sclerosis or with spinal cord injury or disease.
For this indication, competent medicine agencies globally authorize below treatments:
Oral
6 - 36 mg
From 2 To 12 mg 3 time(s) per day every day
4 mg
The effect of tizanidine on spasticity is maximal within 2-3 hours of dosing g and it has a relatively short duration of action. The timing and frequency of dosing should therefore be tailored to the individual, and tizanidine should be given in di vide d doses, up to 3-4 times daily, depending on the patient’s needs. There is considerable variation in response between patients so careful titration is necessary. Care should be taken not to exceed the dose producing the desired therapeutic effect.
It is usual to start with a single dose of 2 mg increasing by 2 mg increments at no less than half-weekly intervals. The optimum the rapeutic response is gene rally achieved with a daily dose of between 12 an d 24 mg, administered in 3 or 4 equally spaced doses. Single doses should not exceed 12 mg. The total daily dose should not exceed 36 mg.
Adverse events may occur at therapeutic doses but these can be minimised by slow titration so that in the large majority of patients they are not a limiting factor.
If therapy needs to be discontinued, particularly in patients who have been receiving high doses for long periods, the dose should be decreased slowly.
Experience in the elderly is limited and use of tizanidine is not recommended unless the benefit of treatment clearly outweighs the risk. Pharmacokinetic data suggest that renal clearance in the elderly may be decreased by up to three fold.
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