Tizanidine Hydrochloride has 18 known drug interactions based on U.S. FDA drug labeling data. Of these, 3 are contraindicated combinations that should be avoided entirely. 11 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Acyclovir, Ciprofloxacin, Fluvoxamine. Patients taking Tizanidine Hydrochloride should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 18
- Contraindicated
- 3
- Major
- 11
- Moderate
- 4
Contraindicated (3)
- Tizanidine Hydrochloride + Acyclovir— Changes in pharmacokinetics of tizanidine when administered with ciprofloxacin resulted in significantly decreased blood…
- Tizanidine Hydrochloride + Ciprofloxacin— 7.2 Ciprofloxacin Concomitant use of ciprofloxacin and Zanaflex is contraindicated. Changes in pharmacokinetics of tizan…
- Tizanidine Hydrochloride + Fluvoxamine— Strong CYP1A2 inhibitor causing significantly decreased blood pressure, increased drowsiness, and psychomotor impairment…
Major (11)
- Tizanidine Hydrochloride + Alcohol— Alcohol increases tizanidine bloodstream concentration and adverse reactions; CNS depressant effects are additive.
- Tizanidine Hydrochloride + Amiodarone— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Cimetidine— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Famotidine— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Mexiletine— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Oral Contraceptives— Moderate CYP1A2 inhibitor; concomitant use not recommended due to risk of hypotension, bradycardia, or excessive drowsin…
- Tizanidine Hydrochloride + Other α2-Adrenergic Agonists— Concomitant use not recommended due to cumulative hypotensive effects.
- Tizanidine Hydrochloride + Propafenone— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Ticlopidine— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Verapamil— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
- Tizanidine Hydrochloride + Zileuton— Concomitant use should be avoided due to potential interactions. If clinically necessary, initiate with 2 mg and titrate…
Moderate (4)
- Tizanidine Hydrochloride + Alpha-2 Adrenergic Agonists— Concomitant use is not recommended because hypotensive effects may be cumulative.
- Tizanidine Hydrochloride + Bromocriptine— Not recommended for concomitant use; hypotensive effects may be cumulative.
- Tizanidine Hydrochloride + Estrogens— Concomitant use not recommended; hypotensive effects may be cumulative.
- Tizanidine Hydrochloride + Nitrazepam— CNS depressants that may cause additive CNS depressant effects including sedation when combined with tizanidine; monitor…