Tizanidne Hydrochloride

7.3 CYP1A2 Inhibitors other than Fluvoxamine and Ciprofloxacin Because of potential drug interactions, concomitant use of tizanidine with other CYP1A2 inhibitors, such as zileuton, fluoroquinolones other than strong CYP1A2 inhibitors (which are contraindicated), antiarrhythmics (amiodarone, mexiletine, propafenone, and verapamil), cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine) should be avoided.

7.2 Ciprofloxacin Concomitant use of ciprofloxacin and tizanidine is contraindicated. Changes in pharmacokinetics of tizanidine when administered with ciprofloxacin resulted in significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment [see Contraindications ( 4 ) and Clinical Pharmacology ( 12.3 )]. 7.3 CYP1A2 Inhibitors other than Fluvoxamine and Ciprofloxacin Because of potential drug interactions, concomitant use of tizanidine with other CYP1A2 inhibitors, such as zileuton, fluoroquinolones other than strong CYP1A2 inhibitors (which are contraindicated), antiarrhythmics (amiodarone, mexiletine, propafenone, and verapamil), cimetidine, famotidine, oral contraceptives, acyclovir, and ticlopidine) should be avoided.

Strong CYP1A2 inhibitor; concomitant use contraindicated due to significantly decreased blood pressure, increased drowsiness, and increased psychomotor impairment.

Alcohol increases overall amount of tizanidine in bloodstream and CNS depressant effects are additive, resulting in increased adverse reactions.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

Should be avoided due to CYP1A2 inhibition. If necessary, initiate tizanidine at 2 mg and titrate cautiously; monitor for hypotension, bradycardia, or excessive drowsiness.

CNS depressants; concomitant use may cause additive CNS depressant effects including sedation; monitor for excess sedation.

Concomitant use not recommended; if necessary, monitor for hypotension, bradycardia, or excessive drowsiness and reduce or discontinue tizanidine.