Tizanidine vs Cyclobenzaprine
TizanidineCyclobenzaprine
Alpha-2 Adrenergic AgonistDrug ClassTricyclic Antidepressant Derivative
Reduces spasticity by increasing presynaptic inhibition of motor neurons. Works centrally at the spinal cord level.Mechanism of ActionReduces muscle spasms by acting on the central nervous system (CNS), particularly in the brainstem.
Muscle spasticity (e.g., from MS or spinal cord injury)IndicationsMuscle spasms related to musculoskeletal conditions
Tablets, CapsulesDosage FormsTablets, Extended-Release Capsules
1–2 hoursOnset of Action1 hour
3–6 hoursDuration of Action12–24 hours (depending on formulation)
- Initial: 2 mg every 6–8 hours - Max: 36 mg/dayCommon Dosage- Immediate-release: 5–10 mg 3 times daily - Extended-release: 15–30 mg once daily
Liver (CYP1A2 enzyme)MetabolismLiver (CYP3A4 enzyme)
- Drowsiness - Dizziness - Dry mouth - Weakness - HypotensionSide Effects- Drowsiness - Dry mouth - Dizziness - Fatigue - Constipation
- Risk of severe liver injury - Avoid use with CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine) - May cause low blood pressureWarnings- Avoid use in patients with heart conditions (e.g., arrhythmias, recent MI) - Risk of serotonin syndrome when combined with certain antidepressants
Category C (risk not ruled out)Pregnancy CategoryCategory B (no evidence of risk in animals; human data unavailable)
- CYP1A2 inhibitors increase levels - Alcohol increases sedation - Antihypertensives increase hypotension riskDrug Interactions- CNS depressants enhance sedation - MAO inhibitors risk serotonin syndrome - Alcohol increases sedation
Use cautiously in: - Elderly - Liver-impaired patientsSpecial PopulationsUse cautiously in: - Elderly - Patients with cardiac conditions
Effective for spasticity in neurological conditionsEfficacyEffective for acute musculoskeletal pain
Liver function testsMonitoringCardiac monitoring in at-risk patients
Limited due to risk of liver damage and dependence.Suitability for Long-Term UseLimited to short-term use (2–3 weeks) due to risk of tolerance.
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