Patient/caregiver was educated on the side-effects of using Tizanidine as follows:

Withdrawal

• Individuals on sudden withdrawal from tizanidine, especially after prolonged use or use in high doses, can present with unpleasant withdrawal symptoms, such as, hypertension, tachycardia, exacerbation of anxiety, agitation, sleep disturbances, mania, rebound spasticity, bad muscle spasms, and seizures. Discontinuation on tizanidine use must be slow and gradual, using tapering doses, and only on your physician recommendation.

Central nervous system side-effects

• Tizanidine use can result in episodes of confusion, dizziness, and light-headedness. This risk with tizanidine can be even high when it is taken along with any other products and medications causing central nervous depression, such as, alcohol, opioid pain medications, antidepressants, antianxiety medications, and sedatives. Watching closely for therapeutic response and gradually changing the dose, to help optimum control of your symptoms, can contribute to controlling/reducing the risk for drowsiness and dizziness due to the medication.
• Tizanidine use, especially in individuals with history of mood disorders, can occasionally result in exacerbation of anxiety and depressive symptoms, changes in behavior, hallucinations, and compromised sexual drive.

Cardiovascular side-effects

• Tizanidine, especially when taken in high doses, carries the risk of depressing the cardiovascular center in the brain, which regulates the heart rate and blood pressure. Consequently, intake of tizanidine can result in low heart rate and blood pressure.
• This risk with tizanidine can be even high when it is taken along with any other products and medications causing hypotension and bradycardia, such as, antihypertensives, antidepressants, antianxiety medications, and sedatives.
• Hypotension and bradycardia, secondary to tizanidine intake, can contribute to the confusion and dizziness, thus significantly increasing the risk for fall and accidents.

Respiratory depression

• Tizanidine, especially when taken in high doses, can lead to depression of respiratory center in the brain and consequently cause exacerbation of SOB, and difficult breathing.
• This risk with tizanidine can be even high when it is taken along with any other products and medications causing central nervous depression, such as, alcohol, antidepressants, antianxiety medications, and sedatives.
• Individuals with history of breathing disorders, such as, asthma, emphysema, and COPD, are at increased risk for presentation with severe debility due to respiratory arrest from tizanidine intake.