Patient/caregiver was educated on contraindications for using Tizanidine as follows:
- 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. Hypotension and bradycardia, secondary to tizanidine intake, can contribute to the confusion and dizziness, thus significantly increasing the risk for fall and accidents. 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, and so, must be avoided.
- Tizanidine is mainly metabolized inside the body by the liver and is excreted out of the body in the urine by the kidneys. If liver is deficient, metabolism of the drug could be compromised, which can result in higher concentrations of the drug in the body for longer periods of time. If kidney function is deficient, elimination of the drug could be compromised, which also can result in higher concentrations of the drug in the body for longer periods of time. Either case can contribute to toxicity and consequent side-effects. So, for individuals with history of compromised hepatic and/or renal function, tizanidine must be either be avoided or used with caution, with close monitoring for symptoms of toxicity with tizanidine.
- Also, tizanidine can rarely induce hepatic dysfunction and liver toxicity, leading to fatal liver failure. Individuals can present with symptoms of liver failure and jaundice, such as, yellowing of skin and eyes, dark yellow colored urine, itching of skin, upper right abdominal pain, abdominal distension, nausea and vomiting, confusion and disorientation, fluid retention in the body with swelling & acute weight gain, and compromised appetite. Individuals with inherently poor liver function can be at increased risk for liver toxicity with tizanidine. So, for individuals with history of compromised liver function, tizanidine must be either be avoided or used with caution, with close monitoring for symptoms of liver toxicity.
