Tizanidine/Strong CYP1A2 Inhibitors Interactions
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Medical warning:
Very Serious. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Your medicine may slow down how quickly your liver processes tizanidine.
What might happen:
The amount of tizanidine in your blood may increase and cause more side effects than normal, including severe low blood pressure, drowsiness, and problems with moving your body.
What you should do about this interaction:
Contact your healthcare professional (e.g. doctor or pharmacist) right away about using these medicines together.Let your doctor know right away if you notice any slow heartbeat or have any dizziness. Use caution when performing tasks that require alertness.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
- 1.Zanaflex (tizanidine hydrochloride) US prescribing information. Acordia Therapeutics, Inc. November 7, 2013.
- 2.Cipro (ciprofloxacin hydrochloride) US prescribing information. Bayer Corporation March, 2022.
- 3.Idhifa (enasidenib) US prescribing information. Celgene Corporation November, 2020.
- 4.Luvox (fluvoxamine maleate) US prescribing information. Jazz Pharmaceuticals, Inc. August, 2023.
- 5.Qelbree (viloxazine) US prescribing information. Catalent Pharma Solutions, LLC April, 2021.
- 6.American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc 2023 Jul;71(7):2052-2081.
- 7.Granfors MT, Backman JT, Neuvonen M, Neuvonen PJ. Ciprofloxacin greatly increases concentrations and hypotensive effect of tizanidine by inhibiting its cytochrome P450 1A2-mediated presystemic metabolism. Clin Pharmacol Ther 2004 Dec;76(6):598-606.
- 8.Momo K, Homma M, Kohda Y, Ohkoshi N, Yoshizawa T, Tamaoka A. Drug interaction of tizanidine and ciprofloxacin: case report. Clin Pharmacol Ther 2006 Dec;80(6):717-9.
- 9.Rudolph A, Dahmke H, Kupferschmidt H, Burden A, Weiler S. Coadministration of tizanidine and ciprofloxacin: a retrospective analysis of the WHO pharmacovigilance database. Eur J Clin Pharmacol 2021 Jun;77(6):895-902.
- 10.Jodicke AM, Curkovic I, Zellweger U, Tomka IT, Neuer T, Kullak-Ublick GA, Roos M, Egbring M. Analysis of Drug-Drug Interactions in Swiss Claims Data Using Tizanidine and Ciprofloxacin as a Prototypical Contraindicated Combination. Ann Pharmacother 2018 Oct;52(10):983-991.
- 11.Granfors MT, Backman JT, Neuvonen M, Ahonen J, Neuvonen PJ. Fluvoxamine drastically increases concentrations and effects of tizanidine: a potentially hazardous interaction. Clin Pharmacol Ther 2004 Apr; 75(4):331-41.
- 12.Momo K, Doki K, Hosono H, Homma M, Kohda Y. Drug interaction of tizanidine and fluvoxamine. Clin Pharmacol Ther 2004 Nov;76(5):509-10.
- 13.Granfors MT, Backman JT, Laitila J, Neuvonen PJ. Tizanidine is mainly metabolized by cytochrome p450 1A2 in vitro. Br J Clin Pharmacol 2004 Mar;57(3):349-53.
- 14.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
- 15.Phansalkar S, Desai AA, Bell D, Yoshida E, Doole J, Czochanski M, Middleton B, Bates DW. High-priority drug-drug interactions for use in electronic health records. J Am Med Inform Assoc 2012 Sep-Oct; 19(5):735-43.
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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.