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Tizanidine

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Chronic Daily Headache: Diagnosis and Management.
Abstract Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. If a red flag for a secondary cause of headache is present, magnetic resonance imaging of the head should be performed. All patients should be asked about medication overuse, which can increase the frequency of headaches. Patients who overuse medications for abortive therapy for headache should be encouraged to stop the medications entirely and consider prophylactic treatment. Several...
Source: American Family Physician - April 15, 2014 Category: Primary Care Authors: Yancey JR, Sheridan R, Koren KG Tags: Am Fam Physician Source Type: research

Alpha2-adrenergic agonists for the management of opioid withdrawal.
CONCLUSIONS: Clonidine and lofexidine are more effective than placebo for the management of withdrawal from heroin or methadone. No significant difference in efficacy was detected for treatment regimens based on clonidine or lofexidine, and those based on reducing doses of methadone over a period of around 10 days but methadone is associated with fewer adverse effects than clonidine, and lofexidine has a better safety profile than clonidine. PMID: 24683051 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 31, 2014 Category: Journals (General) Authors: Gowing L, Farrell MF, Ali R, White JM Tags: Cochrane Database Syst Rev Source Type: research

Non-antiepileptic drugs for trigeminal neuralgia.
CONCLUSIONS: There is low-quality evidence that the effect of tizanidine is not significantly different than that of carbamazepine in treating trigeminal neuralgia. Pimozide is more effective than carbamazepine, although the evidence is of low quality and the data did not allow comparison of adverse event rates. There is also low-quality evidence that 0.5% proparacaine hydrochloride eye drops have no benefit over placebo. Limitations in the data for tocainide prevent any conclusions being drawn. There is insufficient evidence from randomised controlled trials to show significant benefit from non-antiepileptic drugs in trig...
Source: Cochrane Database of Systematic Reviews - December 3, 2013 Category: Journals (General) Authors: Zhang J, Yang M, Zhou M, He L, Chen N, Zakrzewska JM Tags: Cochrane Database Syst Rev Source Type: research

Effect of Antispastic Drugs on Motor Reflexes and Voluntary Muscle Contraction in Incomplete Spinal Cord Injury
Conclusions: These results suggest that antispastic drugs are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic drugs. (Source: Archives of Physical Medicine and Rehabilitation)
Source: Archives of Physical Medicine and Rehabilitation - November 25, 2013 Category: Rehabilitation Authors: Virginia Way Tong Chu, Thomas George Hornby, Brian David Schmit Tags: Featured Articles Source Type: research

The effect of antispastic drugs on motor reflexes and voluntary muscle contraction in incomplete spinal cord injury.
CONCLUSIONS: These results suggest that antispastic agents are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic medications. PMID: 24269485 [PubMed - as supplied by publisher] (Source: Physica Medica)
Source: Physica Medica - November 21, 2013 Category: Physics Authors: Tong Chu VW, Hornby TG, Schmit BD Tags: Arch Phys Med Rehabil Source Type: research

Amitriptyline versus tizanidine in the management of tension‐type headache in Nepal
(Source: Emergency Medicine Australasia)
Source: Emergency Medicine Australasia - November 13, 2013 Category: Emergency Medicine Authors: Ajay Singh Thapa Tags: Case Letter Source Type: research

Use of Intrathecal Baclofen for Treatment of Severe Spasticity in Selected Patients With Motor Neuron Disease
Conclusions. Our findings suggest that ITB can effectively reduce spasticity and related symptoms without compromising function in selected patients with U-MND. (Source: Neurorehabilitation and Neural Repair)
Source: Neurorehabilitation and Neural Repair - October 7, 2013 Category: Neurology Authors: Bethoux, F., Boulis, N., McClelland, S., Willis, M. A., Hussain, M., Machado, A., Mychkovsky, L., Stough, D., Sutliff, M., Pioro, E. P. Tags: Clinical Research Articles Source Type: research

Unintentional Pediatric Exposures to Central Alpha-2 Agonists Reported to the National Poison Data System
Conclusions: The number of unintentional pediatric exposures to alpha-2 agonists increased from 2000-2011. Clonidine exposures were the most commonly reported, more symptomatic, and associated with 3 deaths. Despite central nervous system depression, bradycardia, and hypotension being common, the need for intubation and vasopressors was rare. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - October 3, 2013 Category: Pediatrics Authors: George Sam Wang, Marie-Claire Le Lait, Kennon Heard Tags: Original Articles Source Type: research

Adherence Associated With Oral Medications in the Treatment of Spasticity
Objective: To examine adherence to baclofen, tizanidine, and dantrolene (U.S. Food and Drug Administration–approved oral spasticity medications), and identified determinants of adherence.Design: A retrospective administrative claims data analysis that used medical and pharmacy claims data and enrollment information from a large, national U.S. health plan.Subjects and Methods: The subjects were commercial health plan members who initiated treatment on baclofen, tizanidine, or dantrolene from January 1, 2004, through September 30, 2009, and who had stroke, spinal cord injury, traumatic brain injury, cerebral palsy, or mult...
Source: PM and R - May 6, 2013 Category: Rehabilitation Authors: Rachel Halpern, Patrick Gillard, Glenn D. Graham, Sepideh F. Varon, Richard D. Zorowitz Tags: Original Research Source Type: research

Use of common migraine treatments in breast-feeding women: a summary of recommendations.
CONCLUSIONS: Several excellent resources are available for clinicians making treatment decisions in breast-feeding women. Clinicians treating migraine should discuss both acute and preventive treatment options shortly before and within a few months after delivery, keeping in mind the clinical features of the individual patient, and in consultation with their obstetrician and pediatrician. An awareness of the pharmacological data that are currently available and how to access that data may be helpful in making treatment decisions in this population. PMID: 23465038 [PubMed - in process] (Source: Headache)
Source: Headache - April 1, 2013 Category: Neurology Authors: Hutchinson S, Marmura MJ, Calhoun A, Lucas S, Silberstein S, Peterlin BL Tags: Headache Source Type: research

Use of Common Migraine Treatments in Breast‐Feeding Women: A Summary of Recommendations
ConclusionsSeveral excellent resources are available for clinicians making treatment decisions in breast‐feeding women. Clinicians treating migraine should discuss both acute and preventive treatment options shortly before and within a few months after delivery, keeping in mind the clinical features of the individual patient, and in consultation with their obstetrician and pediatrician. An awareness of the pharmacological data that are currently available and how to access that data may be helpful in making treatment decisions in this population. (Source: Headache: The Journal of Head and Face Pain)
Source: Headache: The Journal of Head and Face Pain - March 6, 2013 Category: Neurology Authors: Susan Hutchinson, Michael J. Marmura, Anne Calhoun, Sylvia Lucas, Stephen Silberstein, B. Lee Peterlin Tags: Review Article Source Type: research

The Pharmacokinetic Profile of the Combination of Naproxen and Tizanidine in Rat
This study examines the pharmacokinetics of naproxen when it is combined with tizanidine. Combining these two drugs is an attractive modality for inflammation complaints. Oral coadministration of naproxen/tizanidine produced a synergistic anti‐inflammatory effect in rats. The swelling of the rat paw was measured by a plethysmometer using carrageenan as an inflammatory agent. In this study, rats received oral doses of naproxen (1, 3, and 4.2 mg/kg), and these doses were combined with a fixed dose of tizanidine (0.01 mg/kg). To evaluate the pharmacokinetic interaction between naproxen/tizanidine, blood samples were obt...
Source: Drug Development Research - February 27, 2013 Category: Drugs & Pharmacology Authors: Selene Isabel Patiño‐Camacho, María Guadalupe Lozoya Moreno, Francisco Javier Flores‐Murrieta, Myrna Déciga‐Campos Tags: Research Article Source Type: research

Clinical Survey of Tizanidine-induced Adverse Effects-Impact of Concomitant Drugs Providing Cytochrome P450 1A2 Modification-.
Abstract The drug-drug interactions of tizanidine and cytochrome (CYP) P450 1A2 inhibitors, which potentially alter the hepatic metabolism of tizanidine, were investigated by retrospective survey of medical records with regard to prescription. One thousand five hundred sixty-three patients treated with tizanidine at University of Tsukuba Hospital were investigated. Of those, 713 patients (45.6%) were treated with coadministration of tizanidine and CYP1A2 inhibitors (37 drugs). The patients who received a combination of tizanidine and CYP1A2 inhibitors were characterized as elderly, having multiple diseases, and tak...
Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan - February 10, 2013 Category: Drugs & Pharmacology Authors: Momo K, Homma M, Matsumoto S, Sasaki T, Kohda Y Tags: Yakugaku Zasshi Source Type: research

A Rational Approach to the Management of Chronic Migraine
About 2% of the adult population has chronic migraine with only 20% diagnosed with this disorder. Those with medication overuse may improve with withdrawal of overuse medications. The intravenous dihydroergotamine regimen usually produces short‐term benefit for those with medically refractory chronic migraine. OnabotulinumtoxinA and topiramate have shown efficacy in large placebo‐controlled randomized trials. Sodium valproate, gabapentin, tizanidine, amitriptyline, fluoxetine, zonisamide, and possibly memantine may be alternative or possibly combined treatment options but with lesser levels of evidence supporting their...
Source: Headache: The Journal of Head and Face Pain - January 8, 2013 Category: Neurology Authors: Randolph W. Evans Tags: Expert Opinion Source Type: research

A rational approach to the management of chronic migraine.
Abstract About 2% of the adult population has chronic migraine with only 20% diagnosed with this disorder. Those with medication overuse may improve with withdrawal of overuse medications. The intravenous dihydroergotamine regimen usually produces short-term benefit for those with medically refractory chronic migraine. OnabotulinumtoxinA and topiramate have shown efficacy in large placebo-controlled randomized trials. Sodium valproate, gabapentin, tizanidine, amitriptyline, fluoxetine, zonisamide, and possibly memantine may be alternative or possibly combined treatment options but with lesser levels of evidence sup...
Source: Headache - January 1, 2013 Category: Neurology Authors: Evans RW Tags: Headache Source Type: research

Tizanidine Increases Antinociceptive Effect and Prevent Gastric Damage Induced by Ketorolac in the Rat
In this study, we evaluated the potential synergistic effect of these drugs in the thermal paw stimulation model and their effect on gastric ulcer production in response in the rat. Dose‐response curves for ketorolac and tizanidine were constructed and from these, an ED40 value was obtained. Isobolographic analysis was carried out based on 0.5:0.5 proportions. In addition, protective effect of tizanidine against ketorolac‐induced gastric damage was evaluated. A synergistic interaction in thermal hyperalgesia and gastroprotective activity was observed, suggesting a good therapeutic potential of this combination in the t...
Source: Drug Development Research - November 21, 2012 Category: Drugs & Pharmacology Authors: Juan Rodríguez‐Silverio, María Elena Sánchez‐Mendoza, Jesús Arrieta‐Valencia, Héctor Isaac Rocha‐Gonzalez, Francisco Javier Flores‐Murrieta Tags: Research Article Source Type: research

Tizanidine Increases Antinociceptive Effect and Prevents Gastric Damage Induced by Ketorolac in the Rat
In this study, we evaluated the potential synergistic effect of these drugs in the thermal paw stimulation model and their effect on gastric ulcer production in response in the rat. Dose‐response curves for ketorolac and tizanidine were constructed and from these, an ED40 value was obtained. Isobolographic analysis was carried out based on 0.5:0.5 proportions. In addition, protective effect of tizanidine against ketorolac‐induced gastric damage was evaluated. A synergistic interaction in thermal hyperalgesia and gastroprotective activity was observed, suggesting a good therapeutic potential of this combination in the t...
Source: Drug Development Research - November 21, 2012 Category: Drugs & Pharmacology Authors: Juan Rodríguez‐Silverio, María Elena Sánchez‐Mendoza, Jesús Arrieta‐Valencia, Héctor Isaac Rocha‐Gonzalez, Francisco Javier Flores‐Murrieta Tags: Research Article Source Type: research

Spasticity: pathophysiology, evaluation and management.
This article reviews the current understanding of pathophysiology, clinical features and management of spasticity. PMID: 22976059 [PubMed - in process] (Source: Practical Neurology)
Source: Practical Neurology - September 19, 2012 Category: Neurology Authors: Kheder A, Nair KP Tags: Pract Neurol Source Type: research

Ciprofloxacin/tizanidine: Bradycardia, hypoxaemia and hypotension: case report
(Source: Reactions)
Source: Reactions - May 22, 2012 Category: Drugs & Pharmacology Tags: Short communication Source Type: research

Development of orodispersible tizanidine HCl tablets using spray dried coprocessed exipient bases
Rajashree Masareddy, A Kokate, V ShahIndian Journal of Pharmaceutical Sciences 2011 73(4):392-396Tizanidine HCl is a centrally acting α-2 adrenergic agonist muscle relaxant with a slightly bitter taste having short half-life of 2.5 h. In the present study effect of co-processed excipient bases in formulation of orodispersible tizanidine HCl tablets by direct compression method was investigated. Co-processed excipient of microcrystalline cellulose with SSL-hydroxypropylcellulose was prepared using spray drier in 1:1, 1:2 and 1:3 ratio. Formulated tablets were evaluated for hardness, friability, in vitro disinteg...
Source: Indian Journal of Pharmaceutical Sciences - May 4, 2012 Category: Drugs & Pharmacology Authors: Rajashree MasareddyA KokateV Shah Source Type: research

Tizanidine: A Cause of Hypokalemia
(Source: American Journal of Kidney Diseases)
Source: American Journal of Kidney Diseases - March 26, 2012 Category: Urology & Nephrology Tags: National Kidney Foundation 2012 Spring Clinical Meetings Abstracts Source Type: research

Drugs used to treat muscle and joint disease
Abstract: There are a wide range of joint and muscle diseases. The main joint diseases covered in this article are osteoarthritis and gout. The former is treated with symptomatic pain relief and the latter with strategies to reduce uric acid deposition in the joint, especially allopurinol. Myasthenia gravis is an autoimmune disease targeted to muscle type nicotinic receptors. Treatment is based on improving neuromuscular function by (i) increasing acetylcholine concentrations with neostigmine and pyridostigmine, (ii) immunosuppression, (iii) thymectomy and (iv) plasmapheresis. General muscle spasticity can be caused by a ...
Source: Anaesthesia and intensive care medicine - March 1, 2012 Category: Anesthesiology Authors: David G. Lambert Tags: Pharmacology Source Type: research

Towards Safer and More Predictable Drug Treatment – Reflections from Studies of the First BCPT Prize Awardee
AbstractThis MiniReview is a personal recollection of selected research topics, which the author in collaboration with colleagues has studied, aiming to improve the predictability of drug therapy. In early studies, we found bi‐ and trivalent cations to reduce the absorption of various tetracyclines and fluoroquinolones. Certain antacids elevated the bioavailability of some non‐steroidal anti‐inflammatory drugs and sulphonylureas. Various brands of phenytoin tablets revealed great differences in their bioavailability, causing clinical consequences. Numerous factors affecting the antidotal effect of activated charcoal ...
Source: Basic and Clinical Pharmacology and Toxicology - February 21, 2012 Category: Drugs & Pharmacology Authors: Pertti J. Neuvonen Tags: MiniReview Source Type: research

Tizanidine (Zanaflex): A Muscle Relaxant That May Prolong the QT Interval by Blocking IKr
Conclusion: Tizanidine prolongs the QT interval by blocking IKr. Patients could be at risk of cardiac proarrhythmia during impaired drug elimination, such as in case of CYP1A2 inhibition during drug interactions. (Source: Journal of Cardiovascular Pharmacology and Therapeutics)
Source: Journal of Cardiovascular Pharmacology and Therapeutics - February 6, 2012 Category: Cardiology Authors: Kaddar, N., Vigneault, P., Pilote, S., Patoine, D., Simard, C., Drolet, B. Tags: Experimental Studies Source Type: research

Muscle relaxants for pain management in rheumatoid arthritis.
CONCLUSIONS: Based upon the currently available evidence in patients with RA, benzodiazepines (diazepam and triazolam) do not appear to be beneficial in improving pain over 24 hours or one week. The non-benzodiazepine agent zopiclone also did not significantly reduce pain over two weeks. However, even short term muscle relaxant use (24 hours to 2 weeks) is associated with significant adverse events, predominantly drowsiness and dizziness. PMID: 22258993 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 26, 2012 Category: Journals (General) Authors: Richards BL, Whittle SL, Buchbinder R Tags: Cochrane Database Syst Rev Source Type: research

Medium-latency reflex response elicited from the flexor carpi radialis by radial nerve stimulation.
Abstract The H reflex obtained from the flexor carpi radialis muscle by median nerve stimulation is a well-known monosynaptic reflex. However, the origin of the late responses is still contentious. Radial nerve stimulation was performed through the spiral groove, and EMG recording was obtained from the flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscles. An M response followed by an F response was achieved from the ECR by radial nerve stimulation; the antagonistic FCR muscle elicited a late response. A total of 25 cases were included in this study. In 22 of these cases, a response with a latency o...
Source: Experimental Brain Research - December 24, 2011 Category: Neuroscience Authors: Uysal H, Kızılay F, Inel SE, Ozen H, Pek G Tags: Exp Brain Res Source Type: research

Doxazosin Versus Tizanidine for Treatment of Dysfunctional Voiding in Children: A Prospective Randomized Open-labeled Trial
Conclusion: Tizanidine could be a safe and effective treatment of children with dysfunctional voiding due to pelvic floor/skeletal sphincter dysfunction. More placebo-controlled trails with larger sample sizes are needed. (Source: Urology)
Source: Urology - December 23, 2011 Category: Urology & Nephrology Authors: Ahmed S. El-Hefnawy, Tamer Helmy, Mohamed M. El-Assmy, Osama Sarhan, Ashraf T. Hafez, Mohammed Dawaba Tags: Pediatric Urology Source Type: research

Tizanidine and tizanidine hydrochloride: on the correct tautomeric form of tizanidine
A crystallization series of tizanidine hydrochloride, used as a muscle relaxant for spasticity acting centrally as an α2-adrenergic agonist, yielded single crystals of the free base and the hydrochloride salt. The crystal structures of tizanidine [systematic name: 5-chloro-N-(imidazolidin-2-ylidene)-2,1,3-benzothiadiazol-4-amine], C9H8ClN5S, (I), and tizanidine hydrochloride {systematic name: 2-[(5-chloro-2,1,3-benzothiadiazol-4-yl)amino]imidazolidinium chloride}, C9H9ClN5S+·Cl−, (II), have been determined. Tizanidine crystallizes with two almost identical molecules in the asymmetric unit (r.m.s. deviation = 0.179 Å...
Source: Acta Crystallographica Section C - December 9, 2011 Category: Chemistry Authors: Bekö, S.L.Thoms, S.D.Schmidt, M.U.Bolte, M. Tags: organic compounds Source Type: research

Spectrophotometric Determination of Tizanidine and Orphenadrine Via Ion Pair Complex Formation using Eosin Y
A simple, sensitive and rapid spectrophotometric method was developed and validated for the determination of two skeletal muscle relaxants namely, tizanidine hydrochloride (I) and orphenadrine citrate (II) in pharmaceutical formulations. The proposed method is based on the formation of a binary complex between the studied drugs and eosin Y in aqueous buffered medium (pH 3.5). Under the optimum conditions, the binary complex showed absorption maxima at 545 nm for tizanidine and 542 nm for orphenadrine. The calibration plots were rectilinear over concentration range of 0.5-8 μg/mL and 1-12 μg/mL with limits of detection of...
Source: Chemistry Central Journal - October 8, 2011 Category: Chemistry Authors: Mohamed WalashFathalla BelalManal EidSamah Abo El Abass Mohamed Source Type: research

Spectrophotometric Determination of Tizanidine and Orphenadrine Via Ion Pair Complex Formation using Eosin Y
A simple, sensitive and rapid spectrophotometric method was developed and validated for the determination of two skeletal muscle relaxants namely, tizanidine hydrochloride (I) and orphenadrine citrate (II) in pharmaceutical formulations. The proposed method is based on the formation of a binary complex between the studied drugs and eosin Y in aqueous buffered medium (pH 3.5) .Under the optimum conditions, the binary complex showed absorption maxima at 545nm for tizanidine and 542nm for orphenadrine. The calibration plots were rectilinear over concentration range of 0.5-8 ug/mL and 1-12 ug/mL with limits of detection of 0.1...
Source: Chemistry Central Journal - October 8, 2011 Category: Chemistry Authors: Mohamed WalashFathalla BelalManal EidSamah Abo El Abass Mohamed Source Type: research

Studies on the characteristics of drug-loaded gelatin nanoparticles prepared by nanoprecipitation.
Abstract The morphology of gelatin nanoparticles loaded with three different drugs (Tizanidine hydrochloride, Gatifloxacin and Fluconazole) and their characteristics of entrapment and release from gelatin nanoparticles were investigated by the analysis on nanoparticle size distribution, SEM and FT-IR in this study. The particles were prepared by nanoprecipitation using water and ethanol as a solvent and a nonsolvent, respectively. The exclusion of a crosslinking agent from the procedure led the system to have an irregularly-shaped morphology. Nonetheless, the uncrosslinked case of Gatifloxacin loading generally led...
Source: Bioprocess and Biosystems Engineering - September 10, 2011 Category: Biomedical Engineering Authors: Lee EJ, Khan SA, Park JK, Lim KH Tags: Bioprocess Biosyst Eng Source Type: research

Tizanidine for alcohol withdrawal treatment
Abstract: The noradrenergic system is an important neurotransmission system implicated in the occurrence of alcohol withdrawal symptoms and anxiety leading to relapse during abstinence from alcohol usage. Tizanidine can play a role in alcohol withdrawal since it interferes with the noradrenergic system neurotransmission. Many noradrenergic system inhibitors in the central nervous system have proven their efficacy in the treatment of alcohol withdrawal syndrome. Imidazoline receptors have been also implicated in the pathophysiology of addiction. Tizanidine is an α2-adrenoreceptor agonist that inhibits noradrenaline release...
Source: Medical Hypotheses - July 6, 2011 Category: Biomedical Science Authors: R. Bou Khalil Tags: Articles Source Type: research

Implications of current clinical trials focused on medication overuse and therapeutic prophylaxis.
(Headache 2011;51;S2:93-100) Chronic migraine (CM) is a complex disorder requiring a multifaceted management approach encompassing lifestyle modification, trigger avoidance, behavioral therapy, pharmacotherapy, patient education and support, management of expectations, and close follow-up. The lack of pharmacotherapies approved by the US Food and Drug Administration (FDA) hinders CM prophylaxis and management. Topiramate, gabapentin, tizanidine, fluoxetine, amitriptyline, and onabotulinumtoxinA have been evaluated for prophylactic treatment of CM in randomized, double-blind, placebo-controlled or active comparator-cont...
Source: Headache - June 30, 2011 Category: Neurology Authors: Aurora SK Tags: Headache Source Type: research

Formulation and evaluation of effervescent floating tablets of tizanidine hydrochloride.
The objective of the present investigation was to develop effervescent floating matrix tablets of tizanidine hydrochloride for prolongation of gastric residence time in order to overcome its low bioavailability (34-40 %) and short biological half life (4.2 h). Tablets were prepared by the direct compression method, using different viscosity grades of hydroxypropyl methylcellulose (HPMC K4M, K15M and K100M). Tablets were evaluated for various physical parameters and floating properties. Further, tablets were studied for in vitro drug release characteristics in 12 hours. Drug release from effervescent floating matrix tablets...
Source: Acta Pharmaceutica - May 31, 2011 Category: Drugs & Pharmacology Authors: Someshwar K, Chithaluru K, Ramarao T, Kumar KK Tags: Acta Pharm Source Type: research

Baclofen/tizanidine: Withdrawal and interaction leading to various toxicities: case report
(Source: Reactions)
Source: Reactions - March 29, 2011 Category: Drugs & Pharmacology Tags: Short communication Source Type: research

5-Chloro-N-(4,5-dihydro-1H-imidazol-2-yl)-2,1,3-benzothiadiazol-4-amine (tizanidine)
There are two independent molecules (A and B) with similar conformations in the asymmetric unit of the title compound, C9H8ClN5S. The benzothiadiazole ring systems of both molecules are essentially planar [maximum deviation = 0.021 (2) Å in molecule A and 0.022 (1) Å in molecule B] and make dihedral angles of 68.78 (9) and 54.39 (8)°, respectively, with the mean planes of their 4,5-dihydro-1H-imidazole rings. An intramolecular N—H...Cl hydrogen bond occurs in molecule B. In the crystal, both molecules form centrosymmetric dimers through π-stacking of their benzothiadiazole rings, with interplanar distance...
Source: Acta Crystallographica Section E - March 12, 2011 Category: Chemistry Authors: John, P.Khan, I.U.Akkurt, M.Ramzan, M.S.Sharif, S. Tags: organic compounds Source Type: research

Lisinopril/tizanidine interaction: Hypotension and bradycardia in an elderly patient: case report
(Source: Reactions)
Source: Reactions - January 31, 2011 Category: Drugs & Pharmacology Tags: Short communication Source Type: research

A case of delirium, motor disturbances, and autonomic dysfunction due to baclofen and tizanidine withdrawal: a review of the literature
We report a case of delirium accompanied by extrapyramidal symptoms and autonomic dysfunction in a 59-year-old man following abrupt cessation of baclofen and tizanidine. An extensive search for the etiology was undertaken, but it was only after a careful history was taken that suspicion for baclofen and tizanidine withdrawal was raised. The delirium and motor disturbances resolved within 24 h of reintroduction of baclofen. Withdrawal from muscle relaxants requires a high index of suspicion but should be considered in patients who manifest signs and symptoms of withdrawal from the medications, particularly visual hallucinat...
Source: General Hospital Psychiatry - November 15, 2010 Category: Psychiatry Authors: David E. Karol, Andrew J. Muzyk, Xavier A. Preud'homme Tags: Case Reports Abstracts Source Type: research

Isolation and characterization of a process impurity in tizanidine hydrochloride
E. K. S. Vijayakumar, VG Gore, A Mahajan, M KumarIndian Journal of Pharmaceutical Sciences 2010 72(3):360-362A new process impurity was detected during the HPLC analysis of Tizanidine hydrochloride (I) batches. The impurity (II) was isolated by preparative HPLC and characterized by NMR and Mass spectral analysis as 5-S-ethyl-N-(4,5-dihydro-1H-imidazol-2-yl)-2,1,3-benzothiadiazol-4-amine hydrochloride. (Source: Indian Journal of Pharmaceutical Sciences)
Source: Indian Journal of Pharmaceutical Sciences - September 23, 2010 Category: Drugs & Pharmacology Authors: E. K. S. VijayakumarVG GoreA MahajanM Kumar Source Type: research

Hypotension and bradycardia associated with concomitant tizanidine and lisinopril therapy.
Conclusion The addition of tizanidine in a patient receiving long-term treatment with lisinopril was associated with severe hypotension and bradycardia. PMID: 20852161 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - September 23, 2010 Category: Drugs & Pharmacology Authors: Publow SW, Branam DL Tags: Am J Health Syst Pharm Source Type: research

Isolation and characterization of a process impurity in tizanidine hydrochloride
E. K. S. Vijayakumar, VG Gore, A Mahajan, M KumarIndian Journal of Pharmaceutical Sciences 2010 72(3):360-362A new process impurity was detected during the HPLC analysis of Tizanidine hydrochloride (I) batches. The impurity (II) was isolated by preparative HPLC and characterized by NMR and Mass spectral analysis as 5-S-ethyl-N-(4,5-dihydro-1H-imidazol-2-yl)-2,1,3-benzothiadiazol-4-amine hydrochloride. (Source: Indian Journal of Pharmaceutical Sciences)
Source: Indian Journal of Pharmaceutical Sciences - September 20, 2010 Category: Drugs & Pharmacology Authors: E. K. S. VijayakumarVG GoreA MahajanM Kumar Source Type: research

Acute Intrathecal Baclofen Withdrawal: A Brief Review of Treatment Options
Conclusions  Critical care practitioners should be prepared to treat this potentially devastating and often refractory complication of ITB therapy. Content Type Journal ArticleDOI 10.1007/s12028-010-9422-6Authors James C. Ross, Department of Pharmacy, Saint Joseph Health System, 1 Saint Joseph Dr, Lexington, KY 40504, USAAaron M. Cook, Pharmacy Services, UKHealthcare, 800 Rose St. H109a, Lexington, KY 40536, USAGary L. Stewart, Department of Anesthesiology, UKHealthcare, 800 Rose St. H109a, Lexington, KY 40536, USABrenda G. Fahy, Department of Anesthesiology, UKHealthcare, 800 Rose St. H109a, Lexingto...
Source: Neurocritical Care - August 18, 2010 Category: Neurology Tags: Neurocritical Care Source Type: research

Clinical assessment and management of spasticity: a review.
Spasticity is a sign of upper motor neurone lesion, which can be located in the cerebrum or the spinal cord, and be caused by stroke, multiple sclerosis, spinal cord injury, brain injury, cerebral paresis, or other neurological conditions. Management is dependent on clinical assessment. Positive and negative effects of spasticity should be considered. Ashworth score and the modified Ashworth score are the most used scales for assessment of spasticity. These and other spasticity scales are based on assessment of resistance during passive movement. The main goal of management is functional improvement. A novel 100-point ...
Source: Acta Neurologica Scandinavica. Supplementum - July 18, 2010 Category: Neurology Authors: Rekand T Tags: Acta Neurol Scand Suppl Source Type: research

Quantification of the effects of an alpha-2 adrenergic agonist on reflex properties in spinal cord injury using a system identification technique
This study was designed to help us understand the mechanisms of action of tizanidine on spasticity in spinal cord injured subjects with incomplete injury, by quantifying the effects of a single dose of tizanidine on ankle muscle intrinsic and reflex components. Methods: A series of perturbations was applied to the spastic ankle joint of twenty-one spinal cord injured subjects, and the resulting torques were recorded. A parallel-cascade system identification method was used to separate intrinsic and reflex torques, and to identify the contribution of these components to dynamic ankle stiffness at different ankle positions, ...
Source: Journal of NeuroEngineering and Rehabilitation - June 22, 2010 Category: Rehabilitation Authors: Mehdi MirbagheriDavid ChenWilliam Rymer Source Type: research

Azithromycin/tizanidine: Fatal torsade de pointes: case report
(Source: Reactions)
Source: Reactions - June 13, 2010 Category: Drugs & Pharmacology Tags: Short communication Source Type: research

Pharmacological prophylaxis of chronic migraine: a review of double-blind placebo-controlled trials
Abstract  Chronic migraine is an important public health problem. The aim of treatment should be to reduce migraine frequency and its negative impact on functioning, as well as to limit the use of acute medications. These goals may be accomplished by introducing effective prophylaxis. The aim of the present article is to critically review the published evidence on the pharmacological prophylaxis of chronic migraine, analysing published double-blind, placebo-controlled studies on adult patients. The results of the review indicate that tizanidine, gabapentin, valproic acid, and particularly topiramate are effec...
Source: Neurological Sciences - May 13, 2010 Category: Neurology Tags: Neurological Sciences Source Type: research

Load Rather Than Length Sensitive Feedback Contributes to Soleus Muscle Activity During Human Treadmill Walking
Walking requires a constant adaptation of locomotor output from sensory afferent feedback mechanisms to ensure efficient and stable gait. We investigated the nature of the sensory afferent feedback contribution to the soleus motoneuronal drive and to the corrective stretch reflex by manipulating body load and ankle joint angle. The volunteers walked on a treadmill (~3.6 km/h) connected to a body weight support (BWS) system. To manipulate the load sensitive afferents the level of BWS was switched between 5 and 30% of body weight. The effect of transient changes in BWS on the soleus stretch reflex was measured by presenting ...
Source: Journal of Neurophysiology - May 11, 2010 Category: Neurology Authors: af Klint, R., Mazzaro, N., Nielsen, J. B., Sinkjaer, T., Grey, M. J. Tags: Articles Source Type: research

Rehabilitation in practice: Spasticity management.
This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'The trainee consistently demonstrates a knowledge of the pathophysiology of various specific impairments including spasticity'. Spasticity is an extremely common feature of chronic neurological conditions and, if badly managed, it can result in pain, contractures and pressure sores, all of which can impact on function. It is therefore essential that a multidiscipli...
Source: Clinical Rehabilitation - March 31, 2010 Category: Rehabilitation Authors: Stevenson V Tags: Clin Rehabil Source Type: research

Production and Stability Evaluation of Modified-Release Microparticles for the Delivery of Drug Combinations.
Production and evaluation of novel formulations of tizanidine and tramadol microparticles was the chief purpose of this project. Microparticles of both drugs were prepared separately via temperature change method. To extend the release of formulations, ethyl cellulose was employed. Higuchi, zero-order, first-order, and Korsmeyer-Peppas kinetic models were applied to appraise the mechanism and mode of drugs release. Higuichi model was found to be best for all release profiles. Stability of microparticles at 40 degrees C/75% RH over a 3-month duration was determined by Fourier transform infrared (FTIR), X-ray diffractome...
Source: AAPS PharmSciTech - March 10, 2010 Category: Drugs & Pharmacology Authors: Aamir MN, Ahmad M Tags: AAPS PharmSciTech Source Type: research

Group I Afferent Pathway Contributes to Functional Knee Stability
The hamstring reflex response has been suggested to play a substantial role in knee joint stabilization during anterior tibial translation. The present study was performed to determine which afferent pathways contribute to the hamstring reflex as well as the potential effects of specific afferent pathways on functional knee stability. Short- and medium-latency hamstring reflexes (SLR and MLR) were evoked by anterior tibial translation in 35 healthy subjects during standing with 30° knee flexion. Nerve cooling, tizanidine, and ischemia were employed to differentiate afferent pathways. Two hours of thigh cooling (n = 10)...
Source: Journal of Neurophysiology - February 5, 2010 Category: Neurology Authors: Friemert, B., Franke, S., Gollhofer, A., Claes, L., Faist, M. Tags: Articles Source Type: research