The reduction of muscle tone that follows the oral administration of a single dose of tizanidine has its peak effect 1 to 2 hours after dosing, and the effect dissipates between 3 to 6 hours. Use must therefore be individualized, directed to those activities and times when relief of spasticity is most important and titrated to avoid intolerance. Evidence demonstrating the effectiveness of tizanidine is derived from a single dose study and from a seven week multiple dose study conducted in patients with multiple sclerosis and spinal cord injury , respectively. A single oral dose of 8 mg of tizanidine reduces muscle tone in patients with spasticity for a period of several hours. The effect peaks at approximately 1 to 2 hours and dissipates between 3 to 6 hours.
Effects are dose-related.
Although single doses of less than 8 mg have not been demonstrated to be effective in controlled clinical studies, the dose-related nature of tizanidine's common adverse events make it prudent to begin treatment with single oral doses of 4 mg. The dose can be repeated at 6 to 8 hour intervals, as needed, to a maximum of three doses in 24 hours. The total daily dose should not exceed 36 mg. Experience with single doses exceeding 8 mg and daily doses exceeding 24 mg is limited. Dispense in containers with child resistant closure.