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Zanaflex Dosage: How Much Is Too Much?

zanaflex dosage

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Tizanidine dosing is not standard across the board. Different conditions are treated with varying amounts of the drug, and Zanaflex dosages should also be adjusted according to the age and size of the patient. Here is what all users should know about tizanidine doses, including how to stay safe while taking it.

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Learn About Zanaflex Dosage:

How to Take Tizanidine

The most important thing patients should keep in mind when using tizanidine hydrochloride is that they should only take it in accordance with the directions provided to them by their doctor. It should never be taken in larger or smaller doses than recommended. Even though Zanaflex 8 mg is considered a safe dose, if the prescription says 4 mg, that is what should be taken.

Most doctors will allow for a tizanidine dose to be taken up to three times a day with 6 to 8 hours between doses. It can be taken with or without food, but it is suggested that it always be taken the same way

. As a result, what is easiest for those taking multiple doses each day is to swallow the Zanaflex dosage after eating something. However, food can impact the pharmacokinetics of the drug, so the patient should consult with their doctor on this decision.
There isn’t a particular time of day when it is best to take a tizanidine dosage. Patients can time this based on the side effects of tizanidine. For example, the medication can cause drowsiness, so the user might want to only take it when they know they can safely fall asleep or be tired without causing risk. If there is ever a concern about taking the medication, the patient should speak to their doctor.

Typical Tizanidine Dose for Muscle Spasms

The most common of Zanaflex uses is the treatment of muscle spasms. The typical dose for muscle spasms will vary based on how severe the spasms are, the size of the patient, and their overall health. The typical starting dose is one tizanidine 2 mg tablet or capsule taken anywhere between one and three times per day. The prescribing doctor will then monitor the progress of the patient and, if needed, increase this to one tizanidine 4 mg tablet or capsule taken between one and three times daily.

In rare instances, the prescribing doctor might choose to go higher, switching to one Zanaflex 8 mg taken one to three times per day.

Even rarer is to up this to single doses that are as high as 16 mg, requiring two tizanidine 8 mg tablets or capsules. However, 36 mg is the limit for the medication per day. This means that a tizanidine high dosage should never result in exceeding this limit within a 24-hour period.

woman taking pills

Tizanidine Renal Dose Adjustments

Due to the manner in which tizanidine is processed, it can be problematic for those with renal impairment. Anyone with this condition should be carefully monitored when taking Zanaflex. It is generally suggested that these patients start with the lowest possible dose and take it as few times per day as possible. Should this result in insufficient effects, it is suggested that doctors increase the individual dosage but not the dosing frequency. For example, it is considered better to switch from Zanaflex 4 mg once per day an 8 mg dose rather than taking two separate doses of 4 mg.

However, any dosing decision should strictly be made between the patient and their doctor.

Tizanidine Liver Dose Adjustments

Because of how the body processes Zanaflex, those with hepatic impairment should only use it when their doctor feels it is necessary. These patients will require careful monitoring. Generally, the doctor will start the patient on tizanidine HCL 2 mg tablets or capsules just once or twice per day. If this is insufficient, guidelines state that the individual doses should be increased to a tizanidine HCL 4 mg tablet or capsule rather than taking more doses per day. Patients should never change their dosing on their own.

Tizanidine Warnings

Patients taking tizanidine should carefully follow their doctor’s instructions when it comes to consuming the medication. This means following the dosage amounts and times and always taking it either after eating or at least 30 minutes before or after food. It is important that patients understand that tizanidine 4 mg tablets function slightly differently than the same dose in capsules, so if the pharmacy substitutes one for the other, they must contact their doctor. This is true for Zanaflex 8 mg and 2 mg medications as well.
If the user is taking any other medications or supplements or abusing substances, they must let their doctor know. Interactions can result in deadly consequences, especially if the patient is taking the max dose of tizanidine allowed.

tizanidine capsule

If One Misses a Dose of Tizanidine

Patients should never double up on tizanidine. However, if they take the medication regularly, missing a dose can also be problematic. In general, if the missed dose is noticed within two hours, it is safe to go ahead and take it.

However, if it has been more than two hours since the dose was missed, the patient should contact their doctor. Even if they are on the lowest post of tizanidine 2 mg, it is best to double-check.

Tizanidine LD50

While the tizanidine maximum dosage is 36 mg per day, some people might be tempted to take more than that. These typically are individuals engaging in tizanidine recreational use. While the answer to if Zanaflex is a controlled substance is no, that doesn’t mean it has no abuse potential.
One way that people often try to determine what is a safe large dose to take is the LD50 for a medication. For Zanaflex, this has been determined to be 414 mg per kilo of weight. That comes out to 20, 700 mg for the average adult, or about 5,175 tizanidine 4 mg tablets. Given the Zanaflex 4mg street value, it is unlikely anyone would be able to gain access to that much of the medication.
However, determining what is safe based on the distance of a dose from the LD50 is dangerous. First, the number is based on the average adult, and everything from weight to medical conditions can change what is safe and what is deadly. Then there is the risk of interactions. For example, tizanidine and tramadol can interact in risky ways, and someone abusing the medication is more likely to mix substances.
If someone is abusing tizanidine, they need to seek out addiction rehab. While the road to recovery may not be a smooth one, addiction can be treated.
Misuse of Zanaflex is dangerous and can become deadly. Drug rehabilitation centers offer the help addicts need to stop use and live a healthier life. The first step is finding the right rehab center for tizanidine treatment.

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Sources
  1. M Emre, G C Leslie, C Muir, N J Part, R Pokorny, and R C Roberts. Correlations between dose, plasma concentrations, and antispastic action of tizanidine (Sirdalud). J Neurol Neurosurg Psychiatry. 1994 Nov; 57(11): 1355–1359. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1073186/
  2. Lapierre Y, Bouchard S, Tansey C, Gendron D, Barkas WJ, Francis GS. Treatment of spasticity with tizanidine in multiple sclerosis. Can J Neurol Sci. 1987 Aug;14(3 Suppl):513–517. https://www.ncbi.nlm.nih.gov/pubmed/3676923

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