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Methocarbamol vs Tizanidine: Understanding the Differences and Similarities

Last Updated: February 29, 2024

Reviewed by David Levin

Muscle relaxants are vital to manage conditions characterized by muscle spasms and discomfort, offering relief to the 126.6 million U.S. adults suffering from musculoskeletal disorders.

Among the options available, Methocarbamol and Tizanidine are prominent medications, each with unique characteristics. In this comprehensive article, we delve into the comparative analysis of Methocarbamol vs Tizanidine, exploring their mechanisms of action, efficacy, potential side effects, and considerations for use to empower individuals and healthcare practitioners alike to make informed decisions for muscle pain management.

What is Methocarbamol (Robaxin)?

Trade name: Robaxin®

Generic name: Methocarbamol

Methocarbamol is a centrally-acting skeletal muscle relaxant (SMR) commonly used to manage and treat acute musculoskeletal pain.2 This medication does not act directly on the muscles, but instead, it’s believed it exerts its effects on the central nervous system (CNS), causing depression.

Methocarbamol’s exact mechanism of action is not fully understood, but it is believed to inhibit nerve impulses or pain sensations that are sent to the brain. By dampening these signals, Methocarbamol helps to relieve muscle tension and discomfort, allowing for improved mobility and reduced pain. It is important to note that Methocarbamol does not treat the underlying cause of muscle pain but rather provides symptomatic relief.

What is Tizanidine (Zanaflex)?

Trade name: Zanaflex®

Generic name: Tizanidine

Tizanidine is a centrally-acting muscle relaxant used to manage muscle spasms, particularly those associated with conditions such as multiple sclerosis or spinal cord injuries. It works by inhibiting nerve impulses that are sent to the brain, leading to a reduction in muscle tone and spasms.

Since the primary goal of Tizanidine is to alleviate muscle spasms and improve muscle function, it is often prescribed as part of a comprehensive treatment plan that may include physical therapy and other measures to address the underlying causes of muscle spasticity.

Methocarbamol vs Tizanidine: Are They the Same Medication?

No, Methocarbamol and Tizanidine are not the same. While both are prescription medications only used as muscle relaxants, they have different mechanisms of action, chemical structures, and potential side effects.


Methocarbamol Acts as a muscle relaxant, affecting the central nervous system and inhibiting nerve impulses or pain signals. Used to relieve muscle spasms and discomfort associated with musculoskeletal conditions like strains and sprains. Typically taken orally, and the dosage is based on the severity of symptoms. 1,500 mg four times daily for the first two to three days, followed by 750 mg four times daily.
Tizanidine A centrally acting muscle relaxant that stimulates alpha-2 adrenergic receptors, reducing excitatory input to motor neurons and causing muscle relaxation. Prescribed for the management of muscle spasms, especially in conditions like multiple sclerosis or spinal cord injuries. Usually taken orally, the dosage is initiated at a low level and adjusted based on individual response. 4 mg initially; may increase by 2 to 4 mg every six to eight hours until relief. Do not exceed 36 mg daily.

Most Common Methocarbamol Side Effects

Methocarbamol, like any medication, can cause side effects. The most common side effects of Methocarbamol include:

  • Possible black, brown, or green urine
  • Mental status impairment
  • Possible exacerbation of myasthenia gravis symptoms
  • Drowsiness: Methocarbamol can cause drowsiness or sedation, and it is advisable to avoid activities requiring mental alertness, such as driving, until the individual’s response to the medication is known
  • Dizziness: Some people may experience dizziness, especially when standing up quickly from a sitting or lying position
  • Lightheadedness: Feelings of lightheadedness or a sensation of being off balance
  • Upset Stomach: Gastrointestinal upset, including nausea and vomiting, may occur in some individuals.
  • Headache: Headaches are reported by some individuals as a side effect of Methocarbamol
  • Flushing: A sensation of warmth or flushing of the skin may occur

Most Common Zanaflex Side Effects

  • Dose-related hypotension
  • Sedation
  • Hepatotoxicity; monitor liver function tests at baseline and one, three, and six months
  • Withdrawal and rebound hypertension may occur in patients discontinuing therapy after receiving high doses for an extended period of time; tapering is recommended
  • Dizziness: Many people experience dizziness, especially when getting up quickly from a sitting or lying position
  • Weakness: Some individuals may feel a sense of weakness or fatigue
  • Dry Mouth: Zanaflex can lead to a dry or cotton-mouth sensation
  • Fatigue: Feeling tired or fatigued is a reported side effect
  • Nervousness: Some individuals may experience heightened nervousness or anxiety
  • Constipation: Zanaflex can cause constipation in some individuals

Choosing Methocarbamol vs Tizanidine: Which One is For You?

When faced with the decision between Methocarbamol and Tizanidine for managing muscle spasms and discomfort, several factors come into play. Depending on individual needs and medical considerations, these medications have distinct characteristics that may make one more suitable than the other.

Here are guidelines to help you navigate the choice between Methocarbamol and Tizanidine:

Choose Methocarbamol if:

  • Muscle Spasms from Strains or Sprains: Methocarbamol is commonly used to relieve muscle spasms and discomfort associated with musculoskeletal conditions such as strains and sprains.
  • Less Sedation is Preferred: While both medications can cause sedation, in Methocarbamol vs Tizanidine, the former may have a milder sedative effect, making it a preferred choice if minimizing drowsiness is a priority.
  • No History of Liver Disorders: Methocarbamol may be a safer option for individuals without a history of liver disorders, as Tizanidine can cause hepatocellular injury.

Choose Tizanidine if:

  • Management of Spasticity: Tizanidine is specifically indicated for the management of muscle spasms associated with conditions like multiple sclerosis or spinal cord injuries, making it a preferred choice in such cases.
  • Rapid Onset of Action is Desired: Tizanidine has a relatively rapid onset of action, making it suitable for quick relief of muscle spasms.
  • Tolerability to Sedation: Tizanidine may be a suitable choice if the patient can tolerate the potential sedative effects and desires a medication with a shorter duration of action.
  • Regular Monitoring is Feasible: Tizanidine may require more frequent monitoring, especially if there is a history of liver disorders or if there are potential drug interactions.

Methocarbamol vs Tizanidine Final Considerations

Methocarbamol and Tizanidine offer distinct therapeutic benefits. Methocarbamol is well-suited for musculoskeletal spasms, prioritizing relief with minimal sedation. Tizanidine is indicated explicitly for spasticity management; it provides rapid relief but may induce more sedation.

When choosing between them, consider the underlying condition and the patient’s tolerance for potential side effects. It is imperative for patients to strictly adhere to prescribed dosages, its recommended short-term use, and avoid taking other drugs concurrently. In the event of an overdose or signs of abuse, immediate professional guidance is essential. A careful and informed decision and vigilant adherence ensure optimal outcomes in therapeutic pain management and muscle spasms.

People Also Ask

What happens if you take Methocarbamol and Tizanidine together?

Combining Methocarbamol and Tizanidine is generally not recommended without medical supervision. Both are muscle relaxants and can have sedative effects. Concurrent use may lead to increased drowsiness, dizziness, and impaired cognitive function.

Is Tizanidine more sedating than Methocarbamol?

In Methocarbamol vs Tizanidine, the latter is often considered more sedating. Tizanidine acts centrally and directly affects the nervous system, potentially causing more pronounced sedation than Methocarbamol, which primarily works as a muscle relaxant without directly affecting the central nervous system.

Can you take Methocarbamol with a muscle relaxer?

Combining Methocarbamol with another muscle relaxer should be done only under the guidance of a healthcare professional. Concurrent use of multiple muscle relaxants may increase the risk of side effects, including sedation and dizziness.

Page Sources

  1. National Academies Press (US). (2020, April 21). Musculoskeletal disorders. Selected Health Conditions and Likelihood of Improvement With Treatment - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559512/
  2. Sibrack, J. (2022, November 14). Methocarbamol. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK565868/
  3. Ghanavatian, S. (2023, August 28). Tizanidine. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519505/
  4. See, S., & Ginzburg, R. (2008, August 1). Choosing a skeletal muscle relaxant. AAFP. https://www.aafp.org/pubs/afp/issues/2008/0801/p365.html
  5. National Institute of Diabetes and Digestive and Kidney Diseases. (2017c, January 30). Tizanidine. LiverTox - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK548048/
  6. Giovannitti, J. A., & Cooke, M. (2017). Sedative-Hypnotics, antianxiety drugs, and centrally acting muscle relaxants. In Elsevier eBooks (pp. 156–175). https://doi.org/10.1016/b978-0-323-39307-2.00011-4

Retrieved on February 27, 2024.

Published on: February 19th, 2020

Updated on: February 29th, 2024

María José Petit-Rodríguez

About Author

María José Petit-Rodríguez

Medically Reviewed by

David Levin

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