Tizanidine contraindications

Tizanidine may increase the effects of antihypertensive drugs. There are two case reports of severe hypotension with iisinoprii. The manufacturer of tizanidine contraindicates the concurrent use of 02-adrenergic agonists (e.g. clonidine). 

Tizanidine hydrochloride is contraindicated in patients with known hypersensitivity to... 

For ciprofloxacin, there is a marked tenfold increase in exposure to tizanidine, with a consequent increase in adverse effects. Some authors recommend that this combination be avoided, whereas others recommend caution. The US manufacturer contraindicates the combination, whereas the UK manufacturers do not mention this potential interaction. If ciprofloxacin is considered the most appropriate antibacterial to use in a patient already taking tizanidine, anticipate the need to reduce the tizanidine dose before starting the ciprofloxacin, and closely monitor adverse effects starting ciprofloxacin may cause marked hypotension, bradycardia, and sedation. Other quinolones also inhibit CYP1A2, but to varying degrees, see Table 33.4 , (p. 1193). 

Are there contraindications to concomitant drug use For instance, tizanidine is contraindicated in patients with concomitant use of CYP450 1A2 inhibitors such as fluvoxamine, amiodarone, mexiletine, propafenone, cimetidine, fluoroquinolones (ciprofloxacin, norfloxacin), rofecoxib, oral contraceptives, and ticlopidine [27]. 

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