20 Renal Dose Adjustments

Tizanidine:

  • Slower titrations and less frequent dosing might be needed in older populations with lower kidney function.1 
  • CrCl <25 mL/min: caution when using, clearance can be reduced by more than 50%, used reduced initial dose and if higher dose needed use higher dose with lower frequency 1 
  • Use with caution with hepatic impairment: individual doses should be reduced and if higher doses need to be used increase individual dose and not frequency. Monitoring aminotransferase levels is recommended for baseline and 1 month after max dose achieved or after hepatic injury.1

References:

  1. Zanaflex tablets (tizanidine hydrochloride) package insert. Ardsley, New York: Acorda Therapeutics Inc.; Oct 4, 2013. Ref ID: 3403524

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The Analgesic Pharmfiles: The Not-so-Secret Lives of Wanna-be Superheroes Copyright © 2021 by Sarah Greiner; Zachary Anderson; Whitney Blasen; Amber Garthwaite; Lyvia Hosch; Paul McClimon; Logan Mougin; Hannah Clausen; Faith Poelker; Bibiana Ruiz Granado; Bryce Andry; Hannah Minor; Sarah Hannig; Theodore Nguyen; and Kashelle Lockman is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.

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