Veropharm, JSC

Country of origin

Russia

Product group

Nervous system

Muscle relaxant central action

Forms of issue

• 10 - blisters (3) - cardboard packs. 30 - polymer bottles (1) - cardboard packs. 30 - polymer cans (1) - cardboard packs. 30 - dark glass jars (1) - cardboard packs.

Description of the dosage form

• pills

pharmachologic effect

Muscle relaxant of central action. Reduces the increased tone of skeletal muscles, relieves their spasm; reduces muscle resistance during passive movements, increases the strength of voluntary contractions. The muscle relaxant effect of tizanidine is probably due to the inhibition of spinal polysynaptic reflexes, which is associated with a decrease in the release of excitatory amino acids from the presynaptic terminals of spinal interneurons, as well as the stimulation of alpha2-adrenergic receptors. Tizanidine does not affect the transmission of excitation in neuromuscular synapses.

Special conditions

Use with caution in patients with impaired liver and kidney function. Influence on the ability to drive vehicles and control mechanisms At the beginning of treatment, if drowsiness occurs, activities requiring a high concentration of attention, rapid psychomotor reactions should be avoided.

Composition

• tizanidine (in the form of hydrochloride) 2 mg excipients: lactose, microcrystalline cellulose, sodium carboxymethyl starch, magnesium stearate tizanidine (in the form of hydrochloride) 4 mg excipients: lactose, microcrystalline cellulose, sodium carboxymethyl starch, magnesium stearate

Tizalud indications for use

• Spastic state of skeletal muscles caused by neurological diseases (multiple sclerosis, chronic myelopathy, stroke, degenerative diseases of the spinal cord). Painful spasm of skeletal muscles caused by damage to the spine (cervical and lumbar syndromes) or arising after surgery (for a herniated disc or osteoarthritis of the hip).

Tizalud contraindications

• Hypersensitivity to tizanidine.

Tizalud dosage

• 2 mg 4 mg

Tizalud side effects

• When using tizanidine in relatively small doses, in rare cases, drowsiness, fatigue, dizziness, dry mouth, nausea, a slight decrease in blood pressure are observed; in higher doses - these effects occur more often and are more pronounced, in addition, insomnia, muscle weakness, bradycardia, increased serum transaminase activity are possible

Drug interactions

With simultaneous use with antihypertensive drugs (including diuretics), severe arterial hypotension and bradycardia may develop. With the simultaneous use of ethanol, drugs with a sedative effect, the sedative effect is enhanced.

Storage conditions

• keep away from children

Information provided

Pharmacodynamics

Miorelaxapt of central action. The main point of the application is at spinal cord... By stimulating presynaptic alpha2-adrenergic receptors, it suppresses the release of excitatory amino acids from the intermediate neurons of the spinal cord, which leads to inhibition of polysynaptic transmission of excitation in the spinal cord. As a result, there is a decrease in muscle tone. In addition to muscle relaxant properties, it also has a central moderately pronounced analgesic effect.

Effective against acute painful muscle spasms and chronic spasms of spinal and cerebral origin. Reduces spasticity and clonic convulsions, as a result of which resistance to passive movements decreases and the range of active movements increases.

Pharmacokinetics

Absorption - high; the time to reach the maximum plasma concentration (Cmax) is 1-2 hours. Bioavailability is 34%. Food intake does not affect the koki netiku farm. The volume of distribution is 2.6 l / kg. Communication with plasma proteins - 30%. In the dose range from 4 to 20 mg, the pharmacokinetics are linear. It is metabolized rapidly and to a large extent in the liver (95%) with the formation of inactive metabolites. The half-life (T1 / 2) is 2-4 hours. It is excreted mainly by the kidneys (70% of the dose in the form of metabolites, 2.7% in unchanged form). In patients with renal insufficiency (CC less than 25 ml / min), the maximum plasma concentration (Cmax) increases 2 times, T1 / 2 - 14 hours, the area according to the concentration-time pharmacokinetic curve (AUC) increases 6 times.

2.indications for use

• painful muscle spasm associated with static and
  functional diseases of the spine (cervical and lumbar syndromes), as well as after surgical interventions (for example, for a herniated disc or hip joint);
• spasticity of skeletal muscles in neurological diseases (for example, with multiple sclerosis, chronic myelopagia, degenerative diseases of the spinal cord, the consequences of cerebrovascular accident, as well as infantile cerebral palsy / patients over 18 years old /).

3. Method of application

Relief of painful muscle spasm: by mouth, 2-4 mg 3 times a day, in severe cases - additionally 2-4 mg at night.

Treatment of spasticity due to neurological diseases: the initial dose is 2 mg 3 times a day, then the dose is gradually increased by 2-4 mg at intervals of 3-7 days. The optimal daily dose is 12-24 mg in 3-4 doses; the maximum daily dose is 36 mg.

Patients with renal failure(with CC less than 25 ml / min) the recommended initial dose is 2 mg once a day. The dose increase is carried out gradually, slowly, taking into account the tolerance and effectiveness. If
it is necessary to obtain a more pronounced effect, it is recommended to first increase the dose prescribed 1 time per day, then increase the frequency of appointment.

4. Side effects

From the side nervous system : drowsiness, dizziness, hallucinations, insomnia, sleep disturbances.

From the side of cardio-vascular system : bradycardia, decrease blood pressure(in some cases, pronounced, up to collapse and loss of consciousness).

From the side digestive system : dry mouth, nausea, dyspepsia, increased activity of "hepatic" transaminases, hepatic insufficiency.

From the musculoskeletal system: muscle weakness.

Other: increased fatigue, hypercreatininemia.

With a sharp withdrawal after prolonged treatment and / or taking high doses of the drug (as well as after simultaneous use together with antihypertensive drugs): tachycardia, increased blood pressure, in some cases - acute cerebrovascular accident.

5. Contraindications

• severe liver dysfunction;
• simultaneous use with strong inhibitors of CYP1A2 isoenzymes (including fluvoxamine, ciprofloxacin);
• hypersensitivity to other components of the drug;
• rare hereditary lactose intolerance, severe lactase deficiency, glucose-galactose malabsorption (for this dosage form containing lactose);

The use of tizanidine in children (under 18 years of age) is not recommended because the experience of using the drug in this category of patients is limited.

Carefully:

Renal failure, arterial hypotension, bradycardia, concomitant use of oral contraceptives, age over 65 years

6. During pregnancy and lactation

Since no controlled trials have been conducted on the use of tizanidine in pregnant women, it should not be used during pregnancy unless the expected benefit to the mother exceeds possible risk for the fetus.

Tizanidn stands out with breast milk in small quantities. However, if it is necessary to use it during lactation, the issue of stopping breastfeeding should be decided.

7. Interaction with other medicinal products

The simultaneous use of tizanidine with fluvoxamine or ciprofloxacin, inhibitors of cytochrome P450 isofermeitis 1A2, leads to a 33-kratioma increase in AUC. The result of the combined use may be a clinically significant and prolonged decrease in blood pressure, leading to drowsiness, weakness, inhibited psychomotor reactions (in some cases, up to collapse and loss of consciousness).

The simultaneous use of tizanidine with other inhibitors of the isoenzyme CYP1A2 - antiarrhythmic drugs (amiodarone, mexiletine, propafenone), cimetidine, fluoroquinolones (enoxatsinn, pefloxacin,), rofecoxib, oral contraceptives, ticlopidine is not recommended.

Antihypertensive drugs (MPs) increase the risk of a pronounced decrease in blood pressure and bradycardia.
Ethanol, sedative drugs can enhance the sedative effect, therefore, simultaneous use with other sedatives and / or alcohol is not recommended.

8. Overdose

Symptoms: nausea, vomiting, marked decrease in blood pressure, dizziness, drowsiness, miosis, anxiety, respiratory failure,.

Treatment: gastric lavage, the appointment of activated carbon, forced diuresis, symptomatic therapy.

9. Release form

Tablets 2 or 4 mg - 30 pcs.

10. Storage conditions

At a temperature not higher than 25 ° C.
Keep out of the reach of children.

Shelf life

2 years.

11. Composition

1 tablet contains:

tizanidine hydrochloride - 2.288 mg and 4.576 mg in terms of tizanidine - 2.0 mg and 4.0 mg;

Excipients: Lactose anhydrous (lactopress)
117.012 mg and 234.024 mg, Microcrystalline cellulose 14.0 mg and 28.0 mg, Sodium carboxymethyl starch
(primogel) 4.2 mg and 8.4 mg, Magnesium stearate 2.5 mg and 5.0 mg.

12. Terms of dispensing from pharmacies

The drug is dispensed by prescription of the attending physician.

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* Instructions for medical use to the drug Tizalud published in free translation. THERE ARE CONTRAINDICATIONS. BEFORE USING IT IS NECESSARY TO CONSULT A SPECIALIST

Tizalud is a centrally acting muscle relaxant that stimulates presynaptic α2-adrenergic receptors, it inhibits the release of amino acids that stimulate N-methyl-D-aspartate receptors (NMDA receptors). As a result, polysynaptic signal transmission at the level of interneuronal connections in the spinal cord, which is responsible for excessive muscle tone, is inhibited, and muscle tone decreases. Tizalud is effective both for acute painful muscle spasms and for chronic spasticity of spinal and cerebral origin. It reduces resistance to passive movements, inhibits spasm and clonic convulsions, and improves the strength of active muscle contractions.

Pharmacokinetics

Absorption and distribution. Tizanidine is rapidly absorbed. Maximum plasma concentrations are reached approximately 1 hour after application. The average absolute bioavailability is 34%. Mean volume of distribution at steady state (Vss) after intravenous use is 2.6 l / kg. Plasma protein binding is 30%. The relatively low deviation of pharmacokinetic parameters (Cmax and AUC) among patients facilitates a reliable preliminary assessment of plasma levels after oral administration.

Metabolism / excretion. The drug undergoes rapid and extensive metabolism in the liver. Tizanidine is metabolized primarily by CYP1A2. The metabolites are inactive. They are excreted mainly by the kidneys (70%). The elimination of the total radioactivity (i.e. the substance in unchanged form and metabolites) is biphasic, with a fast initial phase (half-life T1 / 2 = 2.5 hours) and a slower elimination phase (T1 / 2 = 22 hours). Only a small amount of the substance in unchanged form (about 2.7%) is excreted by the kidneys. The average half-life of the substance in unchanged form is 2-4 hours.

Pharmacokinetics in selected patient groups. In patients with renal insufficiency (creatinine clearance less than 25 ml / min), the mean maximum plasma concentration is 2 times higher than that in healthy volunteers, and the final half-life is extended to approximately 14 hours, as a result of which the area under the concentration-time curve »(AUC) increases by an average of 6 times.

No studies have been performed in patients with impaired liver function.

Tizanidine is metabolized by the CYP1A2 isoenzyme in the liver. Patients with impaired liver function may experience more high concentrations substances in blood plasma.

Tizalud is contraindicated in patients with severely impaired liver function.

Pharmacokinetic data on elderly patients are limited.

Gender does not affect the pharmacokinetic properties of tizanidine.

The effect of ethnicity and race on the pharmacinetics of tizanidine has not been studied.

Influence of food Concurrent consumption of food does not affect the pharmacokinetic profile of Tizalud tablets.

Although the maximum concentration value increases by one third, this is not clinically significant. There was no significant effect on absorption.

Indications for use

Indications for the use of the drug Tizalud are:

Painful muscle spasm.

Spasticity due to multiple sclerosis.

Spasticity due to spinal cord injury.

Spasticity due to brain damage.

Mode of application

Tizalud has a narrow therapeutic range and high variability in plasma tizanidine concentration in different patients. Therefore, it is important to use optimal doses according to the patient's needs. Treatment should be started with a small dose of 2 mg, which makes the risk of adverse effects from taking medicinal product minimal. If necessary, the dose of the drug should be gradually increased with all necessary precautions.

Adults

Relief of Painful Muscle Spasms

Apply 2-4 mg 3 times a day. In severe cases, an additional dose of 2 or 4 mg may be taken before bedtime.

Spasticity in neurological disorders

The dose must be selected individually for each patient.

The initial daily dose should not exceed 6 mg, divided into 3 doses. It can be increased to 2-4 mg 2 times gradually at intervals of 3-7 days. Typically optimal therapeutic effect is achieved with a daily dose of 12-24 mg, divided into 3 or 4 doses. Do not exceed the total daily dose 36 mg.

Application for children and adolescents

The experience of using the drug Tizalud for children and adolescents is limited, therefore the drug is not recommended for use in children and adolescents.

Elderly patients

The experience of using the drug in elderly patients is limited, therefore, caution should be exercised when using the drug Tizalud in this category of patients. It is recommended to start treatment with the lowest dose and gradually increase it with caution in "small steps" until the optimal balance of individual tolerance and therapeutic efficacy of the drug is achieved.

Use in patients with impaired renal function

For patients with impaired renal function (CC<25 мл/мин) рекомендованная начальная разовая доза составляет 2 мг в сутки.

The dose is increased gradually and with caution in "small steps" until the optimal balance of individual tolerance and therapeutic efficacy of the drug is achieved. In order to increase the therapeutic efficacy, you should first increase the single dose before moving on to a more frequent daily intake of the drug.

Use in patients with impaired liver function

Treatment of patients with severe liver dysfunction is contraindicated. Tizalud is extensively metabolized in the liver. The drug should be used with caution in the treatment of patients with moderately severe liver dysfunction. Treatment should be started with the lowest dosage; if necessary, increasing the dose should be carried out with caution and taking into account the patient's individual tolerance of the drug Tizalud.

Interruption of treatment

If necessary, interruption of drug treatment should be reduced slowly and gradually. This is especially true for patients who have received an increased dose of the drug for a long time. Thus, the risk of developing a rebound increase in blood pressure and tachycardia is reduced.

Children. The experience of using the drug in pediatrics is limited. It is not recommended to prescribe Tizalud to children.

Side effects

Adverse reactions (such as drowsiness, increased fatigue, dizziness, dry mouth, low blood pressure, nausea, gastrointestinal disturbances, and elevated serum transaminase levels) are usually mild and transient in patients using low doses recommended for the relief of painful muscle spasms.

At doses higher than those recommended for the treatment of spasticity, the above side effects are more frequent and more severe, but they are rarely severe enough to discontinue treatment. Also, such side reactions may occur: arterial hypotension, bradycardia, muscle weakness, sleep disturbances, hallucinations and hepatitis.

The appearance of such symptoms has been reported after the sudden withdrawal of tizanidine, in particular after long-term treatment and / or high daily doses and / or concomitant therapy with antihypertensive drugs. Under such circumstances, patients may experience hypertension and tachycardia. In some cases, such rebound arterial hypertension can cause a stroke.

Therefore, treatment with tizanidine should not be stopped abruptly, but only by a gradual dose reduction.

From the side of the psyche: insomnia, sleep disturbance; hallucinations.

From the side of the central nervous system: drowsiness, dizziness; confusion of consciousness, vertigo.

From the side of the cardiovascular system: arterial hypotension; bradycardia; syncope.

From the gastrointestinal tract: dry mouth, pain in the gastrointestinal tract, gastrointestinal disorders; nausea.

From the hepatobiliary system: increased levels of serum transaminases; acute hepatitis, liver failure.

From the musculoskeletal system: muscle weakness.

General disorders: increased fatigue; asthenia, withdrawal syndrome, hypersensitivity reactions.

From the side of the organs of vision: blurred vision.

Research: lowering blood pressure, increasing transaminase levels.

Contraindications

Contraindications to the use of the drug Tizalud are:

Hypersensitivity to tizanidine or any excipients of the drug.

Severe liver dysfunction.

Concomitant use of tizanidine with potent inhibitors of CYP1A2, such as fluvoxamine or ciprofloxacin.

Pregnancy

Data on the use of the medicinal product Tizalud pregnant women are limited, so it should not be prescribed during pregnancy, unless the potential benefit to the mother outweighs the possible risk to the fetus.

Lactation. It has been established that tizanidine passes into breast milk in small amounts. Therefore, women who are breastfeeding should not be prescribed the drug.

The available data indicate that tizanidine, which was used at a dose of 10 mg / kg per day in male rats and at a dose of 3 mg / kg per day in female rats, did not cause impairment of fertility. A decrease in fertility was observed in male rats that received tizanidine at a dose of 30 mg / kg per day and in female rats that received tizanidine at a dose of 10 mg / kg per day. Sedation, weight loss and ataxia have also been observed with these doses.

Interaction with other medicinal products

Concomitant use of known CYP1A2 inhibitors can increase plasma levels of tizanidine. An increase in the level of tizanidine in blood plasma can lead to the appearance of symptoms of an overdose, such as a prolongation of the QT interval.

Concomitant use of known CYP1A2 inducers can reduce plasma levels of tizanidine.

A decrease in the level of tizanidine in blood plasma may lead to a decrease in the therapeutic effect of Tizalud.

Concomitant use of potent CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin with tizanidine is contraindicated. The simultaneous use of tizanidine with fluvoxamine increases the AUC of tizanidine by 33 times, while the simultaneous use of tizanidine with ciprofloxacin increases the AUC of tizanidine by 10 times. This can lead to a clinically significant and long-term decrease in blood pressure, accompanied by drowsiness, dizziness, and decreased psychomotor productivity.

Concomitant use of tizanidine with other CYP1A2 inhibitors, such as antiarrhythmic drugs (amiodarone, mexiletine, propafenone), cimetidine, some fluoroquinolones (enoxacin, pefloxacin, norfloxacin), rofecoxib, oral contraceptives, and ticlopi-pilli is not recommended.

The simultaneous use of the drug Tizalud with antihypertensive drugs, including diuretics, can sometimes cause arterial hypotension and bradycardia. In some patients receiving concomitant treatment with antihypertensive drugs, rebound arterial hypertension and rebound tachycardia were observed with sudden withdrawal of tizanidine. In some cases, rebound arterial hypertension can cause a stroke.

The simultaneous use of the drug Tizalud with rifampicin can lead to a 50% decrease in the concentration of tizanidine. Thus, the therapeutic effect can be reduced with the use of rifampicin during therapy with the drug Tizalud, which may be clinically beneficial for some patients. Long-term simultaneous use should be avoided, and if necessary, the dosage should be adjusted very carefully.

The use of the drug Tizalud leads to a 30% decrease in the systemic effect of tizanidine in smoking men (more than 10 cigarettes per day). Long-term use of the drug in men who smoke a lot requires the appointment of higher doses of the drug.

The simultaneous use of the drug Tizalud and other centrally acting drugs (for example, sedatives and hypnotics (benzodiazepine or baclofen), some antihistamines and analgesics, psychotropic drugs, narcotic drugs) can enhance the effects of each of the drugs and enhance the hypnotic effect of Tizalud.

This applies, in particular, to the simultaneous use of alcohol, which can unpredictably change or enhance the effect of Tizaluda and increase the risk of adverse reactions, so you should refrain from drinking alcohol.

The administration of the drug Tizalud together with α2-adrenergic agonists (for example, with clonidine) should be avoided due to their potential additive hypotensive effect.

Overdose

Very few reports of drug overdose received Tizalud.

Symptoms: nausea, vomiting, hypotension, bradycardia, prolongation of the QT interval, dizziness, miosis, respiratory distress, coma, anxiety, drowsiness.

Treatment: multiple use of high doses of activated carbon is recommended to remove the drug from the body. Forced diuresis may speed up the elimination of the drug. In the future, symptomatic treatment should be carried out.

Storage conditions

A drug Tizalud should be stored in its original packaging at a temperature not exceeding 25 ° C.

Keep out of the reach of children.

Release form

Tizalud - tablets of 4 g.

Packing: 10 tablets in a blister; 3 blisters in a pack.

Composition

1 tablet Tizalud contains tizanidine 2 mg or 4 mg.

Excipients: microcrystalline cellulose, anhydrous lactose, anhydrous colloidal silicon dioxide, stearic acid.

Additionally

The concomitant use of CYP1A2 inhibitors with tizanidine is not recommended.

After a sudden discontinuation of the drug or a rapid dose reduction, patients may experience arterial hypertension and tachycardia. In some cases, such rebound arterial hypertension can cause a stroke. Treatment with tizanidine should not be stopped abruptly, but only by gradually reducing the dose.

For patients with renal impairment (creatinine clearance< 25 мл/мин) рекомендованная начальная доза составляет 2 мг 1 раз в сутки. Дозу следует повышать последовательно, небольшими «шагами», с учетом эффективности и переносимости. Для достижения более выраженного эффекта рекомендуется сначала увеличить дозу, которая назначается 1 раз в сутки, после чего увеличивать кратность приема.

Liver failure associated with the use of tizanidine has been reported, but this has rarely been observed in patients receiving daily doses up to 12 mg. In this regard, it is recommended to monitor liver function once a month during the first 4 months of therapy in those patients who are using tizanidine at a dose of 12 mg or more and in patients with clinical symptoms indicating liver failure (for example, nausea, loss of appetite, or increased fatigue of unknown etiology). The use of the drug Tizalud should be discontinued if the levels of ALT or ACT in serum exceed the upper limit of the norm by 3 times or more for a long period.

Arterial hypotension can occur during the use of tizanidine, as well as as a result of drug interactions with CYP1A2 inhibitors and / or antihypertensive drugs. Severe forms of arterial hypotension have been reported, such as loss of consciousness and circulatory collapse.

Caution should be exercised when using this drug with drugs that prolong the QT interval (eg, cisapride, amitriptyline, azithromycin).

Caution is needed for patients with coronary artery disease and / or heart failure. ECG monitoring should be carried out at regular intervals at the beginning of the use of the drug Tizalud in such patients.

Patients with myasthenia gravis need to carefully assess the risk-benefit ratio before using this drug.

The experience of using children and adolescents is limited, therefore, the use of the drug Tizalud is not recommended for this category of patients.

Caution should be exercised when using this drug in elderly patients.

Tizalud tablets contain lactose. Tizalud tablets are not recommended for patients with rare hereditary diseases - galactose intolerance, severe lactase deficiency or glucose-galactose malabsorption syndrome.

The ability to influence the reaction rate when driving or driving other mechanisms.

Tizanidine can cause drowsiness, dizziness and / or arterial hypotension, thus impairing the patient's ability to drive or operate machinery. The risks increase with the simultaneous use of alcohol.

Therefore, one should refrain from activities that require a high concentration of attention and quick reactions, for example, driving vehicles or working with machines and mechanisms.

main parameters

Name:	TIZALUD
ATX code:	M03BX02 -

Tizalud is a centrally acting muscle relaxant. Instructions for use inform that 2 mg and 4 mg tablets help with muscle spasms in osteochondrosis and after a stroke in adults, children and pregnancy.

Composition and form of release

Tizalud is available in the form of tablets: white with a yellow tint or white, round, biconvex, with a dividing line of 2 mg or 4 mg. It is sold in 10 pieces in blisters, in a cardboard box 3 packages, 30 pieces each. in polymer cans, in a cardboard box 1 can. 1 tablet contains the active ingredient: tizanidine hydrochloride - 2 mg or 4 mg.

What does Tizalud help from?

The tablets are intended for oral administration. The main indications for prescribing the drug are the following conditions:

• spastic muscle pains caused by neurological pathologies, for example, multiple sclerosis, chronic myelopathy, infantile cerebral palsy;
• spinal pain and muscle spasms caused by surgical interventions (after an operated herniated disc, for example);
• muscle spasms, accompanied by severe pain and caused by diseases of the cervical and lumbar spine;
• degenerative diseases of the spinal cord, against the background of which muscle spasms occur;
• as part of complex therapy of the consequences of cerebrovascular accident.

Important! The decision on the need for course pharmacotherapy should be made exclusively by the doctor. Self-medication is absolutely unacceptable.

Instructions for use

Tizalud tablets are taken orally (by mouth) with water, regardless of food.

Instructions for the use of Tizaluda for neurological pathologies that cause spastic painful muscle contraction, recommends starting treatment with a daily dose of 6 mg taken in three divided doses. Each subsequent 3-7 days, depending on the nature of the pain and spasm, increase the dose by 2-4 mg. The maximum therapeutic effect is observed when taking a daily dose of 12-24 mg. The 36 mg dose is the maximum allowable daily dose.

To relieve painful spasm of skeletal muscles, a 3-time daily intake of Tizalud, 2-4 mg, is prescribed. In especially difficult situations, an additional intake of 2-4 mg at night is recommended.

The duration of taking Tizalud depends on the dynamics of pain and muscle-tonic manifestations. Acute muscle pain usually requires 7-21 days of therapy. Chronic pain syndrome, depending on the origin and severity, may require longer treatment, which is determined on an individual basis and sometimes lasts up to 1 year.

Pharmacological effects

The active substance of Tizaluda belongs to centrally acting muscle relaxants. The drug is effective in the treatment of acute painful muscle spasms and chronic spasms of cerebral and spinal origin. Taking Tizaluda tablets can reduce muscle stiffness during passive movements.

The action of the drug is based on the inhibition of polysynaptic transmission of excitation in the spinal cord, in which the tone of the skeletal muscles is regulated. Tizalud, according to the instructions, can cause a "withdrawal" syndrome, therefore, at the end of treatment, the dose must be reduced gradually.

Contraindications

According to the instructions, Tizalud is contraindicated to take:

• During lactation;
• In pediatrics;
• Simultaneously with potent inhibitors of the isoenzyme CYP1A2;
• Against the background of hypersensitivity to the active (tizanidine) or auxiliary components that make up the tablets;
• During pregnancy;
• Against the background of severe liver failure.

Tizalud tablets should be taken with extreme caution:

• Against the background of hepatic or renal failure;
• With congenital lengthening of the Q-T interval;
• Against the background of bradycardia;
• Concurrently with oral contraceptives;
• Elderly people over 65;
• With arterial hypotension.

Side effects

• insomnia;
• drowsiness;
• nausea;
• bradycardia;
• increased serum transaminase activity;
• dry mouth;
• dizziness;
• feeling tired;
• muscle weakness;
• some decrease in blood pressure.

Drug interactions

The drug tablets should not be administered concurrently with diuretics and drugs for the treatment of arterial hypertension. This drug interaction requires special care due to the risk of a rapid fall in blood pressure, bradycardia and heart rhythm disturbances.

Tizalud tablets are not recommended to be prescribed to the patient simultaneously with Fluvoxamine or Ciprofloxacin, since this drug interaction causes a sharp and prolonged decrease in blood pressure, accompanied by loss of consciousness, lethargy, severe dizziness, and a decrease in the speed of psychomotor reactions. In severe cases, this drug interaction leads to collapse.

The drug Tizalud is not prescribed simultaneously with antiarrhythmic drugs, fluoroquinolones, oral contraceptives due to an increased risk of side effects from the gastrointestinal tract and liver.

With the simultaneous use of tablets of the drug with sedatives, antihistamines or sleeping pills, the sedative effect of Tizanidine increases.

With extreme caution, Tizalud tablets should be prescribed to patients receiving therapy with Azithromycin, Cisapride. This drug interaction increases the risk of complications and severe side effects from the heart and blood vessels.

Special conditions

Due to the threat of the development of "withdrawal syndrome", in case of refusal of therapy, the dose of tizanidine is gradually reduced.

When carrying out long-term treatment with Tizalud, the state of the liver should be monitored at least once a month, especially during the first 4 months of therapy.

When taking pills, it is better to refuse to drive vehicles and carry out precise or dangerous work.

Analogues of the medicine Tizalud

For treatment, analogs are prescribed:

1. Tizanil.
2. Tizanidine hydrochloride.

Vacation price and conditions

The average price of Tizalud, 2 mg tablets, 30 pieces (Moscow), is 145 rubles.

The tablets are available from pharmacies with a doctor's prescription. The shelf life of the drug from the date of manufacture is 5 years. The instructions for use prescribe the packaging with Tizalud tablets out of the reach of children, avoiding direct sunlight.

Tizalud is a popular drug. Many patients are familiar with it as a powerful pain reliever that is used for spasms or muscle cramps. Experts attribute Thizalud to a group of muscle relaxants that relax the nerve ganglia. Most often, this medicine is prescribed for pathologies of muscle tissue.

The action of the drug is explained by the inhibition of presynaptic receptors, due to which the activity of amino acids decreases. These cells interfere with other receptors that block the production of prostaglandins. Due to this, the neurons in the spine are inhibited, the person gets rid of painful sensations.

Tizalud is a drug that experts attribute to the group of centrally acting muscle relaxants. The greater effect of the medication is on the spinal cord. The active components of the drug increase the production of adrenergic receptors, which suppress the production of specific amino acids. They slow down the work of the spinal cord, due to which its nervous excitability is significantly reduced. Because of this, a person gets rid of serious painful sensations, his muscle tone gradually returns to normal.

Tizalud not only stops and slows down the nerve ganglia, but also fights painful sensations.

This drug is often used to treat muscle spasms caused by spinal and cerebral lesions. The medicine reduces resistance to passive movements, due to which the number of spasms decreases, and the activity of movements increases. After a few days of regular use, a person feels much better, he gets rid of stiffness and limited movement.

When a drug enters the human bloodstream, it is rapidly absorbed by all organs and tissues. Only half of all nutrients from the drug affect the body. You can take the medicine regardless of food intake - this does not affect the effectiveness or safety of therapy. The metabolism in the body occurs rapidly, the components of the tablets are rapidly digested and after 2-3 hours they are half excreted from the body.

Most of the active components of Tizaluda are excreted from the body through the liver. If a person has renal impairment, the elimination half-life can be about 12 hours. All components of the drug are excreted naturally after processing in the liver. Keep in mind that people with kidney disease do not need to review therapy. Based on diagnostic data, your attending physician can make adjustments to the prescribed treatment tactics.

Indications for use

Tizalud is a popular drug that has powerful analgesic effects. It is also known as a means of normalizing the exchange of nerve impulses. Most often, this medicine is prescribed for the following pathologies:

• Diseases of the spine of a neurological and degenerative nature;
• Skeletal muscle plasticity;
• Stretching the muscles of the back;
• Cerebral paralysis.

Tizalud should be taken with extreme caution. It is best that such therapy is prescribed exclusively by the attending physician. You should not use the drug as an independent therapy, because improper use of the drug can lead to the development of serious complications.

Use Thizalud with extreme caution. Remember to stick to the prescribed dose so as not to provoke an overdose. An overdose occurs when a too large dose of the drug is taken at the same time. It can be recognized by the following features:

• Lowering blood pressure;
• Nausea and vomiting
• Drowsiness and lethargy;
• Anxiety, excessive excitability;
• Bradycardia;
• Headache and dizziness;
• Miosis and distress;
• Lengthening of the QT gap;
• Coma development.

To stop the manifestations of an overdose with Tizalud, you must immediately flush the stomach with a solution of activated carbon.

This will help to reduce the concentration of active ingredients, as well as get rid of discomfort. To stop the malaise at home, you need to drink as much clean water as possible. Subsequently, symptomatic therapy of such symptoms is carried out.

Side effects

In case of individual intolerance to the components or incorrect administration of the medication, the patient may experience serious side effects. If you notice their formation, stop therapy immediately. Most often, patients complain about:

• Headache, decreased blood pressure;
• Excessive fatigue;
• Drowsiness;
• Disorders in the digestive tract;
• Dizziness;
• Feeling of dry mouth.

Studies have shown that most of the side effects of Tizalud are experienced by people who use it to treat muscle spasms.

If the patient has spasticity, lower doses of the medication are prescribed. Otherwise, he develops anxiety, blood pressure drops significantly. Very rarely, therapy causes muscle weakness, sleep disturbance, hallucinations.

Mode of application

Tizanidine is a component that is an active ingredient in Tizaluda. The medicine reduces muscle tone, increases the tone of skeletal tissue. At the same time, this helps to reduce their resistance to movement. Experts say that this effect is due to a decrease in the amount of amino acids in the bloodstream. Keep in mind that this change does not affect the neuromuscular connections. Thanks to this, you will not feel any changes and will not aggravate the development of degenerative processes.

To get rid of soreness in the muscles, 1-2 tablets of Tizaluda are prescribed three times a day. Such treatment helps to get rid of many neurological diseases, and also stops degenerative changes in the spinal cord. Quite often, doctors prescribe Tizalud as a therapy for multiple sclerosis or lesions of the spinal column.

If you can't take the pill itself, you can crush it to a fine powder and dilute it in a little clean water.

Use by pregnant and lactating women

At the moment, there is no exact data on the effect of the drug on the body of lactating and pregnant women. It is because of this that Tizalud is not appointed to this category of citizens. The only exception is situations when it is impossible to cure any deviation without the help of this drug. Keep in mind that the components of Tizalud actively pass into breast milk. It is because of this that during therapy with this medicine, the child needs to be weaned for a while. It is not recommended to carry out treatment with Tizalud in children and adolescents.

special instructions

Tizalud is a drug that affects concentration and reaction speed. It is for this reason that you should not work behind complex mechanisms or drive vehicles when using this drug. If you experience side effects, you should immediately consult a doctor. Studies have shown that liver weakness is the most common cause of malaise.

If the side effects bother you constantly, you need to see your doctor to change the dose or the drug itself.

Long-term administration of Tizalud produces the greatest changes in the liver. It can provoke an increase in transaminase levels. If its concentration rises 3 times higher than the norm, the use of the drug is terminated immediately. With kidney dysfunction, it is permissible to take Tizalud in a dose of no more than 1 capsule per day.

Over time, the dosage may be increased, but this should be done under the supervision of a doctor.

It has been proven that it is not recommended to combine the intake of Tizalud and B vitamins. The active components, when interacting with each other, significantly reduce their activity, which is why such a therapy does not make any sense. If you take Tizalud for more than six months, you may develop side effects in the form of permanently low blood pressure. Such treatment requires regular visits to the doctor and blood tests. The drug can lead to serious changes in the human body.