tizanidine / Generic mfg. - LARVOL DELTA

Reply to: Revisiting Safety Assessments of Baclofen and Tizanidine in Older Adults. (PubMed, J Am Geriatr Soc) - No abstract available

Journal

Revisiting Safety Assessments of Baclofen and Tizanidine in Older Adults. (PubMed, J Am Geriatr Soc) - No abstract available

Journal

Effect of Tizanidine on Postoperative Urinary Retention After Sacrospinous Suspension (clinicaltrials.gov) - P3 | N=20 | Completed | Sponsor: Endeavor Health | Recruiting ➔ Completed | N=30 ➔ 20

Enrollment change • Trial completion

the Effect of Integrated Neuomuscular Inhibition Technique on Adult Females With Cervicogenic Headache (clinicaltrials.gov) - P=N/A | N=40 | Completed | Sponsor: Kafrelsheikh University | Recruiting ➔ Completed

Trial completion • Pain

Intrathecal baclofen use in stiff person syndrome (ASRA-FALL 2025) - "Case: Patient Background •57-year-old male with right auricular melanoma •Previous treatments: partial auriculectomy, sentinel node biopsy, radiotherapy, pembrolizumab •4 years later: fatigue, dizziness, hand tremors Disease Progression and Imaging •Lung nodule → metastatic melanoma confirmed •PET scan: hypermetabolic activity (lung, subcarinal & cervical nodes, adrenal gland) •Labs: eosinophilia •EMG: lower extremity motor neuron/axon injury Symptom Management (Pre-Diagnosis) •Symptoms: generalized pain, cramps, dysphagia, fatigue, disrupted sleep •Medications tried: baclofen, tizanidine, hydrocodone, diazepam, gabapentin, tramadol, prednisone, dantrolene •Partial relief: diazepam (cramps), gabapentin (neuropathic pain) •Physical therapy: aquatic therapy unsuccessful •Oswestry Disability Index (from 0-100): 28 (back; Moderate Disability), 26 (neck; Moderate Disability) Diagnosis and Targeted Therapy •Referred to pain management → diagnosed with Stiff Person Syndrome..."

Late-breaking abstract • CNS Disorders • Eosinophilia • Fatigue • Gastrointestinal Disorder • Immunology • Melanoma • Movement Disorders • Neuralgia • Sleep Disorder • Solid Tumor

Sweet Without the Sour: A Genetic Tale of Sugar Loss (KIDNEY WEEK 2025) - "She was taking indomethacin, tizanidine and rimegepant. These risks can be mitigated through education on genitourinary hygiene and frequent monitoring during pregnancy. This highlights the importance of genetic testing, since proper diagnosis can affect future management decisions."

CNS Disorders • Diabetes • Infectious Disease • Metabolic Disorders • Migraine • Nephrology • Urinary Incontinence

Intercostal Neuralgia in Severe Thoracolumbar Scoliosis: A Therapeutic Role for Radiofrequency Ablation (ASRA-FALL 2025) - "Sleep limited to 4 hours with frequent nocturnal awakenings, daytime fatigue and impaired mobility contributed to reduced quality of life, Pain persisted despite treatment with pregabalin, tizanidine, and structured physical therapy; patient declines spinal corrective surgery due to recovery concerns. Larger series or prospective studies are needed to define safety, efficacy, and durability in this population. Conclusion Intercostal RFA for intractable intercostal neuralgia due to severe thoracic scoliosis has meaningful therapeutic value"

Anesthesia • Fatigue • Infectious Disease • Movement Disorders • Musculoskeletal Diseases • Neuralgia • Pain • Respiratory Diseases

WHEN SHAKES AREN'T SEIZURES: A CASE OF REFRACTORY SPASMS IN A PATIENT WITH STIFF PERSON SYNDROME (CHEST 2025) - "The patient ultimately escalated to a D10 infusion, was admitted to the MICU, and went into refractory status spasticus that was refractory to multiple doses of midazolam, lorazepam, and ketamine...The patient resumed her weekly IVIG and eventually tapered back to her home SPS medications (diazepam 300mg three times daily, quetiapine 100mg at night, tizanidine 6mg, and rituximab every 5 months) after routine treatment of her other acute problems. The patient was able to wean off the D10 drip, resumed her home insulin pump at half the normal dose, and resumed prednisone 5mg for her adrenal insufficiency... Clinicians should keep the seizure mimicking diagnosis of SPS on their differential as the management of SPS requires special multi-system considerations, may not require intubation, and often requires significantly higher doses of GABAergic medications than most any other patient will receive."

Clinical • Anesthesia • CNS Disorders • Dermatology • Diabetes • Endocrine Disorders • Epilepsy • Genetic Disorders • Hypoglycemia • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Novel Coronavirus Disease • Rare Diseases • Renal Disease • Septic Shock • Type 1 Diabetes Mellitus • Vitiligo

Assessing the Cardiac Safety of a Multimodal Protocol for 'Tranq Dope' Withdrawal: A Retrospective QTc Analysis. (PubMed, Am J Emerg Med) - "The use of a multi-agent 'tranq dope' withdrawal protocol was not associated with serious adverse events. Pre and post-treatment QTc were variable but overall effects were neutral. These findings suggest these treatments can be used in those at risk, or with known QTc prolongation, though more study is needed to confirm findings."

Journal • Retrospective data • Addiction (Opioid and Alcohol) • Cardiovascular • Ventricular Tachycardia

SEVERE BRADYCARDIA AND HEMODYNAMIC INSTABILITY DUE TO FLUVOXAMINE-TIZANIDINE INTERACTION: A CASE OF RECURRENT SYNCOPE (CHEST 2025) - "CASE PRESENTATION: We present the case of a a 32-year-old female with chronic psychiatric disorders on Fluvoxamine, Lamictal, and Alprazolam who was transferred to our hospital due to syncopal episodes, fatigue, dizziness, and vision changes that had been occurring periodically over the last month...She was eventually discharged in her normal state of health with levothyroxine and discontinuation of Tizanidine and Fluvoxamine... The patient's chronic psychiatric medications, particularly Fluvoxamine, in combination with tizanidine likely resulted in her recurrent syncope and hemodynamic instability. The identification of subclinical hypothyroidism as a possible contributor complicates the picture, but its role in profound bradycardia is less certain. This case underscores the importance of careful medication reconciliation with particular care given to drug interactions that may have serious cardiovascular effects."

Clinical • Cardiovascular • CNS Disorders • Endocrine Disorders • Fatigue • Heart Failure • Infectious Disease • Mental Retardation • Movement Disorders • Psychiatry • Xerostomia • CYP1A2

SYMPATHETIC STORM IN TRAUMATIC BRAIN INJURY: A CASE REPORT ON PAROXYSMAL SYMPATHETIC HYPERACTIVITY (CHEST 2025) - "He was managed using a multimodal pharmacologic approach with; clonidine for central sympatholytic, propranolol for tachycardia, gabapentin for neuropathic modulation, and as-needed lorazepam for agitation. Tizanidine was also added for muscle relaxation... Increased awareness of PSH among clinicians managing severe TBI is essential to improve patient outcomes. Further research is needed to establish evidence-based treatment protocols for this condition."

Case report • Clinical • Cardiovascular • CNS Disorders • Epilepsy • Hematological Disorders • Hypertension • Infectious Disease • Musculoskeletal Diseases • Orthopedics • Septic Shock • Subarachnoid Hemorrhage • Vascular Neurology • Ventriculomegaly

Relax the Body: Dual-Agent Nighttime Therapy for Fibromyalgia: Symptom Reduction Using Tricyclic Antidepressants and Muscle Relaxants (ACR Convergence 2025) - "All participants were prescribed a low dose TCA (amitriptyline, doxepin, or trazodone) in the early evening, titrated as needed to induce deep sleep. Once patients reported improved sleep, a nightly muscle relaxant - either cyclobenzaprine or tizanidine - was introduced and gradually increased based on tolerability, up to 30 mg or 24 mg respectively... This study introduces a novel multimodal pharmacologic regimen combining tricyclic antidepressants and muscle relaxants to target both central and peripheral mechanisms contributing to FM symptomatology. Results suggest that such a combination can improve pain, sleep, and energy in a substantial portion of FM patients, with minimal side effects. Given the limitations of existing monotherapies and the heterogeneity of FM symptoms, this approach warrants further exploration in larger randomized controlled trials."

Anesthesia • CNS Disorders • Fatigue • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology • Sleep Disorder

Myofascial pain syndromes in parkinsonism (MDS Congress 2025) - "Muscle relaxants such as baclofen and tizanidine demonstrated 55-70% efficacy in reducing muscle stiffness, while dopaminergic and non-dopaminergic medications provided 60-75% relief. MPS is a significant but often overlooked contributor to pain in Parkinsonism. A multidisciplinary approach that integrates pharmacological and non-pharmacological treatments yields the best outcomes."

CNS Disorders • Movement Disorders • Musculoskeletal Pain • Pain • Parkinson's Disease

A CASE STUDY (WCN 2025) - "Currently, there is no literature in is role of improving functional outcome in patients with PTS. We present a case of a 56-year-old-lady, with a background of NMOSD, who presented with refractory PTS to conventional antispasmodic agents (Baclofen, Clonazepam, and tizanidine) affecting participation in therapy. The study suggests that early identification and treatment of PTS in NMOSD with Carbamazepine can significantly improve functional outcomes."

Case study • Clinical • CNS Disorders

Postoperative Localized Rhabdomyolysis after Hysterectomy (ASA 2025) - "Initial efforts for pain control were not managed with scheduled oxycodone, magnesium, tizanidine, or naproxen. A low dose ketamine infusion was initiated and pain scores improved."

Endocrine Disorders • Gynecology • Hepatology • Immunology • Inflammatory Arthritis • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Musculoskeletal Pain • Myositis • Obstructive Sleep Apnea • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Sleep Apnea • Sleep Disorder

CARES-Spine (Comprehensive Analgesic, Recovery, and Education Support for Spine Surgery) Trial (clinicaltrials.gov) - P3 | N=375 | Recruiting | Sponsor: Stanford University | Not yet recruiting ➔ Recruiting

Enrollment open • Back Pain • Musculoskeletal Pain • Orthopedics • Pain

Comparative, Multiple-Dose, Fixed Sequence, Pharmacokinetic Study of 2 Sizes of Daily MRX-4TZT TDS (Tizanidine Transdermal Delivery System) Applied for 3 Days and 2 Dose Levels of Oral Tizanidine in Healthy Adult Subjects (ANZCTR) - P1 | N=24 | Terminated | Sponsor: MEDRx Australia Pty Ltd | Not yet recruiting ➔ Terminated

Trial termination • Movement Disorders

Synergistic enhancement of anti-migraine efficacy through supramolecular self-assembly of tizanidine with meloxicam. (PubMed, J Control Release) - "Additionally, tizanidine-meloxicam salt could form uniform and stable molecular clusters in aqueous solution, which could further enhance its efficacy and stability. This study demonstrates that pharmaceutical multicomponent crystals is a significant strategy for the development of novel formulations with improved efficacy."

Journal • CNS Disorders • Migraine • Pain

Painful cranial neuropathy secondary to radiotherapy: Actinic neuropathy, responsive to anesthetic block with corticosteroid. Case report. (IHC 2025) - "He was treated with venlafaxine 150 mg and gabapentin 3600 mg, morphine 15 mg 12 times a month, and paracetamol 750 mg daily; serological, metabolic, and hormonal studies were normal...A diagnosis of cervicogenic headache secondary to actinic neuropathy was established, the dose of venlafaxine was optimized at 225 mg daily, tizanidine 6 mg/day and peripheral nerve block with local anesthetic combined with corticosteroid (betamethasone) in the bilateral greater occipital nerve and 2% anesthetic without corticosteroid in the bilateral lesser occipital nerve, auriculotemporal, supratrochlear and supraorbital nerves, trigger points were activated in the ipsilateral trapezius and semispinalis muscles, improving pain by 90%, maintained for 30 days. There was a reduction in the use of opioids positive impact on quality of life, with a significant reductiomn in disability. Conclusion Cranial peripheral nerve block inhibits the transmission of nerve impulses, modulating pain,..."

Case report • Clinical • CNS Disorders • Migraine

Safety of Baclofen and Tizanidine in Older Adults: A Retrospective Cohort Study in a Large Integrated Health Care System. (PubMed, J Am Geriatr Soc) - "Older adult patients dispensed baclofen or tizanidine were found to have an increased risk of injury when compared with cyclobenzaprine, currently included on the Beers Criteria. These findings support the inclusion of baclofen and tizanidine on the Beers Criteria along with other SMRs as potentially inappropriate medications in use in older adults with musculoskeletal complaints. Due to a retrospective design, the risk for residual confounding may remain."

Journal • Retrospective data • CNS Disorders • Musculoskeletal Diseases • Orthopedics • Vascular Neurology

The role of West Nile Virus in neuropathic pain (NeuPSIG 2025) - "He was started on Gabapentin but this was discontinued due to being ineffective.He was taking PO dilaudidPRN which was weaned down and ultimately discontinued with starting Lyrica and Cymbalta. Several changes were made while he was at IPR and was discharged with an effective pain regimen (primarily Cymbalta, Lyrica, Tylenol, Ibuprofen and TizanidinePRN)... Patients with transverse myelitis due to West Nile neuroinvasive disease may benefit from a multimodal pain treatment regimen with Lyrica and Cymbalta potentially having better effects compared to Gabapentin and Tramadol when it comes to treating neuropathic pain. However, longitudinal prospective studies are needed to determine the type of pain medications that are more effective in treating neuropathic pain in patients with West Nile virus. This case demonstrated that Cymbalta and Lyrica provided good improvement in patient's neuropathic pain."

Back Pain • CNS Disorders • Musculoskeletal Pain • Neuralgia • Pain

Posterior Approach to Sacroiliac Joint Fusion as a Salvage Procedure: A Case Report. (PubMed, Pain Med Case Rep) - "This case report highlights the emerging evidence on the sustained safety and efficacy of a salvage posterior SIJ fusion technique using the LinQ device (PainTEQ, Tampa, FL) in a patient with persistent back pain, following multiple unsuccessful treatments."

Journal • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain

To evaluate the efficacy and safety of tizanidine hydrochloride tablets in the prevention and treatment of migraine - a multicenter, single-arm, self-controlled before-after clinical study (ChiCTR) - P1 | N=100 | Not yet recruiting | Sponsor: Renmin Hospital of Wuhan University; Renmin Hospital of Wuhan University

New P1 trial • CNS Disorders • Migraine • Pain

Assess the Effect of Metaxalone 640 mg (M640) Compared to Tizanidine 8 mg on Truck Driving Ability and Cognition (clinicaltrials.gov) - P4 | N=20 | Completed | Sponsor: Primus Pharmaceuticals | Trial primary completion date: May 2024 ➔ Dec 2024

Trial primary completion date • Alzheimer's Disease • Cognitive Disorders

Efficacy of Muscle Relaxants on a Multimodal Analgesic Regimen in Total Knee Arthroplasty: A Prospective, Double-Blind, Placebo-Controlled, Randomized Trial. (PubMed, J Arthroplasty) - "Adding tizanidine to multimodal analgesia protocols provided clinically meaningful postoperative pain relief during ambulation, reduced the morphine prescription rate, and enhanced knee ROM recovery. These results may offer important implications for optimizing postoperative pain management strategies and inform future clinical practice guidelines for TKA recovery protocols."

Journal • Orthopedics • Pain • CRP • IL6