tizanidine / Generic mfg. - LARVOL DELTA

The Gut on Tranq: A Rare Case of Xylazine-Induced Ischemic Colitis (ACG 2026) - "Upon admission, she experienced severe withdrawal, including 20-30 bowel movements daily, and was treated with buprenorphine, clonidine, and tizanidine. Colonoscopy findings of Xylazine-induced ischemic colitis. Panels show continuous ulceration, bleeding, pallor, and friability throughout the (A) rectum, (B) sigmoid, (C) descending, (D) transverse, and (E) hepatic flexure/ascending colon."

Clinical • Cardiovascular • CNS Disorders • Depression • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hypotension • Immunology • Inflammation

Ultrasound-Guided Alcohol Neurolysis for Poststroke Upper Limb Spasticity to Facilitate Arteriovenous Fistula Creation in Hemodialysis: A Case Report. (PubMed, Arch Rehabil Res Clin Transl) - "Oral agents, including baclofen and tizanidine, were avoided or discontinued because of safety concerns in the setting of ESRD with recurrent intradialytic hypotension. To our knowledge, this is the first reported case of alcohol neurolysis facilitating AVF creation in a dialysis-dependent stroke patient with refractory spasticity. This case highlights alcohol neurolysis as a safe and effective intervention when systemic agents and botulinum toxin are unsuitable or inadequate, and underscores the importance of an individualized, multimodal, and multidisciplinary approach to spasticity management in complex patients."

Journal • Addiction (Opioid and Alcohol) • Anesthesia • Cardiovascular • Chronic Kidney Disease • Hypotension • Movement Disorders • Muscle Spasticity • Nephrology • Pain • Renal Disease

TIPS: Postoperative Tizanidine Use in Pelvic Reconstructive Surgery: A Pilot Study (clinicaltrials.gov) - P2 | N=186 | Recruiting | Sponsor: Hartford Hospital | Not yet recruiting ➔ Recruiting

Enrollment open • Gynecology

Discovering repurposable drugs for Alzheimer's disease and related dementias: target trial emulation using decentralised real-world data. (PubMed, EBioMedicine) - "20 widely used medications may be associated with reduced progression from MCI to ADRD and represent promising candidates for clinical evaluation as repurposed therapies for dementia."

Journal • Real-world evidence • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dementia • Pain

WHEN SPASM BECOMES SHOCK: TIZANIDINE-MEDIATED CARDIOGENIC SHOCK (CHEST 2026) - No abstract available

Cardiovascular

Tizanidine Withdrawal Syndrome: Clinical Manifestations and Management Strategies. Case Series. (PubMed, J Pain Palliat Care Pharmacother) - "Case 1 was a 24 year old female admitted with empagliflozin induced diabetic ketoacidosis who experienced hypertensive crisis and tachycardia following abrupt cessation of chronic high dose tizanidine...Case 3 was a 29 year old female with recurrent pancreatitis, resistant hypertension, and an adrenal incidentaloma who presented with severe hypertension and tremors after discontinuing both tizanidine and diazepam...Case 4 was a 42 year old male with asthma, hypertension, anxiety disorder, bariatric surgery, methamphetamine use, and more than ten prior admissions specifically for tizanidine withdrawal, who presented with palpitations, tremors, vomiting, and hypertensive crisis after abrupt dose reduction...Patient education on avoiding abrupt discontinuation is essential, particularly for individuals with psychiatric comorbidities or prior withdrawal episodes. Awareness of this underrecognized syndrome is critical to prevent misdiagnosis and ensure safe prescribing..."

Journal • Asthma • Cardiovascular • CNS Disorders • Crohn's disease • Gastroenterology • Hypertension • Immunology • Inflammatory Bowel Disease • Metabolic Disorders • Movement Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Pancreatitis • Psychiatry • Pulmonary Disease • Respiratory Diseases

Catecholamine-Mediated Stress Cardiomyopathy Following Abrupt Tizanidine Withdrawal (AHA 2026) - "Abstract is embargoed at this time."

Cardiomyopathy • Cardiovascular

The Effect of Preoperative Administration of Oral Tizanidine on the Postoperative Pain and Sleep Quality (clinicaltrials.gov) - P=N/A | N=68 | Recruiting | Sponsor: Tanta University

New trial • Orthopedics • Pain

Electrical Neuromodulation for Modifying Spinal Network Involved in Spasticity (clinicaltrials.gov) - P=N/A | N=12 | Active, not recruiting | Sponsor: University of Mississippi Medical Center

New trial • CNS Disorders • Movement Disorders • Muscle Spasticity • Musculoskeletal Diseases • Orthopedics

Refractory SPAsticity and hypertonia or spasms treated with steReoTActic radiosurgery (SPARTA) (ESTRO 2025) - P=N/A | "Common treatments are represented by oral or i.v. medication (baclofen, diazepam, tizanidine) or surgical intervention (neurotomies, rhizotomies). This is the first clinical trial on the use of a linac-based SRS for the treatment of spasticity. These preliminary results documented a clinical activity of SRS with no safety concerns. A longer follow-up is necessary to assess better the effectiveness, toxicity, and response duration."

Surgery • CNS Disorders • Movement Disorders • Orthopedics

Fentanyl Taper and Methadone Up-Titration in Patient with Chronic Thoracic Spine Pain (ASA 2026) - "We present a 40-year-old male with refractory chronic thoracic pain and Brown-Sequard syndrome following thoracic decompression and fusion for chordoma resection. Withdrawal symptoms were effectively managed with clonidine and tizanidine. This case highlights methadone as a viable strategy for opioid rotation in complex chronic pain with suspected opioid-induced hyperalgesia."

Clinical • Chordoma • Pain

Interaction of CYP2B6 Genotype and Efavirenz With Methadone and Tizanidine PK (clinicaltrials.gov) - P1 | N=60 | Recruiting | Sponsor: Indiana University | Trial completion date: Dec 2026 ➔ May 2027 | Trial primary completion date: Aug 2026 ➔ May 2027

Trial completion date • Trial primary completion date

Transitioning from Transcriptomics to Proteomics: Enhancing Mechanistic Accuracy in PBPK Modeling via Absolute Protein Abundances. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "The performance of ProteinDB in PBPK modeling was evaluated using the probe substrates midazolam, digoxin, rifampicin, and tizanidine, with associated drug-drug interactions. For PBPK modeling, ProteinDB showed consistently comparable or superior predictive performance for systemic exposure and other clinical endpoints compared with transcriptomics-based baseline and empirically modified library profiles. By providing a direct physiological basis for system parameterization, ProteinDB offers a robust alternative to current transcriptomics PK-Sim databases and reduces the reliance on empirical expression modification, thus improving the reliability of prospective PBPK modeling."

Journal

Comparison of oral tizanidine and baclofen for post-operative pain management after femoral fracture surgery. (PubMed, J Opioid Manag) - "Preoperative administration of 4 mg tizanidine and 25 mg baclofen showed comparable efficacy in post-operative pain management. As this study lacked a placebo control, it cannot confirm the absolute analgesic efficacy of either drug over no treatment. Although tizanidine demonstrated a trend toward lower pain scores at certain intervals, these differences were not statistically significant after adjustment for multiple comparisons. Both drugs exhibited similar safety profiles and supplemental analgesic requirements."

Clinical • Journal • Dermatology • Musculoskeletal Diseases • Orthopedics • Pain • Pruritus

TIPS: Postoperative Tizanidine Use in Pelvic Reconstructive Surgery: A Pilot Study (clinicaltrials.gov) - P2 | N=186 | Not yet recruiting | Sponsor: Hartford Hospital

New P2 trial • Gynecology

Comorbidities of Adult Alkaptonuria Patients Living in Hungary (SSIEM 2026) - "3 patients take central muscle relaxants (2 tolperisone, 1 tizanidine), one patient receives intraarticular steroid treatment regularly. In the described group of AKU patients, orthopedic and cardiovascular comorbidities are the most prevalent. Nitisinone might be able to reduce the burden of orthopedic manifestations."

Clinical • Cardiovascular • Coronary Artery Disease • Heart Failure • Metabolic Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Nephrology • Orthopedics • Osteoporosis • Renal Calculi

Comparison of the side effect profiles of compounds with central muscle-relaxing effect (PubMed, Orv Hetil) - "In addition to other conditions involving increased muscle spasms, centrally acting muscle relaxants (guaifenesin, tolperisone, methocarbamol, chlorzoxazone, diazepam, baclofen and tizanidin) provide relief for a significant proportion of patients suffering from low back pain...Mortality (including suicide) associated with the administration of these medicines is the highest among the reported side effects for diazepam, followed by tizanidine and methocarbamol...Orv Hetil. 2026; 167(31): 1224-1230."

Adverse events • Clinical • Journal • Review • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain • Psychiatry

Tegaserod combined with different non-steroidal drugs for postoperative analgesia after laparoscopic cholecystectomy: a 22 factorial randomized controlled trial (ChiCTR) - P4 | N=428 | Not yet recruiting | Sponsor: Shanghai East Hospital; Shanghai East Hospital

New P4 trial • Respiratory Diseases

Sustainable miniaturized smartphone-coupled TLC platform for innovative cleaning validation: application to tizanidine combinations under challenging concentration ratios. (PubMed, Sci Rep) - "To address this need, a portable at-line analytical platform was developed for TZN determination in combination with aceclofenac (ACF), ibuprofen (IBF), and paracetamol (PRC). Validation according to ICH guidelines demonstrated good linearity and high sensitivity for the investigated drugs, with quantitation limits below established acceptance limits. Multidimensional sustainability was confirmed using moGAPI, CACI, VIGI, and RGB-12 assessments, highlighting the method as a novel sustainable tool for reliable cleaning validation of TZN combinations."

Journal • CNS Disorders • Psychiatry

Hereditary spastic paraparesis type 18: shedding light upon a novel mutation in the ERLIN2 gene. (EAN 2026) - "Previous treatments with oral baclofen, tizanidine, and botulinum toxin showed minimal response. Extended-release fampridine (10 mg b.i.d.) was administered as a therapeutic alternative... The proband case confirms the genotype-phenotype correlation between monoallelic variants of the ERLIN2 gene and pure HSP. This finding suggests a potential dominant negative effect of the erlin2 protein on oligomerization, as the cause of a milder phenotype. Furthermore, this case introduces a new variant in the ERLIN2 gene, contributing to a better understanding of the genetic factors underlying HSP type 18."

Genetic Disorders • Movement Disorders

A Case Report: Tizanidine-Induced Cardiogenic Shock Managed in a U.S. Army Role 3 Field Hospital. (PubMed, Mil Med) - "Despite profound left ventricular dysfunction and multi-drug hemodynamic dependence, cardiac function quickly normalized. This case demonstrates that advanced, physiology-guided shock resuscitation is feasible in trauma-focused, forward-deployed environments and adds to the sparse literature recognizing tizanidine-induced, reversible heart failure."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Mood Disorders

A Multicenter, Randomized, Fixed Sequence, Cross-over Study to Assess the Safety, Tolerability, and Pharmacokinetics of MRX-4TZT TDS (Tizanidine Transdermal Delivery System) versus Oral Tizanidine in Multiple Sclerosis Patients with Established Spasticity (ANZCTR) - P2 | N=80 | Recruiting | Sponsor: MEDRx Australia Pty Ltd | Initiation date: May 2026

Trial initiation date • CNS Disorders • Movement Disorders • Multiple Sclerosis

Tizanidine as an Adjunct to Alpha-Blockers in Adults With Dysfunctional Voiding/Poor Relaxation of the External Sphincter: A Retrospective Review. (PubMed, Low Urin Tract Symptoms) - "Addition of tizanidine to alpha-blocker and pelvic relaxation is associated with clinically significant improvement in LUTS and uroflometry parameters in adults with pelvic floor dysfunction. We acknowledge that causal inference is limited by the study design and randomized placebo-controlled studies are required for deriving stronger conclusions."

Journal • Retrospective data • Anesthesia

Review of Oral Muscle Relaxants Used for Chronic Temporomandibular Disorder Pain. (PubMed, Anesth Prog) - "This review summarizes the pharmacology, clinical evidence, and risk profiles of commonly prescribed SMRs-including cyclobenzaprine, baclofen, tizanidine, and others-within the context of chronic TMD management. Given concerns regarding sedation, dependence, hepatotoxicity, and interactions with polypharmacy, clinicians should employ these medications judiciously and primarily for acute exacerbations rather than long-term therapy. An evidence-based, multimodal approach remains essential for optimizing care in patients with chronic TMDs."

Journal • Review • Anesthesia • Musculoskeletal Diseases • Pain

Intrathecal Baclofen Pump Failure Secondary to Autonomic Dysreflexia (ISPRM 2026) - "Her spasticity (MAS 4; Penn Spasm Frequency 4/4) was unresponsive or poorly tolerated with oral baclofen, tizanidine, dantrolene, botulinum toxin, and phenol neurolysis. This case demonstrates that intrathecal baclofen failure may result from pump-site pain rather than loss of efficacy. Nonstandard pump placement triggered recurrent autonomic dysreflexia, necessitating explantation despite spasticity improvement. Careful surgical planning and recognition of hardware-related pain are critical to prevent morbidity."

CNS Disorders • Genetic Disorders • Movement Disorders • Multiple Sclerosis • Orthopedics • Sleep Disorder