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If therapy needs to be discontinuedparticularly in patients who have been receiving high doses20 mg to 36 mg dailyfor long periods9 weeks or moreor who may be on concomitant treatment with narcoticsthe dose should be decreased slowly2 mg to 4 mg per dayto minimize the risk of withdrawal and rebound hypertensiontachycardiaand hypertoniasee Drug Abuse and Dependence9.3
Tizanidine may cause you to have withdrawal reactionsespecially if it has been used regularly for a long time or in high doses.
Food has complex effects on tizanidine pharmacokineticswhich differ with the different formulationsZanaflex Capsules and Zanaflex tablets are bioequivalent to each other under fasting conditionsmore than 3 hours after a mealbut not under fed conditionswithin 30 minutes of a mealThese pharmacokinetic differences may result in clinically significant differences when switching administration of tablet and capsules and when switching administration between the fed or fasted stateThese changes may result in increased adverse eventsor delayed or more rapid onset of activitydepending upon the nature of the switchFor this reasonthe prescriber should be thoroughly familiar with the changes in kinetics associated with these different conditionssee Clinical Pharmacology12.3
Starting at a lower dose and gradually setraline mail order. increasing the dose minimizes the risk for adverse effects.
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