Drug Uses

Skelaxin is a muscle relaxant. Skelaxin is used to treat the pain and stiffness of muscle injuries, including strains, sprains and muscle spasms.

How Taken

Skelaxin comes as a tablet to take by mouth. The recommended dose for adults and children over 12 years of age is two tablets (800 mg) three to four times a day. Skelaxin may be taken with food or immediately after meals to prevent stomach upset. Do not increase your dose, take it more frequently or take it for a longer period of time than prescribed by your doctor.

Warnings/Precautions

Do not take Skelaxin if you have acute intermittent porphyria. Before taking Skelaxin, tell your doctor if you have liver disease. You may need a lower dose or special monitoring during your therapy. It is not known whether Skelaxin will harm an unborn baby. Do not take Skelaxin without first talking to your doctor if you are pregnant. It is also not known whether Skelaxin passes into breast milk. Do not take Skelaxin without first talking to your doctor if you are breast-feeding a baby. Skelaxin is not approved for use in children younger than 12 years of age.

Missed Dose

If you miss a dose of Skelaxin, take as soon as remembered within 1 hour. Otherwise skip that dose and resume usual dosing schedule. Do not "double-up" the dose to catch up.

Possible Side Effects

The most frequent reactions to Skelaxin include nausea, vomiting, gastrointestinal upset, drowsiness, dizziness, headache, and nervousness or "irritability." Other adverse reactions are: hypersensitivity reactions, characterized by a light rash with or without pruritus; leukopenia; hemolytic anemia; jaundice.

Storage

Store Skelaxin at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from moisture and sunlight. Do not store in the bathroom.

Overdose

If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include severe drowsiness or unconsciousness.

More Information

Use caution when driving, operating machinery, or performing other hazardous activities. Skelaxin may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking Skelaxin.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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RANCHO MIRAGE, CALIF. -- An antispasticity drug, tizanidine, appeared to be effective in treating analgesic rebound headache, chronic tension-type headache, and related pain disorders in several retrospective or open-label prospective trials.
Response to treatment with tizanidine (Zanaflex) for chronic daily headache did not seem to differ in patients based on whether or not they had musculoskeletal symptoms such as spasticity, Dr. Timothy, R. Smith said at a meeting sponsored by the Diamond Headache Clinic.
He conducted a retrospective review of 53 patients at his clinic treated for chronic daily headache that was thought to be caused by analgesic overuse.
The patients were given tizanidine (2 mg to start, titrated up as tolerated), together with a once-daily long-acting NSAID (naproxen) or COX-2 inhibitor (Celecoxib), while eliminating other analgesics.
After 12 weeks, 38 patients (71%) stopped having chronic daily headache and reverted to intermittent headaches, said Dr. Smith of Ryan Headache Center, Chesterfield, Mo.
A separate retrospective review of charts and headache diaries for 62 patients with chronic daily headache found no association between response to tizanidine and the presence of musculoskeletal symptoms, suggesting that the drug's effects on headache are due to factors other than muscle relaxation, he added.
The drug reduced the frequency of headache by at least half in 46 (74%) of patients, 34 (74%) of whom had muscle spasticity at baseline. Muscle spasticity was pre sent in 11 (69%) of nonresponders, a rate that was not significantly different from the responders group, Dr. Smith reported.
"The presence of musculoskeletal symptoms could not predict a clinical response to tizanidine," he said.
Elan Pharmaceuticals, the maker of tizanidine, funded the studies. Dr. Smith has served on the speaker's bureau for Elan Pharmaceuticals and for eight other drug companies.
A separate review of poster presentations on tizanidine at previous medical meetings found four small uncontrolled studies suggesting benefit from treating certain pain syndromes with the drug, Dr. Gary E. Ruoff reported in a separate poster presentation at the meeting.
His review also was funded by Elan Pharmaceuticals. Dr. Ruoff serves on the speaker's list for Elan and five other drug companies.
One open-label trial by Dr. Smith and his associates used 3.6 mg tizanidine daily in 70 patients with analgesic rebound headache who were transitioning to decreased NSAID use, Dr. Ruoff reported.
After 12 weeks, 46 patients (66%) discontinued their chronic NSAID use without worsening headaches. Three patients (4%) experienced treatment-limiting adverse effects, said Dr. Ruoff, who is in practice in Kalamazoo, Mich.
A second open-label trial of 220 patients with recalci- trant chronic tension-type headache who were titrated up to a mean dose of 26 mg tizanidine daily found a response after 10 weeks in 150 patients (68%), reducing headache frequency by a mean of 73%.
In this study, 13 patients (6%) experienced treatment-limited adverse effects.
A third open-label trial of 4-8 mg tizanidine daily in 26 patients with fibromyalgia found decreases on average in the number of tender points, improvements in global assessment scores, Fibromyalgia Impact Questionnaire scores, and visual analog scores after 8 weeks.
In a retrospective chart review, 20 patients who had traumatically induced myofascial pain were given 2-6 mg tizanidine three times daily. Improvements in pain symptoms--including headache--were noted in 14 of the patients (70%) after 4-6 weeks. The drug was well tolerated.
Tizanidine is an imidazoline derivative, an [[alpha].sub.2]-agonist that is structurally related to clonidine.
Many patients with chronic daily headache are thought to have a down regulation of norepinephrine receptors caused by excessive release of norepinephrine from the locus ceruleus.
Tizanidine has been shown to decrease norepinephrine release in the central nervous system. This effect may help restore the homeostatic balance of norepinephrine, thereby reducing patients' perception of pain, Dr. Ruoff speculated.

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