A clinically relevant review of tizanidine hydrochloride dose relationships to pharmacokinetics, drug safety and effectiveness in healthy subjects and patients

International Journal of Clinical Practice
Herbert R Henney, Jacob D Runyan

Abstract

Tizanidine, one of the few oral antispastic therapies approved for use in the USA, has a narrow therapeutic index that can often make optimal patient dosing difficult. We surveyed the published literature for data on potential tizanidine dose relationships to pharmacokinetics, drug safety and effectiveness, as well as to provide practical drug dosing advice. The number of primary studies that describe tizanidine dose proportionality relationships was somewhat limited, even when including studies that used doses above those currently recommended or data from drug-drug interaction studies that resulted in supra-therapeutic tizanidine concentrations. There is substantial evidence to show that plasma tizanidine concentrations are linearly related to dose in healthy subjects and patients, although there is a high degree of intersubject variability. The most common adverse events and pharmacodynamic effects are related to plasma concentrations. The clinical implications of the large interpatient variability in plasma tizanidine concentrations and its narrow therapeutic index make it necessary to individualise patient therapy. Practical advice on tizanidine dosing and/or switching between formulations is provided.

References

Nov 1, 1989·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·P KochB R von Wartburg
Jan 1, 1987·Fundamental & Clinical Pharmacology·F L TseS Bhuta
May 1, 1983·British Journal of Pharmacology·D R CurtisM J Peet
Feb 1, 1982·Journal of the Neurological Sciences·E KnutssonL Gransberg
Dec 1, 1980·Journal of Neurology, Neurosurgery, and Psychiatry·N Hassan, D L McLellan
Jul 1, 1995·Acta Anaesthesiologica Scandinavica·M TaittonenJ Kanto
Nov 1, 1994·Journal of Neurology, Neurosurgery, and Psychiatry·M EmreR C Roberts
Mar 5, 2004·British Journal of Clinical Pharmacology·Marika T GranforsPertti J Neuvonen
Apr 3, 2004·Clinical Pharmacology and Therapeutics·Marika T GranforsPertti J Neuvonen
Jun 8, 2006·European Journal of Clinical Pharmacology·Janne T BackmanPertti J Neuvonen
Aug 29, 2006·British Journal of Clinical Pharmacology·Janne T BackmanPertti J Neuvonen

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Citations

Dec 3, 2014·European Journal of Pharmaceutics and Biopharmaceutics : Official Journal of Arbeitsgemeinschaft Für Pharmazeutische Verfahrenstechnik E.V·Galal M El MahroukMaie S Taha
Nov 27, 2014·Expert Opinion on Drug Metabolism & Toxicology·Antonios DourosRalf Stahlmann
Feb 9, 2017·American Journal of Therapeutics·Umair MasoodOmar Mousa
Sep 21, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Susan W Publow, Donald L Branam
Feb 15, 2011·Journal of Cardiovascular Pharmacology and Therapeutics·Nisrin KaddarBenoit Drolet
Feb 23, 2018·Clinical Medicine Insights. Case Reports·A Suárez-LledóR Jódar
Sep 4, 2019·Hypertension·James M LutherJohn A Oates
Dec 16, 2020·Journal of Pharmacy Practice·John A Dougherty, Christopher T Elder
Jan 7, 2021·European Journal of Clinical Pharmacology·Annette RudolphStefan Weiler

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