Researchers from Finland have found that the antibiotic ciprofloxacin (brand names Ciproxin, Ciprofloxacin etc.) greatly increases the concentrations of tizanidine (Sirdalud, Zanaflex) in blood. Concomitant use of ciprofloxacin and tizanidine results in severe and prolonged decrease in blood pressure and greatly enhances central nervous system effects.
This previously unrecognised interaction can be dangerous, particularly in elderly patients, and the concomitant use of the two agents must be avoided. Tizanidine is widely used for treatment of musculoskeletal pain associated with increased muscle tension or chronic spasticity.
The concentrations of tizanidine in blood were increased on average 10-fold by ciprofloxacin in a carefully controlled study in healthy volunteer subjects. The volunteers ingested the usual 500-mg dose of ciprofloxacin (or placebo) twice daily for 3 days, and then a single 4-mg dose of tizanidine. The interaction was observed in each of the ten subjects; the greatest increase in tizanidine concentration by ciprofloxacin was 24-fold.
Paivi Lehtinen | alfa
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